Keywords: Workers’ compensation; psychological injury; psychiatric injury; Queensland Industrial Relations Commission (QIRC); s 32 Workers’ Compensation and Rehabilitation Act 2003 (Qld); s 558; significant contributing factor; de novo appeal; chronic pain; Telehealth psychiatric assessment; Accor / Pullman Hotel Cairns; O’Connor VP; costs on the papers
By Honest Grace Legal | Workers’ Compensation law | Oct 2025
Subject
QIRC accepts secondary psychological injury following back injury - Austin v Workers’ Compensation Regulator [2025] QIRC 110
What Happened
- Ms Julie Ann Austin worked as a tour desk agent/operator for Accor at the Pullman Hotel in Cairns. On 6 March 2019 she injured her lower back while lifting bags, later lodging a compensation application. Work Cover ultimately accepted a work-related aggravation of preexisting pathology at L4/5 and issued a notice of assessment on 10 July 2020
- In 2022 she advanced a claim that included a psychiatric/psychological injury. WorkCover rejected that psychological component on 7 September 2022; the Regulator confirmed the rejection on 3 March 2023. Ms Austin appealed to the QIRC
- At hearing (12–14 February 2024, Cairns), the Appellant sought to amend her case to add further physical conditions. The Commission limited any amendment so as not to enlarge the appeal beyond the psychological injury decision under review; it allowed only the addition of consequential gastritis (not broader new physical injuries)
- Competing psychiatric opinions were led: Dr Paul Trott diagnosed an adjustment disorder/recurrent Major Depressive Disorder (progressing to a Chronic Moderate Persistent Depressive Disorder) and a somatic symptom disorder "regarding the adverse nature of her chronic low back injury"; Dr John Chalk considered there was no Axis I psychiatric disorder and no psychiatric injury
Key Legal Issues
- Whether Ms Austin sustained a psychiatric/psychological injury within s 32 of the Workers’ Compensation and Rehabilitation Act 2003 (Qld) that arose out of, or in the course of, employment, with employment a significant contributing factor
- The scope of a de novo appeal and limits on amendment: the Commission could not expand its jurisdiction beyond the decision under appeal (the psychological injury rejection)
- How to resolve conflicting expert psychiatric evidence and the role of DSM/Axis I thresholds in determining a compensable “injury” under the Act
What the Court Decided
- Appeal allowed.
- Set aside the Regulator’s review decision dated 3 March 2023 and substituted a decision that the Appellant’s application for workers’ compensation is one for acceptance (i.e., the psychological injury claim is accepted)
- Costs: short written submissions to be exchanged and filed by 4:00 pm, Friday, 13 June 2025; costs to be determined on the papers unless otherwise ordered
Key Findings
- The appeal is a hearing de novo, but confined to the decision under appeal; amendments cannot enlarge jurisdiction
- Under s 32, “significant” means “important” or “of consequence”; employment must contribute in a significant way to the injury (citing principles referenced by the Commission)
- The Commission found the Appellant’s unchallenged lay evidence of ongoing pain, functional limitations, and fluctuating “good days and bad days” compelling and consistent with psychiatric injury
- The Commission preferred Dr Trott’s comprehensive, in person evaluation and reasoning over Dr Chalk’s Telehealth assessment, noting presentation variability and limitations of Telehealth in eliciting full history
- A DSM/Axis I threshold is not determinative of whether there is an “injury” under the Act; the question is one of mixed fact and law and turns on the totality of the evidence
Outcome
The Commission weighed the totality of evidence. It accepted the Appellant’s credible account of chronic backpain related restrictions and mood symptoms since the 2019 incident. It found Dr Trott’s diagnoses (major depressive disorder evolving into persistent depressive disorder, and somatic symptom disorder with predominant pain) to be well supported by a detailed, in person assessment and consistent with the Appellant’s lived symptomatology and function. By contrast, Dr Chalk’s contrary view was based on a brief Telehealth examination and placed heavy emphasis on not meeting an Axis I threshold, which the Commission emphasised is not the statutory test. Applying s 32, the Commission concluded the psychiatric injury arose out of the accepted work-related back injury and that employment was a significant contributing factor, thereby satisfying the Act’s requirements
Why This Case Matters
- Secondary psychological injuries flowing from chronic pain can be compensable in Queensland where the evidence shows employment is a significant contributing factor, even if a particular DSM/Axis category is contested
- The decision underscores the probative value of thorough, in person psychiatric assessments and of lay evidence when experts disagree, and cautions against relying solely on diagnostic checklists or brief Telehealth impressions
- Practitioners should frame appeals tightly: a de novo hearing remains confined to the decision under challenge; amendments that enlarge scope will not be permitted
Source
https://archive.sclqld.org.au/qjudgment/2025/QIRC25-110.pdf
* This summary is based solely on the attached decision: 2025.05.07, Austin v Workers' Compensation Regulator, (QIRC), WORKERS' COMPENSATION.pdf.