Alicier and Secretary, Department of Social Services (Social services second review) - [2017] AATA 538

Alicier and Secretary, Department of Social Services (Social services second review) [2017] AATA 538 (26 April 2017)

Division

GENERAL DIVISION

File Number

2015/1842

Re

Cansel Alicier

APPLICANT

And

Secretary, Department of Social Services

RESPONDENT

DECISION

Tribunal
Deputy President F J Alpins

Date 26 April 2017

Place Melbourne
The decision under review is affirmed.
........................................................................
Deputy President F J Alpins
SOCIAL SECURITY – disability support pension – application for unlimited portability period under s 1218AAA of Social Security Act 1991 (Cth) – whether applicant’s impairment a severe impairment – whether impairment of 20 points or more under a single Impairment Table – date at which eligibility for unlimited portability period to be assessed
Legislation
Administrative Appeals Tribunal Act 1975 (Cth), s 43
Social Security Act 1991 (Cth), ss 23, 26, 27, 94(3B), 1218AAA
Social Security (Administration) Act 1999 (Cth), ss 11, 36, 37, 39, 42, 63, 80, 126, 135, 142, 179; Sch 2 cls 3, 4
Social Security (Tables for the Assessment of Work-Related Impairment for Disability Support Pension) Determination 2011 (Cth), ss 3, 6, 7, 8, 10, 11
Cases
Alcan (NT) Alumina Pty Ltd v Commissioner of Territory Revenue (2009) 239 CLR 27
Certain Lloyd’s Underwriters v Cross (2012) 248 CLR 378
Daccache and Secretary, Department of Social Services [2015] AATA 596
Freeman v Secretary, Department of Social Security (1998) 19 FCR 342
Glinster and Secretary, Department of Social Services [2015] AATA 800
Harris v Secretary of Employment and Workplace Relations (2007) 158 FCR 252
Ljubovic and Secretary, Department of Social Services [2015] AATA 1025
McDonald v Director-General of Social Security (1984) 1 FCR 354
Morton and Secretary, Department of Social Services [2014] AATA 949
Scrivener and Secretary, Department of Social Services [2014] AATA 537
Shi and Migration Agents Registration Authority (2008) 235 CLR 286
Tamua and Secretary, Department of Social Services [2016] AATA 757
WMKR and Secretary, Department of Social Services [2015] AATA 483
Secondary Materials
Explanatory Memorandum to the Social Security and Other Legislation Amendment (Disability Support Pension Participation Reforms) Bill 2012 (Cth)
Persons Giving Expert And Opinion Evidence Guideline (Administrative Appeals Tribunal Guideline dated 30 June 2015)
REASONS FOR DECISION
Deputy President F J Alpins
26 April 2017
INTRODUCTION

