A soft tissue injury to the cervical and thoracic spine can satisfy the 'very considerable' pain and suffering threshold under s 134AB(38)(c) even where imaging does not reveal serious disc pathology, provided the clinical history and the worker's evidence demonstrate ongoing significant pain and functional limitation. Where a worker has suffered two separate workplace injuries, the loss of earning capacity from the first injury must be assessed by reference to the worker's earning capacity in suitable employment excluding the effects of the second injury, and the second injury as an independent supervening event cannot be taken into account. Insufficient evidence of earning capacity in suitable employment — as distinct from actual earnings with the same employer — will be fatal to a loss of earning capacity claim.
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