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Administrative Appeals Tribunal of Australia |
Last Updated: 6 January 2009
Administrative Appeals Tribunal
DECISION AND REASONS FOR DECISION [2009] AATA 1
ADMINISTRATIVE APPEALS TRIBUNAL )
) No. 2007/2242
Applicant
Respondent
DECISION
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Decision
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The Tribunal sets aside the decision under review and substitutes a
decision that generalised anxiety disorder, alcohol dependence
and depressive
disorder are war-caused with effect from 2 June 2005.
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(sgd) G.D. Friedman
Senior Member
VETERANS' AFFAIRS - veterans’ entitlements - generalised anxiety disorder - alcohol dependence - depressive disorder - whether conditions war-caused
Veterans' Entitlements Act 1986 ss 9, 120(1), 196B(2)
Benjamin v Repatriation Commission [2001] FCA 1879; (2001) 70 ALD 622
Lees v Repatriation Commission [2002] FCAFC 398
Re Hillier and Repatriation Commission [2004] AATA 897
Re Spotswood and Repatriation Commission [2003] AATA 152
Repatriation Commission v Bey [1997] FCA 1347; (1997) 79 FCR 364
Repatriation Commission v Cornelius [2002] FCA 750
Repatriation Commission v Deledio [1998] FCA 391; (1998) 83 FCR 82
Repatriation Commission v Gorton [2001] FCA 1194; (2001) 110 FCR 321
Repatriation Commission v Hill [2002] FCAFC 192
Stoddart v Repatriation Commission [2003] FCA 334; (2003) 197 ALR 283
White v Repatriation Commission [2004] FCA 633
Woodward v Repatriation Commission [2003] FCAFC 160; (2003) 131 FCR 473
REASONS FOR DECISION
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5 January 2009
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G. D. Friedman, Senior Member
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LEGAL FRAMEWORK
1. The Tribunal must consider all the material which is before it and determine whether that material points to a hypothesis connecting the injury, disease or death with the circumstances of the particular service rendered by the person. No question of fact finding arises at this stage. If no such hypothesis arises, the application must fail.
2. If the material does raise such a hypothesis, the Tribunal must then ascertain whether there is in force an SoP [Statement of Principles] determined by the Authority under s 196B(2) or (11). If no such SoP is in force, the hypothesis will be taken not to be reasonable and, in consequence, the application must fail.
3. If an SoP is in force, the Tribunal must then form the opinion whether the hypothesis raised is a reasonable one. It will do so if the hypothesis fits, that is to say, is consistent with the "template" to be found in the SoP. The hypothesis raised before it must thus contain one or more of the factors which the Authority has determined to be the minimum which must exist, and be related to the person's service (as required by ss 196B(2)(d) and (e)). If the hypothesis does contain these factors, it could neither be said to be contrary to proved or known scientific facts, nor otherwise fanciful. If the hypothesis fails to fit within the template, it will be deemed not to be "reasonable" and the claim will fail.
4. The Tribunal must then proceed to consider under s 120(1) whether it is satisfied beyond reasonable doubt that the death was not war-caused, or in the case of a claim for incapacity, that the incapacity did not arise from a war-caused injury. If not so satisfied, the claim must succeed. If the Tribunal is so satisfied, the claim must fail. It is only at this stage of the process that the tribunal will be required to find facts from the material before it. In so doing, no question of onus of proof or the application of any presumption will be involved.
ISSUES
5. The issues before the Tribunal are:
WHAT ARE MR SCOTT’S MEDICAL CONDITIONS?
6. The respondent accepted that Mr Scott’s medical conditions of persistent left spontaneous pneumothorax, bilateral sensorineural hearing loss, chronic obstructive airways disease and erectile dysfunction are war-caused. The respondent rejected his claims that anxiety disorder, alcohol abuse and depressive disorder are war-caused.
7. The Tribunal is required to determine to its reasonable satisfaction whether Mr Scott suffers from any particular injury or disease (Benjamin v Repatriation Commission [2001] FCA 1879; (2001) 70 ALD 622). Dr A Velakoulis, Mr Scott’s treating psychiatrist, diagnosed generalised anxiety disorder, major depressive disorder of mild severity and alcohol abuse. Dr L Walton, consultant psychiatrist, agreed, except that he preferred a diagnosis of alcohol dependence rather than alcohol abuse because Mr Scott gave a clear history of developing tolerance and also withdrawal symptoms reversed by taking further alcohol. Dr Walton said that Mr Scott has neglected important occupational activities due to alcohol misuse and the marriage is significantly compromised because of alcohol. On the basis of the medical evidence the Tribunal finds that Mr Scott suffers from generalised anxiety disorder, alcohol dependence and major depressive disorder of mild severity. Therefore, the Tribunal needs to make a determination on whether each of these conditions is war-caused.
