Case: Scott v Return to Work Corporation of South Australia [2026] SAET 52
A recent decision by the South Australian Employment Tribunal confirms that workers may remain entitled to compensation for medical treatment many years after a work injury, even where age-related degeneration has also occurred.
In Scott v Return to Work Corporation of South Australia [2026] SAET 52, the Tribunal found that a worker was entitled to compensation for a total knee replacement more than 22 years after his original work injury because there remained a sufficient connection between the original injury and the need for surgery.
The background
Mr Colin Scott suffered an accepted work injury on 2 March 2002 while working as a construction carpenter. He struck his left knee against a timber bench while building a pergola, resulting in a medial meniscal tear. Imaging showed no evidence of arthritis, and he subsequently underwent arthroscopic surgery and a partial meniscectomy.
Although Mr Scott returned to work, his symptoms never fully resolved. He continued to experience pain, instability and functional limitations in his left knee over the following years.
By 2011, scans showed degenerative changes in his left knee, while his right knee showed only minor degeneration. By 2017, the degeneration in his left knee had progressed to “bone-on-bone” osteoarthritis, and a total knee replacement was recommended. However, on medical advice, Mr Scott delayed surgery because of his age and the limited lifespan of a knee replacement prosthesis.
In 2024, Mr Scott sought pre-approval from the Return to Work Corporation of South Australia for a left total knee replacement. The application was rejected on the basis that he now had severe osteoarthritis in both knees and that the need for surgery was said to arise from the natural progression of age-related degeneration rather than the work injury.
The issue before the Tribunal
Her Honour, Deputy President Judge Carrel was required to determine whether the proposed total knee replacement was compensation for costs reasonably incurred “in consequence of” Mr Scott’s 2002 work injury, as required by Section 33 of the Return to Work Act 2014 (SA).
Ultimately, Deputy President Judge Carrel found in Mr Scott’s favour.
The Tribunal accepted that there was no evidence of degeneration in the left knee at the time of the original injury. It also found that the work injury and subsequent meniscectomy contributed to, and accelerated, the development of osteoarthritis in the left knee.
Significance was given to the 2011 radiology scans, which showed substantially greater degeneration in the injured left knee than in the uninjured right knee. The Tribunal considered that this evidence supported that the work injury had accelerated the degenerative process.
The Tribunal also accepted evidence that:
- Mr Scott’s left knee symptoms persisted since the 2002 injury and never completely resolved;
- there was no new injury;
- by 2017, the left knee reached “bone-on-bone” degeneration, and it could not progress past this point;
- the total left knee replacement surgery was recommended years earlier; and
- the decision to delay surgery in accordance with medical advice did not break the connection between the injury and the treatment.
Although both knees appeared similarly degenerated by 2024, the Tribunal accepted medical evidence that degeneration cannot progress beyond “bone-on-bone”. The fact that the right knee had eventually “caught up” did not erase the role played by the work injury in accelerating the deterioration of the left knee.
The Tribunal found that a sufficient connection remained between the 2002 work injury and the need for the total knee replacement and set aside the Corporation’s decision, entitling to Mr Scott to compensation for the surgery.
Why does this decision matter?
This decision provides an important reminder that treatment can remain compensable many years after a work injury.
According to Section 33 of the Return to Work Act 2014 (SA), a worker does not need to prove that the work injury is the sole or dominant cause of the treatment. The relevant question is if there remains a sufficient causal connection between the work injury and the treatment sought.
The decision also highlights that:
- delayed surgery does not necessarily break the chain of causation;
- the Tribunal will consider the worker’s entire medical history, not just current findings;
- where a work injury accelerates degeneration, compensation may remain payable many years later.
Workers who have lived with the consequences of a work injury for many years should not assume that compensation entitlements end simply because time has passed or because age-related degeneration has also developed.
Get in touch with our specialist workers compensation lawyers
At Turner Freeman, we have specialist lawyers in workers compensation who will assess your case and provide personalised advice regarding your legal entitlements.
Strict time limits can apply, so if you would like to obtain advice about your entitlements, please contact our SA workers compensation team.
We also have workers compensation lawyers across Australia. If you are located in Queensland, New South Wales, the ACT or Western Australia, you can also contact our local teams.
