Key Takeaways:
- A former NSW Police officer with PTSD had his mental health incorrectly challenged by a doctor who never consulted or examined him during a year-long battle with the force’s insurer.
- The officer, Adam Watts, was diagnosed with Graves’ disease, a thyroid autoimmune condition, which can cause bulging eyes, a swollen neck, and heightened anxiety.
- The police force’s insurer, Employers Mutual Limited (EML), declined Mr. Watts’s claim for $6,000 surgery bill, citing his "strong family history of hyperthyroidism" but ignoring his doctor’s note that it was "possible" his condition and relapses were "triggered by severe stress and anxiety" originating from his time with the force.
- The Personal Injury Commission sided with Mr. Watts, finding "an unbroken chain of evidence" in the opinions of his treating doctors linking the two conditions of PTSD and Graves’ disease.
- The case highlights the challenges faced by former police officers in seeking compensation for psychological injuries, with many feeling that the current system "isn’t looking out for them".
Introduction to the Case
The case of Adam Watts, a former NSW Police officer, highlights the challenges faced by those suffering from post-traumatic stress disorder (PTSD) and other psychological injuries. Mr. Watts, who was medically discharged from the police force in 2012, has been battling with the force’s insurer, Employers Mutual Limited (EML), over a claim for $6,000 surgery bill related to his diagnosis of Graves’ disease. The disease, a thyroid autoimmune condition, can cause bulging eyes, a swollen neck, and heightened anxiety. Mr. Watts’s treating psychologist found that he continued to do "poorly" after his diagnosis, with ongoing "nightmares of past traumas, including seeing dead bodies".
The Dispute with the Insurer
The dispute between Mr. Watts and EML began when the insurer declined his claim, citing his "strong family history of hyperthyroidism" but ignoring his doctor’s note that it was "possible" his condition and relapses were "triggered by severe stress and anxiety" originating from his time with the force. EML relied on the expert opinion of a doctor who never consulted or examined Mr. Watts, instead providing opinions based on his medical records. The doctor, referred to as ‘Dr X’, questioned Mr. Watts’s mental health in the lead up to his diagnosis, claiming there were no notes from his doctor to indicate he was "markedly stressed leading up to the diagnosis in 2019". However, the Personal Injury Commission found this argument to be incorrect based on several medical notes referring to Mr. Watts’s suffering from severe anxiety, lethargy, and depression in early 2019.
The Personal Injury Commission’s Decision
In April last year, the Personal Injury Commission sided with Mr. Watts, finding "an unbroken chain of evidence" in the opinions of his treating doctors linking the two conditions of PTSD and Graves’ disease. The disputes officer overseeing the case saw Dr X’s submission as "brief", "unclear", and "based upon an assumption" that was not supported by evidence. EML was ordered to cover Mr. Watts’s $6,000 surgery bill, but the ordeal pushed Mr. Watts to his "breaking point". He stated that the experience was "shocking" for him and his family, and he does not want anyone else to go through it.
The Broader Implications
The case highlights the challenges faced by former police officers in seeking compensation for psychological injuries. According to a recent auditor general report, psychological injury claims made up 74% of the NSW Police force’s compensation costs, totaling $1.75 billion compared to just 26% for physical injuries. Workers’ compensation lawyer and spokesperson for the Australian Lawyer’s Alliance, Shane Butcher, has represented dozens of former police officers seeking compensation from EML. Mr. Butcher stated that many former officers feel the current compensation system "isn’t looking out for them" and that these types of disputes often "compound" their injuries.
Conclusion
The case of Adam Watts is a stark reminder of the challenges faced by those suffering from PTSD and other psychological injuries. The fact that EML relied on the opinion of a doctor who never consulted or examined Mr. Watts is concerning, and the Personal Injury Commission’s decision highlights the need for insurers to take a more nuanced approach when dealing with psychological injury claims. As Mr. Butcher noted, the current system is not set up to help former officers get back to some kind of work, and there is an assumption that they need to prove themselves, even when their treating doctors have stated that they are suffering significantly. It is essential that we prioritize the well-being of our first responders and ensure that they receive the support and compensation they need to recover from their injuries.