IS GENERALISED ANXIETY DISORDER WAR-CAUSED?
8. Mr Scott said that he was born in Northern Ireland and left school at the age of 14 years. He worked as a labourer and sales assistant before coming to Australia in 1965 to seek new opportunities, and he obtained employment as an export clerk. He was called up for National Service in 1966. Mr Scott told the Tribunal that after recruit training at Puckapunyal and Ordnance Corps training at Bandiana he was posted to headquarters at Albert Park in Melbourne where he worked as a stores clerk until he was selected for service in Vietnam towards the end of his compulsory service as a replacement for another soldier. He stated that in March 1968 he undertook a three-week course in jungle training at Puckapunyal before his deployment to Vietnam. He said that he had suffered no emotional problems before his service in Vietnam, but that the experience in Vietnam, although brief, was extremely stressful.
9. Mr Scott said that he was based at the Australian headquarters in Nui Dat, and was engaged in clerical duties and stock control. He acknowledged that his duties were relatively sedate when compared to other soldiers. However, he said that he was generally apprehensive when on duty in Vietnam, and had an overwhelming perception of threat, fear, tension and anxiety. He did not feel safe at any time, even when inside the base. Mr Scott described a number of events which he found to be particularly stressful. The first was when he was travelling to the nearby town of Baria in a Land Rover two or three times to take soiled laundry to be washed and to collect clean laundry (the laundry incident). He said that he was anxious and apprehensive about the prospect of an ambush during the journey and while at Baria. He said that he was also fearful of the possibility of mines on the road. Mr Scott stated that he had heard stories about enemy action during the Tet Offensive and fighting in that area which had occurred shortly before his arrival in Vietnam.
10. The second event was when he was performing routine piquet (or guard) duty at the perimeter of Nui Dat (the piquet incident). He said that he was scared of possible attacks, although none occurred, and he was conscious of not wishing to display any signs of fear.
11. The third event was during an enemy alert (the alert incident), when the entire base was called to stand-to, which was the highest form of alert, when each soldier was sent to his designated defensive position in the weapon pits. He said that he was told by an officer that enemy forces were approaching the base. Mr Scott stated that he saw flares and heard the sound of helicopters in the distance, and spent more than one hour in the pits. He said that he was terrified, although the base was not fired upon, and he tried to hide his fear from other soldiers.
12. Mr Scott stated that when he returned from Vietnam he was anxious, irritable, short-tempered and moody. He said he found it difficult to settle down, was restless. and frequently changed jobs. He described troublesome memories and nightmares. Mr Scott stated that his anxiety and agitation led to avoidance behaviour, difficulty with sleeping and poor concentration. He said that for the past 17 years he has worked at the County Court of Victoria as a tipstaff (or personal assistant) to a Judge. He said that he did not seek psychiatric assistance until 2005.
13. In a report dated 11 February 2008 Dr Walton stated that the clinical criteria in relation to the Statement of Principles (SoP) for Mr Scott’s generalised anxiety disorder are met, although he said that the specific events that are claimed to constitute the various definitions of psychosocial stressors and severe stressors, do not appear to be met. Dr Velakoulis stated that generalised anxiety disorder seems to have been caused primarily by Mr Scott’s military service in Vietnam. He stated that prior to this service there was no suggestion of any such anxiety-based symptoms and there is a clear temporal relationship between Mr Scott’s service and the onset of symptoms. Dr Velakoulis said that Mr Scott described a constant perception of life-threatening and potentially traumatic events during his service in Vietnam and extreme levels of generalised anxiety related to his own safety, his capability to defend himself and to be defended by others.
14. In a report dated 14 April 2008, prepared on behalf of Writeway Research Service Pty Ltd, Mr H Conant, researcher, stated that in relation to the laundry incident, the trips to Baria were generally routine administrative affairs that occurred two or three times per week. The six or seven kilometre trip took a route that was generally flat, open and under cultivation. Mr Conant said that laundry trips attracted little attention and were seldom the target of enemy attention. There were no reports of incidents in the period in which Mr Scott was in Vietnam, and the level of threat was low, although vigilance was required. Mr Conant told the Tribunal that laundry trips were undertaken in a single vehicle when reconnaissance indicated there were no undue safety concerns. On other occasions vehicles travelled in groups or convoys, with adequate protection as required. He said that the period June to August 1968 was relatively quiet after an increase in enemy activity in May 1968, but he acknowledged that at all times there was some risk involved in travelling outside the base.
