Knee Replacements are No Longer Subject to Time Limits

By 24 January 2019WorkCover Claims

Some of the most common injuries sustained in work accidents are joint injuries such as those involving hip and knee replacements. Because joints such as these are vital to everyday movement, knee injuries can severely impact both your ability to work and your general quality of life.

Moreover, even if you receive prompt and appropriate treatment, the very nature of joint injuries is that they are degenerative. This means that often, you may not even realise the true impact of an injury until a great deal of time has passed. Since 2012, the opportunity for injured workers to claim was subject to new time limitations, with a few exceptions added in 2015. Recently, a Presidential decision by the State Insurance Regulatory Authority (SIRA) was made that secures an unrestricted time limit for knee replacement surgeries.

Pacific National Pty Ltd v Baldacchino [2018]
Introduction

In late October of 1999 a long term railway employee, Mr. Baldacchino, seriously injured his left knee, badly twisting it while exiting a train-car. A few months later, he filed a claim and underwent an arthroscopic surgery to try and rectify the situation. He received payment for his treatment expenses, as well as weekly compensation for lost wages. Despite receiving treatment early on, however, Mr. Baldacchino’s knee condition deteriorated over the next several years.

Facts

When Mr. Baldacchino’s position became redundant in 2014, he was forced to retire from work. In 2016 when he turned 65, Mr. Baldacchino was sent to an orthopedic surgeon who suggested he undergo yet another surgery to address his knee injury. This time, a full knee replacement was recommended and he filed a claim regarding the costs of the surgery. After an extended review of their liability, the insurance agency (Pacific National) denied his claim. Their reason? That the original 1999 knee injury was not responsible for the knee replacement surgery recommended to Mr. Baldacchino in 2016.

Arguments

After a review by the Workers Compensation Commission, Pacific National was directed to pay for Mr. Baldacchino’s knee surgery. Pacific National objected, however, arguing that 1) there was no causal connection to the injury; and 2) the claim was precluded by the time limits listed in section 59A of the Workers Compensation Act 1987. Section 59A of the Act stated the prescribed periods of time for which an injured party can claim compensation, as well as the exceptions to the time limits.

Mr. Baldacchino’s claim was precluded from compensation by the time limit and, due to the fact that he was over the age of retirement at the time of the claim, he was not eligible to reopen a claim for weekly compensation. However, it was ruled that his knee replacement surgery did fall under one of the exceptions: artificial aid.

The reasoning was that the nature of ‘artificial aid’ has changed dramatically from its initial interpretation almost 40 years earlier, and that the term now included “anything that was specifically constructed to enable the effects of the disability to be overcome”. Additionally, it was clear that the knee replacement surgery was a result of the injury from 1999.

Consequences

The decision of the Baldacchino case serves to alleviate many of the harsh consequences caused by the 2012 amendments to the Workers Compensation Act. In particular, retired workers stand to benefit from the decision because it grants them the freedom to receive compensation for injuries that have degenerated severely over long periods of time. Moreover, the decision will likely not only affect knee replacement surgeries, but also other joint surgeries with similar impacts, such as hip replacements.

If you or a loved one have any questions regarding what types of injuries will be affected by this decision, what devices and methods will fall under the definition of ‘artificial aid’, or how you can pursue compensation after the age of retirement, please contact a professional lawyer today.

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