This application for review arises out of the rejection of the applicant’s application for a written determination under s 1218AAA of the Social Security Act 1991 (Cth) (the “Act”) that her maximum portability period for disability support pension (“DSP”) is an unlimited period. The applicant, Mrs Cansel Alicier, was granted DSP on 3 July 2009 in respect of her impairment resulting from a brain tumour (craniopharyngioma) and depression. Mrs Alicier sought an unlimited portability period on 3 March 2014. The respondent’s decision that Mrs Alicier was ineligible for such a determination was successively affirmed, giving rise to this proceeding.
LEGISLATION
Section 1218AAA of the Act provides:
(1)The Secretary may make a written determination that a particular person’s maximum portability period for disability support pension is an unlimited period, if all of the following circumstances (the qualifying circumstances) exist:
(a)the person is receiving disability support pension;
(b)the Secretary is satisfied that the person’s impairment is a severe impairment (within the meaning of subsection 94(3B));
(c)the Secretary is satisfied that the person will have that severe impairment for at least the next 5 years;
(d)the Secretary is satisfied that, if the person were in Australia, the severe impairment would prevent the person from performing any work independently of a program of support (within the meaning of subsection 94(4)) within the next 5 years.
(2)The Secretary must not make a determination under subsection (1) in relation to a person who is outside Australia unless the Secretary is satisfied that:
(a)the person is unable to return to Australia because of either of the following events:
(i) a serious accident involving the person;
(ii) the hospitalisation of the person; and
(b)the person’s portability period for disability support pension had not ended at the time the event occurred.
(3)The Secretary may revoke the determination if any of the qualifying circumstances ceases to exist.
(4)A determination under subsection (1) is not a legislative instrument.
(5)In this section:
work means work:
(a)that is on wages that are at or above the relevant minimum wage; and
(b)that exists in Australia, even if not within the person’s locally accessible labour market.
It is made clear by the terms of s 1218AAA(1) that paragraphs (a) to (d) contain conjunctive requirements – that is to say that all of the expressed circumstances must exist before the Secretary may make a written determination under that subsection.
With respect to paragraph (b) of s 1218AAA(1), s 94(3B) of the Act provides that a person’s impairment is a severe impairment if the person’s impairment is of 20 points or more under the Impairment Tables, of which 20 points or more are under a single Impairment Table. The “Impairment Tables” are the tables set out in the Social Security (Tables for the Assessment of Work-related Impairment for Disability Support Pension) Determination 2011 (Cth) (the “Determination”), which also contain the rules that are to be complied with in applying them (see ss 23, 26(1), 26(3) and 27(3) of the Act).
Relevantly, s 6 of the Determination provides:
“6     Applying the Tables
Assessing functional capacity
(1)The impairment of a person must be assessed on the basis of what the person can, or could do, not on the basis of what the person chooses to do or what others do for the person.
Applying the Tables
(2)The Tables may only be applied to a person’s impairment after the person’s medical history, in relation to the condition causing the impairment, has been considered.
...
Impairment ratings
(3)An impairment rating can only be assigned to an impairment if:
(a)the person’s condition causing that impairment is permanent; and
...
(b)the impairment that result from that condition is more likely than not, in light of available evidence, to persist for more than 2 years.
Permanency of conditions
(4)       For the purposes of paragraph 6(3)(a) a condition is permanent if:
(a)the condition has been fully diagnosed by an appropriately qualified medical practitioner; and
(b)the condition has been fully treated; and
...
(c)the condition has been fully stabilised; and
...
(d)the condition is more likely than not, in light of available evidence, to persist for more than 2 years.
Fully diagnosed and fully treated
(5)In determining whether a condition has been fully diagnosed by an appropriately qualified medical practitioner and whether it has been fully treated for the purposes of paragraphs 6(4)(a) and (b), the following is to be considered:
(a)whether there is corroborating evidence of the condition; and
(b)what treatment or rehabilitation has occurred in relation to the condition; and
(c)whether treatment is continuing or is planned in the next 2 years.
Fully stabilised
(6)For the purposes of paragraph 6(4)(c) and subsection 11(4) a condition is fully stabilised if:
(a)either the person has undertaken reasonable treatment for the condition and any further reasonable treatment is unlikely to result in significant functional improvement to a level enabling the person to undertake work in the next 2 years; or
(b)the person has not undertaken reasonable treatment for the condition and:
(i)     significant functional improvement to a level enabling the person to undertake work in the next 2 years is not expected to result, even if the person undertakes reasonable treatment; or
(ii)     there is a medical or other compelling reason for the person not to undertake reasonable treatment.
...
Reasonable treatment
(7)For the purposes of subsection 6(6), reasonable treatment is treatment that:
(a)is available at a location reasonably accessible to the person; and
(b)is at a reasonable cost; and
(c)can reliably be expected to result in a substantial improvement in functional capacity; and
(d)is regularly undertaken or performed; and
(e)has a high success rate; and
(f)carries a low risk to the person.
Impairment has no functional impact
(8)The presence of a diagnosed condition does not necessarily mean that there will be an impairment to which an impairment rating may be assigned.”
The term “condition” is defined for the purposes of the Determination to mean a medical condition; the term “impairment” is defined to mean “a loss of functional capacity affecting a person’s ability to work that results from the person’s condition” (s 3).
Section 7 of the Determination provides:
“(1)Subject to subsection (2), in applying the Tables the following information must be taken into account:
(a)the information provided by the health professionals specified in the relevant Table; and
(b)any additional medical or work capacity information that may be available; and
(c)any information that is required to be taken in to account under the Tables, including as specified in the introduction for each Table;
(2)A person may be asked to demonstrate abilities described in the Tables.”
Section 8 of the Determination provides:
“(1)Symptoms reported by a person in relation to their condition can only be taken into account where there is corroborating evidence.
…
Unless required under the Tables, the impact of non-medical factors when assessing a person’s impairment must not be taken into account.”
Section 10(3) of the Determination provides that “where a single condition causes multiple impairments, each impairment should be assessed under the relevant Table”. Section 10(4) provides that “[w]hen using more than one Table to assess multiple impairments resulting from a single condition, impairment ratings for the same impairment must not be assigned under more than one Table.”
Section 11(1)(c) of the Determination provides that “if an impairment is considered as falling between 2 impairment ratings the lower of the 2 ratings is to be assigned and the higher rating must not be assigned unless all the descriptors for that level of impairment are satisfied”.
Section 11(2) requires a comparison as between relative descriptors in determining the impairment rating to be applied. Section 11(3) provides that a descriptor concerning the performance of an activity applies if the person “can do the activity normally and on a repetitive or habitual basis”. Section 11(4) provides that “[w]hen assessing impairments caused by conditions that have stabilised as episodic or fluctuating a rating must be assigned, which reflects the overall functional impact of those impairments, taking into account the severity, duration and frequency of the episode or fluctuations as appropriate”.
ISSUES BEFORE THE TRIBUNAL
