The Workers' Compensation and Injury Management Act
1981 (WA) contains statutory limits on the amounts of
compensation paid to injured workers. This article comments on the
circumstances in which the entitlement to "reasonable medical
and other expenses" under Clause 17 of Schedule 1 of the Act
(currently fixed at $65,391) are paid.
Authorities on this area of the Act are limited, however the WA
Court of Appeal recently added some further thoughts on the
In Napier v BHP Billiton (Worsley Alumina) Pty Ltd
 WASCA 230 the Court was asked to consider the employer's
liability to pay compensation for reasonable expenses incurred or
likely to be incurred in respect of medical treatment under Clause
It was noted that as Clause 17 required that the expenses be
"with respect" to medical treatment, it was a (perhaps
obvious) necessary condition of the entitlement that the medical
treatment be with respect to an "injury" as defined under
the Act. But that was not all. The reasonableness of the medical
treatment with respect to the injury would be required to embrace
(without being exhaustive) matters going to the appropriateness,
effectiveness and cost of the treatment.
For example, a large outlay for a marginal outcome was unlikely
to be reasonable. In Napier the worker sought payment for
C5/6 disc replacement surgery, arguing that it was
"reasonable" in the circumstances.
The Court held that the evidence fell well short of establishing
that the surgery was medically and surgically appropriate for the
appellant's injury, being mechanical neck pain and further, the
evidence did not establish that the surgery was medically and
surgically appropriate to relieve pain caused (or contributed to)
by the injury.
If either had been established, there would have been a
sufficient factual foundation to characterise the claim as being
one for reasonable expenses.
The content of this article is intended to provide a general
guide to the subject matter. Specialist advice should be sought
about your specific circumstances.
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An employee that refused a reasonable offer of settlement was ordered by the FWC to pay his ex-employer's legal costs.
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