15. In relation to the alert incident Mr Conant said that there were several occasions during the relevant period when there were alerts, involving the entire personnel at Nui Dat, that were caused by people or animals making noise and movement around the perimeter of the base. He said that the use of flares and helicopter activity were common during such events. One such alert occurred on 18 August 1968 when information from South Vietnamese sources warned that an attack on the base at Nui Dat could be expected that night. Mr Conant confirmed that Mr Scott’s position during the alert would have been near the centre of the base. Ultimately no such attack occurred on that occasion or during Mr Scott’s time at Nui Dat.
16. In relation to the first step from Deledio, after considering evidence from Mr Scott and the psychiatrists about his generalised anxiety disorder and operational service, the Tribunal determines that the material points to a hypothesis connecting the condition with the circumstances of the particular service rendered by Mr Scott. Therefore he satisfies the first step.
17. In respect of the second step from Deledio, there is an SoP in force, being SoP Nº 101 of 2007 concerning Anxiety Disorder. Therefore Mr Scott satisfies the second step. If Mr Scott does not satisfy that SoP, the Tribunal is required to consider SoP N° 1 of 2000 concerning Generalised Anxiety Disorder, which has now been revoked but was in force at the time Mr Scott made his claim (Repatriation Commission v Gorton [2001] FCA 1194; (2001) 110 FCR 321).
18. In relation to the third step from Deledio the Tribunal takes into account that in Repatriation Commission v Hill [2002] FCAFC 192 the Federal Court held that the material must raise or point to the hypothesis, which must fit the relevant SoP. In Repatriation Commission v Bey [1997] FCA 1347; (1997) 79 FCR 364 at 372-3 the Federal Court held that a reasonable hypothesis involves more than a mere possibility, and is pointed to by the facts, even though not proved upon the balance of probabilities.
19. Mr Scott described a number of incidents suggesting that he satisfied the relevant factors in SoP Nº 101 of 2007, or alternatively in SoP Nº 1 of 2000. The Tribunal has considered all the material, including the evidence from Mr Scott and the medical practitioners, and considers that the material points to the hypothesis linking Mr Scott’s operational service with his generalised anxiety disorder. Therefore Mr Scott satisfies the third step.
20. In relation to the fourth step from Deledio, the Tribunal must decide whether it is satisfied beyond reasonable doubt that there is no sufficient ground for determining that Mr Scott’s generalised anxiety disorder was due to his operational service within the meaning of s 9 of the Act. It is at this stage that the Tribunal is called upon to make findings of fact. The claim will succeed unless one or more of the facts necessary to support the hypothesis is disproved or the truth of a fact inconsistent with the hypothesis is proved.
21. Factor 6 in Instrument Nº 101 of 2007 provides:
(a) for generalised anxiety disorder or anxiety disorder not otherwise specified only:
...
(ii) experiencing a category 1A stressor within the five years before the clinical onset of anxiety disorder; or
(iii) experiencing a category 1B stressor within the five years before the clinical onset of anxiety disorder; or
...
In paragraph 9 of the SoP:
"a category 1A stressor" means one or more of the following severe traumatic events:
(a) experiencing a life-threatening event;
(b) being subject to a serious physical attack or assault including rape and sexual molestation; or
(c) being threatened with a weapon, being held captive, being kidnapped, or being tortured;
"a category 1B stressor" means one of the following severe traumatic events:
(a) being an eyewitness to a person being killed or critically injured;
(b) viewing corpses or critically injured casualties as an eyewitness;
(c) being an eyewitness to atrocities inflicted on another person or persons;
(d) killing or maiming a person; or
(e) being an eyewitness to or participating in, the clearance of critically injured casualties;
22. Mr Scott gave evidence in a frank and truthful manner and did his best to recall events that occurred about forty years ago. There was no dispute that during the brief period of his operational service there were potential threats to his safety in Vietnam, and that he was apprehensive about his well-being. In relation to the laundry incident the Tribunal accepts the evidence from Mr Conant that single vehicles were used when the level of risk was relatively low, and that there were no major incidents on such trips during the period Mr Scott was in Vietnam. The Tribunal finds that on the two occasions when he travelled to Baria the threat was low, no incident occurred and Mr Scott was not in immediate danger. Similarly, the Tribunal accepts that Mr Scott was apprehensive while on routine piquet duty on the perimeter of the base at Nui Dat. In relation to the alert incident the Tribunal recognises that Mr Scott was fearful for his safety. On balance the Tribunal is satisfied that none of the stressful events constitutes a severe traumatic event as defined in the SoP, and none was a category 1A or category 1B stressor.
