Ms Clarke was employed by Ramsay as a registered nurse at the Joondalup Health Campus. On 13 September 2009 she injured her lower back and claimed compensation under the Workers’ Compensation and Injury Management Act 1981 (WA).

Liability was accepted and payments were made for her back injury. Ms Clarke was subsequently diagnosed with severe depression said to be a consequence of chronic lower back pain.

She resigned from Ramsay on 7 November 2010 and one year later commenced employment with the King Edward Memorial Hospital in a different role.

In 2016 Ms Clarke sought an order that Ramsay pay weekly payments of compensation between 18 November 2010 and 16 January 2011, and 24 September 2015 to 2 October 2015. She also claimed reimbursement for her for various statutory expenses relating to her depression.

After hearing the evidence, the Arbitrator was not satisfied that Ramsay was liable to pay weekly payments or reimburse Ms Clarke’s schedule 17 expenses. This was because he was unable to accept that Clarke’s chronic pain results from the compensable injury and therefore there was no link to her depression.

There had been an eight-month gap between Clarke’s full recovery from the compensable injury before she alleged further back pain in August 2011. Clarke had therefore recovered from the compensable injury, and she had not satisfied the Arbitrator as to the cause of the chronic back pain leading to the need for the psychological treatment.


Clarke only appealed the Arbitrator’s findings in relation to the claimed statutory expenses and contended that the test from Napier v BHP Billiton (Worsley Alumina Pty Ltd) [2015] WASCA 230, was applied incorrectly.

Specifically Clarke claimed the Arbitrator was wrong to conclude that because Clarke’s back pain was not a result of the compensable injury, it followed that any expense relating to the psychological condition was not connected with the injury.

The Arbitrator made findings about the lower back, but needed to make findings in relation to the psychiatric evidence and specifically had to address whether there was the connection enunciated in Napier.

Ramsay argued that the starting point is to identify the compensable injury and then establish whether the compensable injury was a cause of the psychiatric injury. This is on the basis that a compensable injury, must be a material contributing cause to, in this case, the psychiatric injury – Leggett v Argyle Diamond Mines Pty Ltd [2000] WASCA 182.


On appeal, Bowden J found the Arbitrator had correctly identified the issues requiring determination and did not overlook the test in Napier.


The decision was foreseeable and confirms that before considering whether treatment is reasonable, the first step is to establish that the treatment is for a compensable injury, or a condition that directly results from a compensable injury.