It did not appear to be in dispute that Mrs Alicier was receiving DSP at all material times for the purposes of para (a) of s 1218AAA(1) of the Act.
Nor was it in dispute that Mrs Alicier had an impairment for the purposes of para (b) of s 1218AAA(1), which the respondent accepted resulted from her conditions of craniopharyngioma and also anxiety and depression; the latter conditions were described in more general terms in Mrs Alicier’s written submissions as a “mental health condition”, perhaps to encompass a diagnosis made more recently by her later treating clinical psychologist, to which I refer to below.
In any event, the essential issue between the parties with respect to para (b) of s 1218AAA(1) was whether the Tribunal ought to be satisfied that Mrs Alicier’s impairment was a “severe impairment” within the meaning of s 94(3B), that is to say that her impairment was of 20 points or more under a single Impairment Table. Mrs Alicier contended that that requirement was satisfied under each of the following Impairment Tables - Table 7 (Brain Function), Table 12 (Visual Function) (both being impairments resulting from Mrs Alicier’s craniopharyngioma) and Table 5 (Mental Health Function). The respondent contended that the provision was not satisfied under any of the three Tables in issue.
The parties also differed with respect to the date at which the Tribunal should assess Mrs Alicier’s eligibility for an unlimited portability period for the purposes of s 1218AAA of the Act. It was submitted on behalf of Mrs Alicier that her eligibility ought to be assessed as at the date of the Tribunal’s decision. The respondent submitted that her eligibility should instead be assessed as at 3 March 2014, being the date when Mrs Alicier sought a written determination under that provision.
I note that the Tribunal has reached inconsistent conclusions about this issue, despite common reliance upon the High Court’s decision in Shi and Migration Agents Registration Authority (2008) 235 CLR 286. That is perhaps unsurprising given that the High Court’s reasoning is, necessarily, general in its guidance on this issue – its resolution turns upon the statutory question raised by the terms of s 1218AAA, read in context, and the nature of the decision under review (see Shi at [43]-[46] per Kirby J, at [99]-[101] per Hayne and Heydon JJ).
Should the Tribunal confine its review to consideration of whether the circumstances enumerated in s 1218AAA(1) existed at the time a written determination under that provision was sought? The temporal aspects of s 1218AAA(1) do not evince any such statutory limitation (see Shi at [48], [97], [101]). In that regard, it is important to read s 1218AAA(1) as a whole. In my view its terms require that each of the “qualifying circumstances” must exist at a contemporaneous point in time. Accordingly, the criteria enumerated in paragraphs (a) to (d) of s 1218AAA(1) give rise to statutory questions “which [invite] attention to the state of affairs as they exist at the time the Tribunal makes its decision” (Shi at [101]).
In that regard, the terms of paragraph (a) are particularly telling. Significantly, they raise the question of whether the person “is receiving” DSP (rather than whether the person “is qualified” for DSP (cf. s 37 of the Social Security (Administration) Act 1999 (Cth) (the “Administration Act”). The use of the present tense in para (a) contemplates consideration of circumstances as they are at the time of the relevant decision-maker’s decision.
On the respondent’s contended construction, upon review the Tribunal would be required to disregard the fact that an applicant was no longer receiving DSP at the time of its decision. That might be so for various reasons, including if the person’s DSP were to be cancelled pursuant to s 80 of the Administration Act after an application was made for a determination under s 1218AAA. It is instructive to note, as is suggested by the terms of s 1218AAA(2), the following statement in the Explanatory Memorandum to the Social Security and Other Legislation Amendment (Disability Support Pension Participation Reforms) Bill 2012 (Cth), by which s 1218AAA was introduced:
“It is generally intended that, before the Secretary makes a determination under new section 1218AAA, the disability support pensioner would be required to undergo an assessment in Australia to determine whether they meet the criteria for a severely impaired overseas disability support pensioner.”
Such an assessment might result in an applicant’s DSP being cancelled, for example, on the basis that they are not qualified for DSP (see s 80 of the Administration Act). Given that the Tribunal is empowered by s 43(1) of the Administrative Appeals Tribunal Act 1975 (the “AAT Act”) to make a decision “in substitution for” the decision under review (having its genesis in the decision to refuse to make a written determination under s 1218AAA: see ss 126, 135, 142 and 179 of the Administration Act), “it would be remarkable if the substituted decision could not take into account evidence of relevant, and even critical, supervening events” (Shi at [49] per Kirby J). In my opinion, cancellation of DSP following an application for a determination under s 1218AAA, whether as a consequence of that application or for any other reason, would constitute such a supervening event.
In Shi, the High Court acknowledged by way of contradistinction that legislation providing for pension entitlements may require consideration of whether a criterion was satisfied at a point in time preceding the Tribunal’s decision (at [44], [46] per Kirby J; at [101] per Hayne and Heydon JJ). However, those observations were not expressed as a rule governing all social security decisions but rather, consonantly, as depending upon the nature of the decision under review and the statutory question raised by the legislation in issue.
For example, it is inherent in the nature of a decision to cancel an applicant’s DSP (for example, under s 80 of the Administration Act) that it raises a statutory question of whether the applicant qualified for DSP at the date on which it was cancelled (see Shi at [44]-[46]], at [99] citing Freeman v Secretary, Department of Social Security (1998) 19 FCR 342).
Further, a review concerning a decision to reject a claim for DSP (see s 36(1) of the Administration Act) raises the statutory question of whether the applicant qualified for DSP under s 94 of the Act at any time during the period commencing on the date of claim and ending 13 weeks thereafter, given the effect of particular provisions of the Administration Act (ss 39(3), 42 and cls 3(1) and 4(1) of Sch 2) (Harris v Secretary of Employment and Workplace Relations (2007) 158 FCR 252 at [1]).
However, having regard to the wider statutory context, there are no such provisions containing temporal aspects affecting s 1218AAA of the Act. Section 1218AAA is to be read in the context that it is a beneficial provision (see Alcan (NT) Alumina Pty Ltd v Commissioner of Territory Revenue (2009) 239 CLR 27 at [57]) but what ultimately matters is the text of the provision and what it reveals as to statutory purpose and legislative intention (Alcan at [47]; Certain Lloyd’s Underwriters v Cross (2012) 248 CLR 378 at [25])).
Section 1218AAA is concerned not with a claim for DSP and whether it ought to have been granted (see s 11, 36, 37 of the Administration Act), but rather with the circumstances in which relief from the prescribed customary portability periods for DSP may be granted. Reading the section according to its terms evinces a legislative intention that the Secretary is to determine whether the prescribed qualifying circumstances exist at the time of considering whether to make a written determination.
Upon review, “the Tribunal’s task is ‘to do over again’ what the original decision-maker did” (Shi at [100] per Hayne and Heydon JJ) and thus to make its decision pursuant to s 43 of the AAT Act having regard to the circumstances at the time of its decision, including an assessment of the applicant’s condition at that time, rather than as it was at the time a determination under s 1218AAA(1) was sought. I therefore agree with the reasoning of Senior Member Walsh in Morton and Secretary, Department of Social Services [2014] AATA 949 at [48] and Daccache and Secretary, Department of Social Services [2015] AATA 596 at [22]-[26] (cf. Scrivener and Secretary, Department of Social Services [2014] AATA 537 at [6], WMKR and Secretary, Department of Social Services [2015] AATA 483 at [27]-[31] and Glinster and Secretary, Department of Social Services [2015] AATA 800 at [11]-[15]).

