“It is very difficult after 33 years to say the bony exostosis on the dorsum of the foot was caused by the index accident”
“Many thanks for referring this 55 year old gentleman, who presents with right foot pain. I note he gives a history of having injured his right foot in 1962 after falling from scaffolding, landing heavily on the right heel and also having some bricks fall on the foot, causing soft tissue damage. He made a good recovery at the time, however he tells me that over the last 10 years, things have deteriorated and he is now left with pain in the great toe joint over the dorsum of his midfoot related to a prominent bony swelling and also in the area of his right heel cord.”
“I believe the accident was a trigger factor for the osteoarthritis in his right foot and ankle. However, he has now developed arthritis in most joints of his body as a result of degenerative process. Therefore, it is unlikely to attribute his present condition to the accident which happened 35 years ago.”
“Mr Jain considers that the diagnoses that you received were perfectly correct. Your history did suggest that you had an injury to the foot leading to metatarsal fractures and some soft tissue injuries. Those fractures and injuries are quite prone to produce secondary metatarsalgia and some arthritic change.”
“Mr Bansal’s report states that he had soft tissue damage only as a result of his accident. This would be unlikely to cause long-term disability…X-Rays done by Mr Bansal showed early degenerative changes only. This would not be consistent with an injury in 1972. They would however be consistent with his generalized degenerative arthritis. Mr Jain’s report does state that fractures can lead to early OA changes, quite correctly, but the degree of change noted is not consistent with the time elapsed from the date of injury. Thus it is highly unlikely that his foot pain is as a direct result of his accident in 1972.”
“It is for the President of the Appeals Service to select members of the appeal tribunal in a particular case and the pool is inevitably limited to those on the appointed membership panel. Even if a case is unusual, a medical member on the tribunal will ordinarily be able to deal adequately with competing medical views. I do not consider the tribunal erred in law in failing to ensure that it had particular specialists sitting on the tribunal” (paragraph 48). I therefore dismiss this second ground of appeal. (3) The tribunal’s treatment of the “expert medical reports”
“It seems to me that the requirement that assessments of disablement be aggregated makes it abundantly clear that there can only be one award of disablement pension in respect of any period and that that single award will take account of all disablement arising from industrial accidents and prescribed diseases. It must follow that the award must be reviewed each time an assessment of disablement is made in respect of any further industrial accident or prescribed disease. If there were no aggregation then separate claims would be required in respect of each accident or disease and there would be separate awards.”
“I do not therefore think what was said in CI/420/1994 should be taken as a ground for depriving claimants of the benefit of the normal prescribed time for claiming a new entitlement in the way that happened here”