23. Factor 5 of SoP Nº 1 of 2000 provides:
(a) for generalised anxiety disorder or anxiety disorder not otherwise specified, only
...
(ii) experiencing a severe psychosocial stressor within the two years immediately before the clinical onset of anxiety disorder...
In paragraph 8 of the SoP:
“severe psychosocial stressor” means an identifiable occurrence that evokes feelings of substantial distress in an individual, for example, being shot at, death or serious injury of a close friend or relative, assault (including sexual assault), major illness or injury, experiencing a loss such as divorce or separation, loss of employment, major financial problems or legal problems;
24. In White v Repatriation Commission [2004] FCA 633 Spender J said the test for severe psychosocial stressor had both a subjective and an objective element. He explained at [30]:
...the definition of severe psychosocial stressor concerns an occurrence that, objectively, is an occurrence the nature of which is such as to evoke feelings of a particular kind in a person exposed to that occurrence and which, subjectively, evokes feelings of substantial distress in the particular person concerned. Both aspects are relevant and necessary.
25. In Re Hillier and Repatriation Commission [2004] AATA 897 the Tribunal held that the particular occurrence must be such as to cause substantial distress to a reasonable member of the armed forces with the experience of the claimant, who is not idiosyncratic or unduly timorous or sensitive, taking into account the diversity of age and experience, including formal training. In Re Spotswood and Repatriation Commission [2003] AATA 152 the Tribunal held that the call to action stations on a ship was objectively capable of evoking substantial distress in a young seaman.
26. The Tribunal accepts Mr Scott’s evidence, supported by Mr Conant, that the alert incident was an identifiable and objective occurrence that took place because of information that an enemy attack on the base was imminent, causing the entire personnel to stand-to and adopt defensive positions. The Tribunal accepts that, subjectively, Mr Scott felt substantial distress, having been informed of a likely attack and being forced to occupy a weapon pit for more than one hour in a defensive position in the dark and fearing for his life.
27. Mr Scott was a young national serviceman who had been in Vietnam for only a brief period. His deployment to the war zone occurred in circumstances where his jungle warfare training consisted of a three-week period in Puckapunyal, unlike the more intensive training normally undertaken at the Land Warfare Centre, Canungra in tropical Queensland. He was employed in a clerical capacity and had limited exposure to weapons and infantry training. In the particular circumstances of a threatened attack during that alert the Tribunal accepts that the occurrence was such to evoke objective feelings of substantial distress in a person in Mr Scott’s situation. For these reasons the Tribunal finds that Mr Scott experienced a severe psychosocial stressor.
28. There is no definition of the term clinical onset in the SoPs or in the Act. In Lees v Repatriation Commission [2002] FCAFC 398, Repatriation Commission v Cornelius [2002] FCA 750 and other cases, the clinical onset of a condition was said to occur when the symptoms of a condition have become sufficiently specific and severe for a medical practitioner to diagnose that particular condition, within the definition of the condition in the relevant SoP; or the condition is actually found on diagnostic testing, regardless of the extent of symptoms. Dr Walton stated that, although Mr Scott did not seek treatment until 2005, he would have attracted diagnoses if he had been assessed psychiatrically at the time of discharge. The Tribunal finds that clinical onset occurred at the time of operational service in Vietnam in 1968.
29. Consequently the Tribunal finds that Mr Scott satisfies factor 5(a)(ii) of SoP Nº 1 of 2000, so he satisfies the fourth step.
IS ALCOHOL DEPENDENCE WAR-CAUSED?
30. Mr Scott told the Tribunal that before his enlistment he was a light social drinker, consuming 8 to 10 glasses (200 ml per glass) of beer once per week. He said that after enlistment his consumption increased to 8 to 10 pots (240 ml per pot) per night on most nights when he was not on duty. His consumption increased further in Vietnam to the point when he drank every night he was not on duty at a minimum of 10 cans (375 ml per can) per night. Mr Scott said that the increase in his alcohol consumption in Vietnam was related to the stressors that he described, as well as to the general culture among Australian service personnel of living for the day and drinking. He stated that in addition there was little else to do when off-duty.