However, while I have considered it appropriate to address the parties’ submissions about this issue, particularly given the lack of uniformity in decisions of the Tribunal in that regard, it is important to note that my conclusion that the applicant’s submission about the correct date of assessment for the purposes of s 1218AAA(1) is to be accepted has not affected the Tribunal’s decision in this proceeding, as will be apparent from the reasons that follow.
I note in passing that the terms of s 1218AAA(1), particularly the prefatory phrase “[t]he Secretary may”, raise the statutory question of whether the Secretary is obliged to make a written determination if the “qualifying circumstances” exist (in that the word “may” merely serves to empower the Secretary to do so) or whether the use of the word “may” signifies the conferral of a discretion, so that the existence of the qualifying circumstances is merely a prerequisite to the exercise of that discretion by the Secretary. However, given the conclusion I have reached in this proceeding, it is unnecessary for me to address that question.
I note that Mrs Alicier contended in her written submissions that the Secretary, in considering whether to make a written determination under s 1218AAA(1), is not entitled to revisit the relevant person’s qualification for DSP (nor to exercise the powers prescribed under s 63 of the Administration Act in that regard), nor to cancel the payment of DSP pursuant to s 80 of the Administration Act, in that context.
As will be apparent from my above reasoning about the issue of the date at which a person’s condition is to be assessed for the purposes of s 1218AAA(1), Mrs Alicier’s contention might be said to lack foundation. However, as the respondent submitted, that contention has no bearing upon the issues before the Tribunal in this proceeding, given the nature of the decision under review, even more so given that it is not in dispute that Mrs Alicier has received DSP at all material times for the purposes of s 1218AAA(1)(a). The essential issue is whether the Tribunal is satisfied upon the evidence before it that the (other) qualifying circumstances enumerated in s 1218AAA(1) exist (see McDonald v Director-General of Social Security (1984) 1 FCR 354).
EVIDENCE
I turn now to the factual background and the evidence before the Tribunal. In that regard, I note that some of the documents were taken into evidence at the hearing, while others were treated as being in evidence in accordance with a joint list of exhibits prepared by the parties after the hearing.
In January 2009, prior to being granted DSP, Mrs Alicier underwent surgery, particularly pterional craniotomy and decompression, following a pre-operative diagnosis of a likely craniopharyngioma cyst (brain tumour) which was thought to be compressing her optic nerve, in order to drain the cyst. This surgery was the subject of an apparently undated report prepared by Professor Gavin Fabinyi, neurosurgeon.
In a medical certificate dated 29 January 2009, Dr G Mirmilstein recorded that Mrs Alicier had been diagnosed as having a “cystic tumour (brain) – benign”, resulting in lethargy, headaches and reduced vision, the prognosis being that her symptoms were likely to show considerable improvement within two years.
In a letter dated 2 February 2009 written in support of a visa application for Mrs Alicier’s mother (who lived in Turkey), Ms Maria Karantoni, a social worker, stated that Mrs Alicier was temporarily living with her son in a friend’s home, due to her marriage breakdown. It was noted that Mrs Alicier had only lived in Australia for two years, had only a couple of Turkish friends she had met in Australia and had no family support.
In a letter dated 8 February 2009 also written in support of the visa application, Dr Saban stated that Mrs Alicier was being treated for anxiety and depression. Dr Saban noted that Mrs Alicier had recently been diagnosed as having a brain tumour, which was not completely removed by recent surgery. Dr Saban stated that Mrs Alicier “currently needs physical as well as psychological support during this difficult time”, ideally from her mother.
In a medical report dated 11 February 2009 prepared in support of Mrs Alicier’s application for DSP, Dr S Saban stated that Mrs Alicier had been diagnosed as having a brain tumour, being the condition with the greatest impact on her ability to function. He stated that her current symptoms were headaches and visual problems and that she also was lethargic and lacked concentration. He noted that current and future planned treatment involved analgesia and that the condition was expected to affect Mrs Alicier’s ability to function for more than two years. Dr Saban also recorded that she had anxiety and depression, for which she was having psychological treatment and which brought about depression, lethargy and lack of concentration, but categorised those as being generally well-managed and causing minimal or limited impact on her ability to function.
At a job capacity assessment interview conducted on 18 February 2009, Mrs Alicier reported experiencing “blurred/double vision”, intermittent headaches, episodes of dizziness, nausea, loss of balance, forgetful, lethargy, difficulties concentrating, disturbed sleep and fatigue. She also said, shortly stated, that she was socially withdrawn and that she was engaging in limited activity, given that she was recovering from her recent surgery.
In medical certificate dated 12 March 2009, Dr Saban recorded that Mrs Alicier had been diagnosed as having craniopharyngioma, the prognosis being that her symptoms were likely to show considerable improvement within two years. He also noted her anxiety and depression, the symptoms of which (depressed mood, lethargy and insomnia) he considered were likely to persist.
Following a radiology report diagnosing a recurrent and enlarging residual Rathke’s cleft cyst, on 28 May 2009 Mrs Alicier underwent a further pterional craniotomy and resection of her cyst.
In a report dated 23 June 2009, Dr Mervin Lawrence, of Austin Health’s neurosurgical unit, noted that Mrs Alicier’s recurrent cyst had been diagnosed as being either a Rathke’s cyst or craniopharyngioma and that an Omaya’s reservoir (a shunt) had recently been inserted to allow for superficial drainage of the cyst if it reoccurred in the future. Furthermore, he referred Mrs Alicier to a radiation oncologist for possible radiotherapy. A related inpatient discharge summary, apparently prepared by Dr Lawrence, indicates that the shunt was inserted on 18 June 2009.
In a report prepared in relation to Mrs Alicier’s DSP claim and dated 21 July 2009, Dr Saban diagnosed Mrs Alicier as having the condition of papillary craniopharyngioma and experiencing headaches, severe drowsiness and blurred vision in her left eye. Dr Saban noted that Mrs Alicier had undergone craniotomy three times and that she was to have treatment in the nature of radiotherapy. While describing her vision in her left eye as poor, he categorised that as causing minimal or limited impact on her ability to function. Dr Saban also diagnosed Mrs Alicier as suffering from anxiety and depression, for which she was having psychological treatment. He said that she had taken anti-depressants in the past and that she might need to take them in the future. He expected that her ability to function would be affected (by lethargy and lack of concentration) for more than two years.
Ms Serpil Ozturk, clinical psychologist, wrote a letter dated 11 April 2012 in support of a visa application made by Mrs Alicier’s daughter, Ms Safiye Cin. In that letter, Ms Ozturk stated that Mrs Alicier had been attending psychological therapy since March 2008 for “depressive and anxious symptoms” and also referred to her “three surgeries for a Supracellar cystic tumour”. She stated that Mrs Alicier “has numerous appointments she needs to attend for her conditions, and suffers with progressive visual failure, and headaches”. Furthermore, she stated that Mrs Alicier had therefore “been struggling to cope with her day to day chores”, in that she had “difficulty with cooking meals, bathing and cleaning her house” and therefore required “assistance and support to help her cope with daily life”.
In a report dated 16 April 2012 prepared upon neurosurgical review, Dr Chandrashan Perera noted that Mrs Alicier’s complaint of poor vision in her left eye should be assessed by an ophthalmologist and that in the absence of any local eye pathology to explain it, consideration should be given to remove the shunt tubing as it was primarily designed to drain the cyst, which was no longer there. That followed an earlier statement, ambiguous in its meaning, that the MRI performed in February 2012, which showed no change compared with the previous one, “does not however [sic] that the shunt tubing is sitting near the left optic trap”.
In a further report, dated 23 April 2012, Dr Perera noted that Mrs Alicier had been seen by the ophthalmologist, who felt that there is no local cause for her decreased visual acuity in the eye. He also stated that he had an “extensive discussion with Mrs Alicier regarding the risks and benefits of removing the reservoir tubing”; on the one hand noting that it might not be the cause of her symptoms and “there are some risks involved in removing the tube even though it is considered minor”; on the other hand noting that that it would be advisable to remove it if it was causing deterioration in her visual acuity, although there was no convincing evidence that that was so. He noted that he and Professor Fabinyi would undertake a review in two months’ time.
In a medical adviser’s report dated 22 May 2012 prepared for the purposes of Mrs Alicier’s daughter’s carer visa application, Dr Peter Tutton (of Medibank Health Solutions) opined:
“Ms Alicier’s medical problems are mixed anxiety and depression and the consequence of a brain tumour (craniopharyngioma).
