14.2 Denying Benefits Where There is No Current Entitlement

The duration of liability to pay compensation is dependent upon the duration of the effects of that medical condition. Where there are permanent effects, the liability continues indefinitely. Where on the other hand, the matter appears to resolve  i.e. there has been a complete cure or a wound has completely healed and produces no current symptoms, liability should be denied under each of the sections that benefits are claimed.

 

15.2 What does the Varying Nexus mean to the Delegate?

These separate tests of the nexus with employment are highly significant in the investigation of claims for liability. Diseases require a contribution (either material or to a significant degree) from employment and in some circumstances may be the easier of the two criteria to prove. Since the status of the claimed condition as 'injury' or 'disease' is therefore critical, Delegates should seek to establish this distinction early in the investigation.

26.3.5 Case example - Causal link

In Re Grime and Telstra Corporation Limited (1994) an employee had an accident while driving a car to work in the morning with a blood alcohol level of 0.136%, after drinking approximately 16 light beers the night before. The Tribunal found that he was not aware that he was still substantially affected by alcohol, but it accepted without argument that he was still under the influence of alcohol and that this caused the accident. (i.e.

17.1.1 SRCA

Section 6(1)(b) of the SRCA extends liability for compensation where the member was 'travelling between' certain specified places:

(ii)place of residence and place of work

(iii)normal place of residence and temporary place of residence

(iv)two places of work

(v)place of work or residence and place of education

(vii)place of work or residence and certain other places specified in S6(1)(b)(vii) of the SRCA.

9.1.3 Property under former Acts

Although S28 of the 1971 Act does not use the term 'property' it nevertheless relates to damage or loss to artificial limbs or other artificial substitutes, medical surgical or other similar aids or appliances in exactly the same terms as S15 of the SRCA. The provisions of S28 are in fact identical to those of the SRCA.

 

In contrast, the 1930 Act does not provide for compensation in relation to damage to 'property' i.e. prosthetic devices etc. Nor is it anticipated that RCG will receive any such claims.

 

23.1.1 Psychiatric assessments and unverified allegations re employment

Psychiatric and psychological examinations involve the client discussing their personal and employment history, and including his or her perceptions of circumstances relating to the origins of their symptoms. This means that the psychiatrist is often reliant only on the client's version of the circumstances, i.e. those prevailing prior to and up to the time of the development of the mental illness.

16.10.1 Growth of doctrine from 'ordinary recess'

Landmark case-law has seen the extension of the provision under 6(1)b(i) – i.e. relating to injuries occurring during an 'ordinary recess' – to longer periods in some special cases.

 

Briefly, in those circumstances where the employee is required to reside away from his/her usual residence temporarily for the purposes of the employment, injuries occurring after the formal 'close of business' for the day, may still be compensable.

 

 

20.1.2 Paid for by the Commonwealth

The phrase 'paid for by the Commonwealth' is to be taken to refer to medical treatment provided to the member by ADF Health Services, either directly by ADF medical personnel or by a private provider on referral from, and at the expense of, the ADF.

 

The phrase is NOT to be taken to have the possible wider meaning of paid by the Commonwealth through Medicare bulk billing or through some other Commonwealth medical assistance program.