Fall through an opening or fragile surface: NSW workers compensation guide

Fall through an opening or fragile surface can occur through a roof sheet or skylight breaking beneath a worker and a temporary opening cover shifting, breaking or being absent. The incident history should identify the task, equipment, location and sequence of events rather than relying on the job title alone.

People commonly exposed include roofers, solar installers and maintenance workers and builders, formworkers and services trades working around penetrations. Employment records should identify each person's task, employer and position in the work area when the incident occurred.

Medical records after a fall through an opening or fragile surface may identify spinal fracture and traumatic brain injury. Each diagnosis should be linked to the event or exposure and to the worker's actual functional change.

After a fall through an opening or fragile surface, immediate reporting and safety records may include photographs of the opening, cover, fragments and landing area before alteration and roof or penetration plan and records of who installed or removed a cover. These records can establish what was known at the time without requiring the worker to repeatedly recount a traumatic event.

• Notifiable-incident reference and scene-preservation material where applicable.
• If the facts may meet the WHS Act definition of a notifiable incident, the SafeWork notification reference, inspector correspondence and scene records, without delaying emergency assistance or other action permitted by section 39.

For a fall through an opening or fragile surface, the first evidence to preserve includes SWMS, edge/opening register, site induction and toolbox records and manufacturer or condition records for fragile roofing or skylights. It is most useful when dates, people, equipment, duties and later medical histories tell a consistent account.

• Witness positions, task instructions and material carried.
• Ambulance, hospital, surgery and rehabilitation records.

Medical and psychological evidence after a fall through an opening or fragile surface may include first-aid, ambulance and early clinical histories describing the fall through an opening or fragile surface sequence and diagnosis-specific examination, imaging and specialist evidence for spinal fracture, traumatic brain injury, pelvis injury, multiple injuries. A diagnosis alone may not answer causation or capacity: the records should explain the work event, symptoms, treatment and practical restrictions.

• Certificates of capacity stating functional restrictions, hours and treatment rather than only a diagnosis.
• Operative, rehabilitation and psychological records where the event caused surgery, prolonged recovery or trauma symptoms.

After a fall through an opening or fragile surface, an insurer may dispute whether the worker was directed or permitted to enter the area and whether the opening was covered or identifiable at the relevant time. The written decision should be answered with evidence directed to those stated reasons.

These incidents can produce multiple fractures, head injury or spinal injury requiring staged treatment. Future surgery and rehabilitation disputes should be addressed diagnosis by diagnosis. If treatment is disputed after a fall through an opening or fragile surface, the request should explain the accepted diagnosis, expected functional benefit and reasonable alternatives.

Work capacity after a fall through an opening or fragile surface may turn on height, balance, climbing, lifting, concentration and trauma triggers and whether any site-based duties can safely accommodate the combined restrictions. Proposed duties must be compared with the real task demands and the worker's ability to sustain them for the proposed hours.

Multiple stable impairments may be combined only where the NSW Guidelines permit; a severe mechanism alone is not a WPI assessment. The accident mechanism, surgery, imaging finding or pain report alone does not establish a WPI percentage. Any WPI assessment after a fall through an opening or fragile surface occurs after stabilisation under the NSW method for the accepted body system; the accident or surgery alone does not determine a percentage.

A principal contractor, roof owner, cover installer or product supplier may be relevant to another claim pathway. Any separate occupiers-liability, product, TPD or work injury damages issue is distinct from statutory workers compensation and depends on its own evidence and legal criteria. These issues are separate from workers compensation and depend on the particular facts.

For a fall through an opening or fragile surface, assistance may involve separate the fall through an opening or fragile surface mechanism from the diagnoses and identify any missing incident record and compare the insurer’s written reasons with medical, treatment and work-capacity evidence. The purpose is to identify the disputed decision and the evidence needed for the next step, not to promise an outcome.