She has had three majour [sic] neurosurgical operation [sic] in an attempt to remove the tumour. The tumour has essentially blinded her in her left eye and greatly restricted her visual field on the right side in her right eye. She also experiences severe headaches.
Her visual impairment is not optical and is not improved by visual aids. Her impairment is due to damage to nerves taking visual information to the brain. She clearly fullfills [sic] the descriptor for 30 points on Table 12.”
Dr Tutton indicated in the report checklist that Mrs Alicier required direct assistance with hygiene, dress/undressing/grooming, eating/feeding, mobility, giving or supervising medication, supervision/monitoring and assistance with transport. He indicated that she required daily personal care and attention to carry out routine bodily functions and required constant supervision or monitoring. He opined that the condition was permanent in that it would persist for at least two years. Dr Tutton also opined that Mrs Alicier’s depression and anxiety warranted a rating of 10 points under Table 5 of the Impairment Tables.
In a further report, dated 25 June 2012, Dr Perera noted that Mrs Alicier had been reviewed that day. Further, he noted that the reservoir tubing was sitting near her left optic nerve, giving rise to the concern as to whether it was causing decreasing visual acuity on the left side. He said that “[t]hough it seems somewhat unusual, we have offered Mrs Alicier the option to remove the tube on 2 occasions, which she has declined”. He said that, as the ophthalmologist could not find any local cause for her decreasing visual acuity, Mrs Alicier had been referred to the neurology unit for their opinion.
In a report dated 17 July 2012, Dr Georgina Thomas, endocrinologist, recorded that Mrs Alicier reported ongoing headaches and retro-orbital pain, worsening visual acuity in the left eye with difficulty focussing during the day and had stopped driving at night due to brightness of lights. She noted that Mrs Alicier was awaiting neurological review and recommended prompt review with respect to her worsening visual acuity.
Professor Fabinyi prepared a report dated 19 November 2012 upon his review of Mrs Alicier. He said that:
“Over the last 6 months she has really been quite unchanged. A recent visual examination confirmed a static problem with the left eye with reduced vision of 6/36 but normal vision in the right eye. Despite this she finds it difficult to do things at home without the lights on and has lost confidence in driving. Overall she is very anxious and her husband, who accompanied her today, feels that this is the major issue. She does have a complicated home life from what I can glean.
…
…. [O]ne of the main issues at the moment remains her anxiety which is not all that easy to treat. I discussed today that I didn’t think removing the shunt would be of particular value and she was happy about this”.
In a report dated 15 January 2013, Professor Jeffrey Zajac, an endocrinologist, noted that Mrs Alicier had reported that she was currently experiencing dizziness, lethargy and generally feeling very unwell and said that he considered that further investigations would be required.
Dr Patrick Carney, neurologist, prepared a report dated 15 April 2013 upon his examination of Mrs Alicier that day. He addressed Mrs Alicier’s concern that the shunt was causing her headaches. He said that “I certainly concur with Professor Fabinyi, there is no indication to remove her shunt” and opined that “I do not think her headaches related to her intracranial problems but they … have a cervicogenic origin”; he recommended physiotherapy as “the most appropriate and only clearly-indicated treatment for her headaches”.
Reports dated 26 July 2013 and 24 August 2013 prepared by Ms Serpil Ozturk, clinical psychologist, indicate that Mrs Alicier had psychological therapy sessions prior to those dates.
Dr Nicholas Russell, a registrar in Austin Health’s Endocrine Clinic, reported on 3 December 2013 that Mrs Alicier’s pituitary function remained normal; he recommended review in 12 months’ time and referral to a neurosurgeon and ophthalmologist given her visual loss and headaches, her visual acuity being 6/6 in her right eye but < 6/60 in her left eye.
In a decision dated 2 January 2014 concerning Mrs Alicier’s daughter’s application for a carer visa, the Migration Review Tribunal (the “”MRT”) in its reasons for deciding that she met the criteria for a Subclass 116 (Carer) visa, made certain findings on the basis of a certificate from Health Services Australia and oral evidence given at the hearing about the care and assistance required by Mrs Alicier, including that “she requires assistance to move around even in familiar environments and needs assistance to perform most day to day activities” and that she “requires personal care and attention on a daily basis and constant supervision or monitoring”.
Ms Susan Carey, a clinical neuropsychologist, prepared a report dated 10 June 2014 to ascertain Mrs Alicier’s current level of cognitive functioning and to determine whether she fulfilled the criteria for an acquired brain injury. She noted her understanding that Mrs Alicier’s cyst had not recurred since the insertion of the shunt and that although its removal had been canvassed, Mrs Alicier felt “too scared” to undergo further surgical procedures. She further noted that, while medical records indicated that her condition had been in remission for a number of years, Mrs Alicier reported that she was currently experiencing a return of visual difficulties, being her main concern as she had experienced a “steady decline” in vision since her last surgery, which affected her ability to participate in activities of daily living, such as “not being able to see whether pots and pans were dirty or clean, being unable to distinguish between vegetables, and burning cooking and her hands because she was unable to see the flame”. Mrs Alicier also stated that she was experiencing memory difficulties, generally not feeling well, numbness in her arms, hormonal issues and dizziness when outside.
Ms Carey noted that Mrs Alicier no longer took the anti-depressant medication previously prescribed for her, but was currently receiving psychotherapeutic intervention (for 5‑6 sessions). Mrs Alicier “described experiencing increased [sic] in panic symptoms”.
Ms Carey opined that, upon assessment by various tests, Mrs Alicier’s “overall neuropsychological profile revealed a number of areas of weaknesses and inconsistencies” based upon the following results:
(a)“visuoconstructional abilities were broadly intact, whereas visuospatial reasoning was severely reduced”;
(b)“[b]est performances indicated that visual acuity for fine visual stimuli was intact”;
(c)“[v]erbal abstract reasoning skills were intact, whereas her general fund of knowledge was well below expectations”;
(d)her “immediate memory span was poor” and “[w]orking memory … performance fluctuated”;
(e)her “acquisition of verbal information was extremely poor” and her “delayed recall of verbal information was also very poor”;
(f)her “[i]nitial acquisition of visual information was intact”, while “[d]elayed recall was moderately reduced but characterised by withdrawal of effort”’;
(g)a “brief screen of executive functioning revealed further fluctuations in performances such that at times she performed better on more complex tasks in comparison to the easier tasks;
(h)she “demonstrated generally adequate cognitive flexibility that was secondarily impacted by slowed processing speed”.
Ms Carey opined:
“Ms Alicier’s neuropsychological profile was characterised by fluctuations and inconsistencies across a number of cognitive domains, which makes it difficult to elicit a clear picture of cognitive strengths and weaknesses. It is difficult to ascertain whether poor performances are due to neurologically based aetiology or other factors (e.g., high levels of anxiety, withdrawal of effort, being of a non-English speaking background, etc.). Overall, the pattern of results does not fit any particular neuropsychological syndrome.
I note that the visual concerns described by Ms Alicier … were not commensurate with some aspects of her performance on tests that required a high degree of visual acuity. That is, although some visually based task performances were poorer than others, she was able to demonstrate a normal level of visuospatial ability on tasks that involved complex visual stimuli.
Ms Alicier’s three craniotomies and subsequent brain radiotherapy certainly confer entitlement to experiencing brain changes. …
The aetiology of Ms Alicier’s current neuropsychological performances is likely to be multifactorial in nature. I cannot exclude the possibility of an ABI accounting for some impairment. However, Ms Alicier’s high level of psychological distress (self-report [sic] and observed) is also likely to be contributing to her performance. Personality factors, too, are likely to have contributed to some of the early withdrawal of effort noted. I wonder whether the effect of surgical entrance and resection has resulted in a neuropsychiatric syndrome, particularly given disturbance of the right inferior frontal lobe. Furthermore, suprasellar cysts and their excision have been known to be associated with neuropsychiatric disturbance in up to 30% of cases. Unfortunately, I do not have sufficient knowledge of Ms Alicier’s premorbid personality and behaviour to determine whether there has been a change.
With regards to a target group assessment, at this time I do not have sufficient evidence to definitively conclude whether Ms Alicier has or has not sustained permanent cognitive and/or behavioural impairments as a result of her suprasellar cyst and surgical intervention. This is largely due to the inconsistencies in her neuropsychological findings.”