31. Dr Walton stated that Mr Scott gave a history of continuing to drink heavily on his return from Vietnam and he still drinks to excess, although his level of consumption has decreased somewhat to 20-30 pots of beer per week, plus a few bottles of wine. Dr Velakoulis stated that Mr Scott‘s alcohol problems seem to be related primarily to his service in Vietnam, his exposure to military alcohol culture and his attempts to deal with overwhelming generalised anxiety, as there are no other overt risk factors evident in his family or personal history. Dr Velakoulis said that Mr Scott continues to binge drink at least 15 standard drinks per session interspersed with regular alcohol-free days, which has created major social and marital difficulties.
32. In relation to the first step from Deledio, after considering the evidence from Mr Scott and the psychiatrists about his alcohol dependence and operational service, the Tribunal determines that the material points to a hypothesis connecting the condition with the circumstances of the particular service rendered by Mr Scott. Therefore he satisfies the first step.
33. In respect of the second step from Deledio, there is an SoP in force, being SoP Nº 17 of 2008 concerning Alcohol Dependence and Alcohol Abuse. Therefore he satisfies the second step. If Mr Scott does not satisfy that SoP, the Tribunal is required to consider the revoked SoP Nº 76 of 1998 concerning Alcohol Dependence or Alcohol Abuse.
34. In relation to the third step from Deledio, the Tribunal has considered all the material, including the evidence from Mr Scott and from the medical practitioners. The Tribunal considers that the material points to the hypothesis linking Mr Scott’s operational service with his alcohol dependence. Therefore Mr Scott satisfies the third step.
35. In relation to the fourth step from Deledio, factor 6 of SoP Nº 17 of 2008 provides:
...
(b) experiencing a category 1A stressor within the five years before the clinical onset of alcohol dependence or alcohol abuse; or
(c) experiencing a category 1B stressor within the five years before the clinical onset of alcohol dependence or alcohol abuse;
...
36. For reasons already given in relation to generalised anxiety disorder, the Tribunal finds that none of stressful events constitutes a severe traumatic event as defined in the SoP, and none was a category 1A stressor or a category 1B stressor.
37. Factor 5 of SoP Nº 76 of 1998 concerning Alcohol Dependence or Alcohol Abuse provides:
...
(b) experiencing a severe stressor within the two years immediately before the clinical onset of alcohol dependence or alcohol abuse;
Paragraph 8 of the SoP provides:
“experiencing a severe stressor” means, the person experienced, witnessed or was confronted with, an event or events that involved actual or threat of death or serious injury, or a threat to the person’s or other people’s physical integrity, which event or events might evoke intense fear, helplessness or horror.
In the setting of service in the Defence Forces, or other service where the Veterans’ Entitlements Act applies, events that qualify as severe stressors include:
(i) threat of serious injury or death; or
(ii) engagement with the enemy; or
(iii) witnessing casualties or participation in or observation of casualty clearance, atrocities or abusive violence;
38. In Stoddart v Repatriation Commission [2003] FCA 334; (2003) 197 ALR 283 Mansfield J stated at 296:
In my judgment the language of the definition of "experiencing a severe stressor" caters for the applicant experiencing or being confronted with an event or events that involved threat of death or serious injury, or a threat to physical integrity, if the event or events which are said to constitute the threat, judged objectively from the point of view of a reasonable person in the position of and with the knowledge of the person experiencing those events, are capable of and did convey (that is, are subjectively experienced) the risk of death or serious injury or to physical integrity.
39. In Woodward v Repatriation Commission [2003] FCAFC 160; (2003) 131 FCR 473the Full Federal Court approved the decision in Stoddart. The Court held at 498-499:
It would be open to the AAT to conclude the situation involving Mr Woodward was similar, in relevant respects, to that considered by Mansfield J in Stoddart. It would be open to the AAT to find that the material pointed to Mr Woodward believing that he was in danger whilst he was on patrol and that such a belief was reasonable. It would also be open to conclude that the material pointed to Mr Woodward perceiving a threat of serious injury or death from actual events, experienced in circumstances in which it was reasonable to perceive a threat. It would be open to conclude that there were one or more "events" which precipitated the perception and that the events were real in the sense that they had an objective existence. If the reasoning of Mansfield J is accepted, the material before the AAT was capable of satisfying the requirements of the definition of "experiencing a severe stressor" in the SoP in relation to the incident on patrol.