In a letter to Mrs Alicier dated 11 June 2014, Ms Carey said that “the pattern of your results were quite unusual”, that “[o]verall, your neuropsychological profile fluctuated” and that it “is hard to make sense of the results”. She attributed her results to the likely impact of her surgery and radiotherapy (while stating that should could not be certain in that regard), stress and anxiety and the fact that “you sometimes gave up quite quickly”, so that “some of your results are likely to be an underestimate of what you can do”. Ms Carey advised Mrs Alicier that she should continue to see her psychologist and that such help would be “likely to also have an improvement in your thinking skills”. She also suggested using antidepressants or medication to manage her anxiety.
In a report dated 28 July 2014 prepared for the purposes of the review of Mrs Alicier’s qualification for DSP in the context of her application for an unlimited portability period, Dr Saban stated that Mrs Alicier had been diagnosed as having craniopharyngioma in 2009, which currently affected her ability to function in that it brought about lethargy, poor concentration and poor visual acuity. He opined that the effect of the condition was likely to remain unchanged over the next five years, in that Mrs Alicier’s “[o]ngoing symptoms of headaches, poor vision [were] unlikely to improve in the foreseeable future”. He also recorded diagnosed anxiety and depression and that brought they brought about lethargy, loss of concentration and poor motivation. He opined that those conditions were likely to remain unchanged over the next five years and to have such impacts on her ability to function for more than that period.
I note that Dr Saban, in answer to a question as to whether the patient had any other medical conditions that are generally well managed and that cause minimal or limited impact on ability to function?” responded “[s]ignificant loss of visual acuity, headaches, [c]ervicogenic headaches …”, and provided further information as follows: “ongoing visual problems, headaches, with major depression – unlikely to be employable in any trade”.
In a work capacity form prepared for Centrelink and dated 4 August 2014, which was stated to have been completed with the assistance of Dr Firdevs Tat, Mrs Alicier stated that she suffered from craniopharyngioma (being the “primary diagnosis”), and poor visual acuity, poor concentration, lethargy, “headache” (sic) and depression. It was further stated that she was expected to undergo further neurosurgery in the future, although it was “not definite as yet” being “[d]ependent on [a] neurosurgeon’s decision”.
A job capacity assessment report dated 19 September 2014 records that, at a face-to-face assessment undertaken on 14 August 2014, Mrs Alicier reported that was “[u]nable to concentrate for prolong [sic] periods of time, unable to care for her son (less than 2 years old), unable to perform house hold [sic] duties” and “[u]nable to managed day to day house hold activities due to limited support network, disturbed sleep, unable to plan and concentrate for prolong [sic] periods of time”.
I note that in was recorded in the report that Dr Saban had advised the Health Professional Advisory Unit that, in a letter dated 19 March 2012 from an ophthalmologist, Mrs Alicier’s left eye visual acuity was “count fingers at 2 metres and with blurred vision in the left eye and the right eye was 6/6 – normal visual acuity” and that she should not be driving. It was also recorded that Mrs Alicier “reported that she is able to drive short distances” and that she had access to suitable transport.
In a “support letter” dated 26 November 2014 with respect to Mrs Alicier’s daughter’s visa application, Dr Tat stated that Mrs Alicier was currently her patient and noted that she was “referred for psychological therapy for depression and anxiety”. She stated that Mrs Alicier “requires support with her day-to-day activities of living including cleaning, cooking, driving, shopping and for herself and her baby”. She said further that Mrs Alicier “feels that her daughter would be able to provide her with both physical and emotional support that she may need on a day-to-day basis”. Dr Tat also noted that Mrs Alicier had “reported extreme dizziness, lack of concentration and low mood” and had been “extremely distressed” since one of her older sons was recently assaulted. In conclusion, she stated that Mrs Alicier “needs the support and practical care from her daughter as soon as possible given these recent events and her increased emotional distress”.
In a further “support letter” dated 9 March 2015, Dr Tat stated that Mrs Alicier “requires support with her day-to-day activities of living including cleaning, cooking, driving, shopping and for herself and her baby”. Dr Tat further stated that visiting family members in Turkey “helps to improve [Mrs Alicier’s] mood at least temporarily and she enjoys re‑connecting with loved ones” but that the limited portability period for her DSP “does have a negative impact on her”. Dr Tat stated further that:
“She finds its increasingly difficult to travel for almost 24 hours and then cope with the recovery of this (jet lag and fatigue in particular). She is therefore requesting special consideration with this rule, such that her payments continue for the duration that she is overseas in Turkey”.
I note that Mrs Alicier gave evidence before the Social Security Appeals Tribunal (which affirmed the decision under review on 24 March 2015) concerning the difficulties she was experiencing in engaging in daily activities. It was recorded that she gave evidence that her vision was poor. It was recorded that she “told the Tribunal that she spends most of her day looking after her young child … [h]er daughter now helps with this but prior to her daughter’s arrival two months ago she managed on her own.”
In a report dated 18 June 2015, Dr Michael Jamieson, ophthalmology registrar, diagnosed Mrs Alicier has having very poor vision in her left eye and severe visual field constriction in her right eye. He measured her visual acuity as “[r]ight eye 6/9+2, left eye count fingers”. Dr Jamieson stated that:
“The current visual field testing results are stable compared to one year ago. However, I note that there was a significant drop in vision involving a global visual field loss in the left eye and significantly constricted peripheral visual field loss in the right eye over the period from 2012 and 2014. As you know, this is in the context of a craniopharyngioma with multiple previous operations from 2009. I particularly note, that in 2012 it was noted that the shunt tubing was sitting near the left optic nerve and neurosurgery was offered to reposition this; however, this was declined on two separate occasions by the patient.
Currently there is no sign of any acute change and there is certainly no papilloedema or any ocular cause for the reduced vision. The neurosurgeons are planning to repeat the MRI scan in September 2015 and see her shortly after that. I am not certain if surgery on the tethered optic chiasm would be able to restore any vision to pre-2013 levels; however, as there has been no change in the past year and it was deemed not necessary to operate last year, I expect that our approach will be to continue to monitor if there are no significant changes on the MRI.
We will repeat the visual field testing in one year’s time.”
Dr Tat, a clinical psychologist and neuropsychologist, prepared a report dated 8 September 2015. In that report, she recounted Mrs Alicier’s personal history and her educational and occupational history. In the former regard, she recorded that Mrs Alicier reported a difficult childhood, involving her witnessing abusive behaviour engaged in by her father and her uncle (the latter also being directed towards her). Furthermore, Mrs Alicier “reported significant domestic violence and substance abuse with each of her three ex-husbands”.
Dr Tat also recounted Mrs Alicier’s medical history, noting her history of craniopharyngioma, stated to be in remission and her related surgery and the insertion of the shunt. She noted that Mrs Alicier had been referred to her practice by Dr Saban in March 2014 for ongoing management in related to her previously diagnosed anxiety and depression “and more recent increased levels of stress”. She noted that Mrs Alicier had attended nine session with her, having previously seen Ms Ozturk.
Dr Tat said that she had assessed Mrs Alicier through observation of her clinical presentation, history, consultation with her treating general practitioner and “self-report (including a self-report measure; The Posttraumatic Stress Disorder Checklist (PCL-5)”, being “a self-screening tool to help in the diagnosis of post-traumatic stress disorder (“PTSD”). She said that Mrs Alicier scored 63, “which indicates probable diagnosis”.
Dr Tat noted that “on initial presentation, Mrs Alicier presented with lability of mood and was tearful throughout the session”, expressing feelings of vulnerability about her current situation and lack of close relationships. She said further that:
“As sessions progressed, she reported a number of psychological symptoms/problems including insomnia, constant worry, (especially about her and her children’s health), irritability, low mood/sadness, hyper-vigilance, social withdrawal, interpersonal difficulties [sic] fatigue, poor memory and concentration and feelings of hopelessness about the future”.
Dr Tat opined that she assessed Mrs Alicier’s clinical symptoms against the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and that he fulfilled the criteria of post-traumatic stress disorder.
She explained as follows:
“She has experienced trauma arising from a cumulative impact of intentional, premeditated and multiple abusive episodes within her interpersonal relationships. She is a survivor of childhood abuse and domestic violence, which has impacted on her psychological and neurobiological development. She has also experienced a serious potentially life threatening illness (craniophryngioma), which has further exacerbated her symptoms, especially anxiety and depression.
While complex trauma is not in the DSM-5, it is a well-recognised disorder.
…
As her treatment with myself progressed it became apparent that her symptoms of anxiety and depression were best understood in the context of her having complex trauma. People with complex trauma are more vulnerable to develop Posttraumatic Stress Disorder, which in my opinion is Mrs Alicier’s primary diagnosis.”
Dr Tat then described the functional impact of Mrs Alicier’s condition on various activities. She concluded that “[i]n my opinion Mrs Alicier’s clinical presentation is consistent with a severe impairment” and that, having treated her since 14 March 2014, she would have been of the same view on 14 August 2014. She said further that “I would be inclined to say that her condition of [PTSD] is chronic and likely to continue for the next 5 years” and that her “current level of severe mental illness would be a barrier for her to engage in any kind of work in the next five years”.
Dr Sandra Armstrong, previously a medical practitioner of lengthy experience and now a medical adviser in the Health Professional Advisory Unit of the Department of Human Services, prepared a report dated 8 December 2015 for the purpose of this proceeding, based upon her review of various materials including medical reports. Dr Armstrong opined in substance that Mrs Alicier’s craniopharyngioma was “permanent” for the purposes of the Determination. In her opinion, an impairment rating of 5 points (mild functional impact) was warranted in respect of Mrs Alicier’s visual function (under Table 12). Dr Armstrong concluded, despite having noted discrepancies, that an impairment rating of 10 points (moderate functional impact) was warranted in respect of Mrs Alicier’s functional impairment related to neurological or cognitive function (Table 7). She concluded, despite noting difficulties in determining the relative impact of Mrs Alicier’s cognitive impairment compared with the impact of her mental health conditions, that the latter conditions were fully stabilised and warranted an impairment rating of 10 points (moderate functional impact) in respect of functional impairment due to Mrs Alicier’s mental health conditions (Table 5); she concluded that an impairment rating of 20 points could not be assigned as most of the descriptors were not met, although she considered that the descriptors in paragraph (c) (interpersonal relationships) and paragraph (f) (work/training capacity) “may be met at a severe impairment level”.
Dr Jaisian Teh, an intern of Austin Health’s neurosurgery clinic, prepared a report dated 8 February 2016 concerning his review of Mrs Alicier conducted that day with Professor Fabinyi. He stated that “[o]n review today her MRI brain from 3 December 2015 [sic], was stable with no evidence of disease recurrence”. He noted that Mrs Alicier “reported some ongoing headaches and diplopia”. He reported that “[o]n examination today, there was no sign of acute change in her visual acuity” and concluded that she would be reviewed in one year’s time “with repeat MRI brain”.
I turn now to the oral evidence before the Tribunal. At the hearing, Mrs Alicier gave evidence with the assistance of an interpreter. Mrs Alicier described a difficult childhood; she said that her father was “very tough” and had beaten her, so she married “to get away from her family”.
Mrs Alicier gave evidence that she came to Australia in 2007, with her then husband, but without her three children; she had sought a visa for her then youngest child (a son), but the child’s father had refused at that stage to sign the application, although he later did so. Mrs Alicier said that she was first referred to Ms Ozturk because she was distressed that her youngest child was not with her. Under cross-examination, Mrs Alicier said that he came to Australia in 2009 when he was 11 and that she lived alone with him until her daughter came and joined her on a carer’s visa. She acknowledged that her son was a very difficult child but that she nevertheless cared for him, in that “I helped him to survive”. She said that fourth child, also a son, was born in 2013 and that her now ex-husband helped her in caring for him. It was apparent from Mrs Alicier’s evidence that her third son was in Australia periodically during 2013 to 2014, although that part of her evidence under cross-examination was somewhat unclear.
Mrs Alicier said that she attended the review appointments following the insertion of a shunt by ambulance, because she could not drive and could not use public transport either. She said that she was forgetful at that time. Having separated from her husband, she would ask for help from her son, neighbours and social workers.
Mrs Alicier said that that she had decided against having the shunt removed upon hearing of the possible risks from Professor Fabinyi, his assistance and a radiotherapist at the Alfred Hospital, because he latter had advised that she should not do so and she was scared of the risks, which she understood to be the possibility of blindness or a stroke.
Mrs Alicier said that she had sought a carer visa for her daughter in 2012 because “[m]y life became very difficult and [I was] all alone in the house … I needed somebody to be with me to help me”.
Mrs Alicier recounted that, as she had told a job capacity assessor in 2009, she had left her stove on for two days, as she had believed she had turned it off but must have merely reduced the heat. She said that she now makes sure that she stays in the kitchen until her cooking is finished as she cannot see whether the flame is on or not, and that “I’ve burnt my hand many times” and that she had burned newspapers or towels on occasion “because I didn’t realise what I was doing”. She said she puts her hand over the flame to feel the heat and that she often eats “breakfast things” instead of cooking. She said that she usually cooks twice a week, sometimes three times. She said that she sometimes ask a neighbour to help her while she cooks as she “can’t see to mix the food” and the neighbour helps to put it in the oven.
She said that it is impossible for her to read cooking instructions and that sometimes she takes a picture of it to increase the size of the font. She said that she tends to use taste and touch when handling food. She also said that, to fill a tea cup, she uses her finger to gauge when the hot water is reaching the top.
Mrs Alicier said that, in 2014 and as at the date of the hearing, she needed help getting into the bath or shower and that she does not shower as often as possible because “I get very dizzy and … I fall a lot because I’m always hitting my head everywhere”. She said that she has “difficulty seeing” and that “also my concentration is not there”.
Mrs Alicier said that she cannot use stairs, as she cannot see them clearly and that she will instead use elevators if available. She said that does not take public transport because she becomes dizzy and nauseous. Mrs Alicier said that her ex-husband had accompanied her to the hearing room for the hearing. She said that the council provides a fortnightly cleaning service for her.
Mrs Alicier said that she asks for assistance when looking for items in the supermarket. She said that she does not go shopping on her own, as “it’s dangerous” and “I’m very forgetful too”; she does not carry a purse because she tends to lose it and would need the cashier to count the money for her. She said that “I don’t go to my son very often”; rather, he “might drop in every now and then to see if I need anything … so if I need shopping things I’ll tell him”. However, under cross-examination, Mrs Alicier acknowledged that she can go shopping by herself, although it is difficult. She said that if it’s just … milk or a few things I can manage”. She said that her ex-husband encourages her to “do things on her own”. Mrs Alicier also acknowledged under cross-examination that she is able to drive herself to the supermarket but said “I don’t unless I really have to, like milk for the baby or something and I can’t find somebody at that moment, because it’s only two minutes away”.
Mrs Alicier said that she no longer listens to music, as “I just don’t want any noise” and “[i]t doesn’t relax me anymore”… [it] feels like I’m cornered, like I’m suffocating” and that “I don’t enjoy it like I used to”. She said that “to do something on my own is not very wise to do or healthy” because her “forgetfulness is really high”.
Under cross-examination, Mrs Alicier denied exaggerating her symptoms to Dr Tat. Further, she denied that she “didn’t try [her] best” in completing the tests undertaken by Ms Carey.
Dr Tat gave oral evidence by telephone. She said that she is a clinical psychologist and clinical neuropsychologist, although she did not currently practise as a neuropsychologist. She said that she had previously engaged in some child neuropsychology after completion of her studies, in the field of learning difficulties.
Dr Tat said that she had concluded in her report that Mrs Alicier’s condition of post‑traumatic stress disorder, as diagnosed by her, was chronic because her “treatment has been low but there is difficulty in engaging with her, I feel, and I think that it’s going to be a … slower process for her to learn to trust … somebody like myself to be able to work with her”. When asked about the statement in Professor Fabinyi’s report of 19 November 2012 that Mrs Alicier’s anxiety “is not all that easy to treat”, Dr Tat said “I found treating her difficult as well” and that “I did not really get a sense of how deep her issues were until probably … early 2015” and that “even up to the point of a few weeks ago there was still bits to her story she hasn’t revealed yet – some traumatic parts”. She said that Mrs Alicier had first revealed the extent of her childhood trauma in May 2014.