40. In relation to the alert incident the Tribunal finds that, judged objectively, a reasonable person in the position of Mr Scott would have the following knowledge in the circumstances: he was told by an officer on duty (verified in evidence by Mr Conant) that an enemy attack on the base was imminent; he knew that stand-to alerts were not frequent occurrences and were only activated in times of serious danger; a stand-to involved assuming a defensive position with his weapon in the dark; it involved the entire personnel at the base; and was a major logistical operation. The Tribunal finds that, objectively, the alert incident constituted a threat of death or serious injury, or a threat to Mr Scott’s physical integrity.
41. Subjectively, the Tribunal accepts Mr Scott’s evidence that the stand-to involved a threat of death or serious injury to him, and that the event might evoke intense fear, helplessness or horror. Consequently the Tribunal finds that Mr Scott experienced a severe stressor and that he satisfies factor 5(b) of SoP Nº 76 of 1998, so he satisfies the fourth step.
WAS DEPRESSIVE DISORDER WAR-CAUSED?
42. Mr Scott stated that his operational service led to his depressive disorder. Dr Walton stated that the clinical criteria in relation to the SoP for Mr Scott’s depressive disorder are met, although he said that the specific events that are claimed to constitute the various definitions of psychosocial stressors and severe stressors do not appear to be met. He said that Mr Scott reported ongoing depressed mood, poor concentration and a sense of sadness about the futility of war. Dr Velakoulis told the Tribunal in a report dated 24 February 2006 that he first saw Mr Scott in 2005. He stated that in recent years Mr Scott’s mood symptoms have deteriorated, and although he has made some gains with outpatient treatment and antidepressants, he remains lacking in motivation, and with diminished leisure pursuits. Dr Velakoulis concluded that the major precipitants for the depression have been underlying general anxiety disorder, marital strain, social isolation and work stress.
43. In relation to the first step from Deledio, after considering all the material including evidence from Mr Scott and the psychiatrists about his depressive disorder and operational service, the Tribunal determines that the material points to a hypothesis connecting the condition with the circumstances of the particular service rendered by Mr Scott. Therefore he satisfies the first step.
44. In relation to the second step from Deledio the Tribunal has ascertained that there is in force an SoP, being SoP Nº 27 of 2008 concerning Depressive Disorder so Mr Scott satisfies the second step. If Mr Scott does not satisfy that SoP, the Tribunal is required to consider the revoked SoP Nº 17 of 2007 concerning Depressive Disorder.
45. In relation to the third step from Deledio, the Tribunal has considered all the material, including the evidence from Mr Scott and the medical evidence. The Tribunal considers that the material points to the hypothesis linking Mr Scott’s operational service with his depressive disorder. Therefore, Mr Scott satisfies the third step.
46. In relation to the fourth step from Deledio, factor 6 of SoP Nº 27 of 2008 provides:
(a) ...
...
(vii) having a clinically significant psychiatric condition within the two years before the clinical onset of depressive disorder;
Paragraph 9 of the SoP provides:
"a clinically significant psychiatric condition" means any Axis 1 disorder of mental health that attracts a diagnosis under DSM-IV-TR which is sufficient to warrant ongoing management, which may involve regular visits (for example, at least monthly), to a psychiatrist, clinical psychologist or general practitioner;
47. The Tribunal accepts the evidence from Dr Velakoulis in his 2006 report about Mr Scott’s depressive symptoms in recent years. The Tribunal finds that clinical onset of depressive disorder was about 2005. In view of its findings that Mr Scott’s generalised anxiety disorder and alcohol dependence are war-caused, the Tribunal finds that each of these conditions constitutes a clinically significant psychiatric condition that Mr Scott had within the two years before the clinical onset of depressive disorder. Consequently the Tribunal finds that Mr Scott satisfies factor 6(a)(vii) of SoP Nº 27 of 2008, so he satisfies the fourth step.
DECISION
48. The Tribunal sets aside the decision under review and substitutes a decision that generalised anxiety disorder, alcohol dependence and depressive disorder are war-caused with effect from 2 June 2005.
I certify that the forty-eight [48] preceding paragraphs are a true copy of the reasons for the decision of:
G. D. Friedman, Senior Member
(sgd) Mara Putnis
Associate
Date of hearing: 22 December 2008
Date of decision: 5 January 2009
Counsel for the applicant: Ms J Bornstein
Solicitor for the applicant: Williams Winter
Advocate for the respondent: Mr K Rudge, Department of Veterans’ Affairs
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