Dr Tat said that Mrs Alicier had presented with high levels of anxiety on occasion, but not to the point that she was unable to function; she pointed out that the clinic where she held her sessions with Mrs Alicier was the same one where she attends her general practitioner and was therefore familiar to her. However, shortly after that Dr Tat agreed that she had observed occasions where Mrs Alicier was overly anxious and could not concentrate on what Dr Tat was saying she explained that “it’s not every single session, but it just depends what is happening in her life”.
With respect to Mrs Alicier’s social life, Dr Tat commented that “I’ve never, ever heard her mention a best friend’s name … She is quite isolated. … There nothing that – a remotely pleasant activity. It’s always basically at home …”.
Dr Tat said that Mrs Alicier “is kind of easily distracted when I’ll be talking about something.” She said that when Mrs Alicier’s toddler attends her sessions, she “can’t divide her attention” between the child (being “quite behaviourly difficult”) and what Dr Tat is saying to her. She said further that “”[s]he can be quite passive aggressive with me””, for example after she was absent from her practice, and that “trying to get to really know her has been very difficult”.
Under cross-examination, Dr Tat acknowledged that a person who did not suffer from PTSD could be distracted by a disruptive toddler. She accepted that she had not performed any neurological assessment of Mrs Alicier and that she assessed her only by her self-reported PTSD questionnaires.
When asked under cross-examination whether she accepted that a person who is able to deal with email, liaise with Centrelink without the use of a nominee and file application documents could not be said to have a severe difficulty with planning, Dr Tat pointed out that that was explicable in Mrs Alicier’s case in the context that “she’s probably controlling her environment at home”. Dr Tat said further that she had considered referring Mrs Alicier to a psychiatrist and had considered medication.
When asked under cross-examination whether she accepted that she was “advocating for M[rs] Alicier’s social security rights, Dr Tat replied “I do accept that as a treating professional, that’s what we do … [w]e advocate for our clients”.
In re-examination, Dr Tat said she did not believe that Mrs Alicier had shown signs of malingering in their sessions, saying she “does put in her best effort”.
In answer to a question asked by the Tribunal during her re-examination as to statement concerning her advocacy for Mrs Alicier, Dr Tat said that “I’m not advocating for the claim” but rather meant that she was assisting Mrs Alicier with the processes, “especially because of her limited English” and “providing the treatment report”.
When asked by the Tribunal why she did not read the Tribunal’s Guideline for “Persons Giving Expert and Opinion Evidence” issued by the President of the Tribunal and dated 30 June 2015 before preparing her report, Dr Tat said that “it’s possible it was an oversight on my behalf” as she was recovering from surgery at the time.
Dr Armstrong also gave oral evidence by telephone at the hearing. She said that her report was not based upon any examination of the applicant she had conducted; rather it concerned her opinion about the medical reports she had reviewed.
Dr Armstrong explained that the term “visuospatial functioning” as used in table 7 of the Impairment Tables concerned a person’s “ability to perceive objects and determine the special relationship between them”, such as that used in trying to catch a ball. The term “visual acuity”, as used in certain reports, she explained to mean “how clear your vision is, whether with or without glasses and it is how sharp the detail is that you can see in things”, which is typically tested by having a person read a board with letters on it to determine the size they can see at a set distance.
Dr Armstrong opined that a person’s ability to drive is affected by impairments to both visuospatial function and visual acuity, “but certainly … visuospatial impairment causes significant problems”. She said that difficulty in telling whether pots and pans were clean would be due to an impairment in visual acuity, rather than visuospatial impairment as would being able to tell whether a gas stove was on or off.
Dr Armstrong said that she had assessed a moderate level of impairment with respect to descriptor A (concerning self-care and independent living) in Table 5 rather than severe impairment because Mrs Alicier lived alone at times and the reports indicated that she was able to care for herself and her young child. She said that she thought that Dr Tat reported that “her self-care was usually good and that … she’s previously been able to perform other activities of daily living”. She had concluded that the descriptor in paragraph (c) (concerning interpersonal relationships) might be met on the basis of severe impairment based upon Dr Tat’s statement that Mrs Alicier has relationship difficulties with her family, although it was difficult to determine on the available information and she could not be certain.
Dr Armstrong concluded that the descriptor in paragraph (f) (concerning work/training capacity) was met at the level of severe impairment based upon the “definition of being able to work 15 hours a week or more”.
Under cross-examination, Dr Armstrong confirmed that she was qualified as a general practitioner. She said that although she was aware of reports prepared after that of Dr Mirmilstein which indicated that Mrs Alicier’s visual acuity was much reduced, she recalled that no local ophthalmic cause was given. She said, with regard to Mrs Alicier’s evidence concerning the visual difficulties she experienced that corroborative evidence would be required for her to change her view that the impairment rating should be more than five points.
Dr Armstrong accepted under cross-examination that factors such as concentration, memory, problem-solving and planning can be impaired by a mental health condition.
CONSIDERATION
I turn now to the question of whether I am satisfied that Mrs Alicier’s impairment is a “severe impairment” for the purposes of s 1218AAA(1)(b). As I have indicated, it did not appear to be in dispute that her impairment is of 20 points or more under the Impairment Tables (so that she remains qualified for DSP); the essential issue is whether her impairment is of 20 points of more under a single Impairment Table, relevantly Table 7 (Brain Function), Table 12 (Visual Function) (both being impairments resulting from Mrs Alicier’s craniopharyngioma) and Table 5 (Mental Health Function).
Visual Function (Table 12)
Mrs Alicier submitted that an impairment rating of 20 points ought to be given under Table 12 in respect of the functional impairment of her vision resulting from her craniopharyngioma. In that regard, she relied particularly upon the findings of the MRT made in 2014 to which I have referred, the report of Dr Tutton dated 22 May 2012 (in which he opined that an impairment rating of 30 points (for extreme functional impact) was warranted under Table 12. Furthermore, she referred to what was apparently the report of Dr Jamieson, ophthalmology registrar, dated 18 June 2015.
Mrs Alicier relied particularly upon her evidence given at the hearing, including her demonstrations of visual function as demonstrated at the hearing. In that regard, it was submitted that the Tribunal should prefer Mrs Alicier’s evidence given at the hearing over Ms Carey’s conclusion that Mrs Alicier’s “visual acuity for fine visual stimuli was intact”. It is convenient to note at this point that in her Statement of Facts, Issues and Contentions, Mrs Alicier relied on Ms Carey’s conclusion that her “visuospatial reasoning was severely reduced”, albeit in the context of her submission that an impairment rating of 20 points was warranted under Table 7 (in respect of her brain function: see the descriptor in paragraph (g)).
I note that in her written submissions lodged after the hearing, Mrs Alicier appeared to submit, albeit in the context of criticising Dr Armstrong’s report, that for the purposes of Table 12 corroborative evidence was only required with respect to the diagnosis of the condition causing visual impairment and that it was not necessary for there also to be corroborative evidence with respect to whether the descriptors in the table were met, albeit it was submitted that Dr Tutton’s report satisfied that requirement in any event. Mrs Alicier submitted that the Tribunal could rely upon Mrs Alicier’s demonstrations of her visual ability given during her oral evidence, relying upon s 7(2) of the Determination, which, as indicated above, provides that “[a] person may be asked to demonstrate abilities described in the Tables”.
The respondent submitted that it was open to the Tribunal to find that Mrs Alicier’s craniopharyngioma was not “permanent” for the purposes the Determination so that no impairment rating could be assigned, on the basis that Mrs Alicier’s shunt, on the basis of some medical reports, might yet be removed. Alternatively, the respondent submitted that an impairment rating of 5 points was warranted under Table 12.
It is clear from s 8(1) of the Determination (as reflected in the prefatory words of Table 12 in the particular context of visual impairment) that corroborating evidence is required not only in respect of the diagnosis of relevant conditions but also in respect of a claimant’s reported symptoms in relation to their condition; the Tribunal cannot properly accept Mrs Alicier’s oral evidence given at the hearing as to her degree of impairment in the absence of corroborative evidence having sufficient probative value. Moreover, her demonstrations given in the course of her oral evidence cannot properly be accepted as establishing her degree of impairment to the Tribunal’s satisfaction; s 7(1) of the Determination confirms the probative significance of corroborating evidence and indeed requires that the Tribunal take it into account as indicated.
Based upon the evidence before the Tribunal, I am satisfied that Mrs Alicier’s craniopharyngioma is permanent for the purposes of s 6(3)(a) of the Determination, given the report of Professor Fabinyi dated 19 November 2012 and that of Dr Carney dated 15 April 2013, both of whom saw no reason to remove the shunt, which I have preferred over the opinion of Dr Perera, which appeared somewhat equivocal (as indicated in his reports of 16 April 2012 and 23 April 2012. I am also satisfied that Mrs Alicier’s impairment to her visual function satisfies s 6(3)(b) of the Determination, so that an impairment rating can be assigned.
However, I am not satisfied, based upon the evidence before the Tribunal, that an impairment rating of 20 points is warranted under Table 12. In that regard, I do not consider that there is sufficiently probative medical evidence to justify such a conclusion.
I give little weight to the report of Dr Tutton. It lacks probative value given the date at which it was prepared and the paucity of explanation for his conclusion that an impairment rating of 30 points is warranted, despite that signifying an “extreme functional impact”. I prefer the evidence of the more appropriately qualified specialists to his report. Moreover, his conclusion that Mrs Alicier needs assistance to move around even in familiar environments stands at odds with the other evidence before the Tribunal. His conclusion that her “visual impairment is “not improved by visual aids” gives rise to a doubt as to whether he undertook a comparative assessment of the descriptors for 20 points and 10 points, given that the descriptor in paragraph (b) for each of those two ratings states “needs to use vision aids or assistive devices other than spectacles and contact lenses for some tasks”.
Furthermore, the Tribunal is not bound by the findings of the MRT concerning Mrs Alicier’s degree of impairment, which were made in a different legislative context and which, I note, appear to have been based largely upon the oral evidence given at that hearing. The Tribunal is required to make its own findings of fact based upon the evidence before it and, moreover, is required to apply the relevant provisions of the Determination and the Impairment Tables.
The descriptors relating to an impairment rating of 20 points under Table 12 are conjunctive. I am not satisfied, based on the evidence before the Tribunal, that the descriptor in paragraph (b) is met, given the lack of corroborating medical evidence in that regard; Mrs Alicier’s oral evidence that she sometimes uses her phone to assist her in that regard is not sufficient in that regard. The report of Dr Tutton is not sufficiently reliable so as to justify such a finding.
Based upon the evidence before the Tribunal, particularly the measurements of Mrs Alicier’s vision recorded in the reports of Professor Fabinyi dated 19 November 2012, Dr Russell’s report 3 December 2013 and Dr Jamieson’s report of 18 June 2015, I am satisfied that an impairment rating of 5 points is warranted, as Mrs Alicier has functional vision in only one eye. While Dr Jamieson’s report would support a conclusion that the descriptor in paragraph (d)(iii) for 10 points is met, in that Mrs Alicier also has mild problems with the vision in her functioning eye, the descriptors for 10 points, like those for 20 points, are conjunctive, so that only 5 points may be allocated based upon the evidence before the Tribunal given the descriptor in paragraph (b). In any event, based upon the evidence before the Tribunal, I am not satisfied that an impairment rating of 20 points can be given under Table 12; as will be apparent, that conclusion would not have been different if I have confined consideration to an assessment of Mrs Alicier’s condition as at the time she sought an unlimited portability period.
Brain Function (Table 7)
Mrs Alicier submitted that an impairment rating of 20 points should be assigned under Table 7, that is to say that her craniopharyngioma results in severe functional impairment related to her neurological or cognitive function (see prefatory words of Table 7). In particular, she submitted that she needs frequent (at least once a day) assistance and supervision and that she has severe difficulties in visuo-spatial function (the descriptor in paragraph (g)), relying in that regard upon the report of Ms Carey dated 10 June 2014 and also on the report of Dr Tutton. Furthermore, she relied upon the reports of her treating psychologists, Ms Ozturk and Dr Tat with regard to her ongoing difficulties with activities of daily living.
Mrs Alicier criticised aspects of the evidence of Dr Armstrong, relying in that regard upon observations made by the Tribunal in Ljubovic and Secretary, Department of Social Services [2015] AATA 1025 about a report prepared by a clinical psychologist in the Health Professional Advisory Unit.
I note that there was some uncertainty given the evidence before the Tribunal as to whether Mrs Alicier’s functional impairment with respect to matters addressed in the descriptors in Table 7 (such as memory, concentration, problem solving and the like) was attributable to her craniopharyngioma or instead her mental health condition (governed by Table 5) or other factors. I note Ms Carey’s conclusion that “[t]he aetiology of [Mrs] Alicier’s current neuropsychological performances is likely to be multifactorial in nature”, so that “[p]ersonality factors, too, are likely to have contributed to some of the early withdrawal of effort noted”. For the avoidance of doubt, I have considered the evidence according to its evidentiary value most favourable to Mrs Alicier under both Table 7 and Table 5, in order to determine whether I am satisfied that an impairment rating of 20 points can properly be assigned under either Table. As stated above, I am satisfied that Mrs Alicier’s craniopharyngioma is permanent for the purposes of s 6(3)(a) of the Determination; furthermore, I am satisfied that the impairment related to neurological or cognitive function for the purposes of Table 7 resulting from that condition satisfies s 6(3)(b), so that an impairment rating can be assigned under that Table.
As stated above, Mrs Alicier relied upon the report of Ms Carey dated 10 June 2014 in support of her contention that the descriptor in paragraph (g) was satisfied, so as to warrant an impairment rating of 20 points under Table 7, that is to say that she has severe difficulties in her visuo-spatial function. However, as the respondent submitted, that conclusion must be read in the wider context of Ms Carey’s other conclusions, particularly that the neuropsychological findings she made were inconsistent. She stated that she was therefore not able to reach a definitive conclusion as to Mrs Alicier’s cognitive impairment. Furthermore, as confirmed by her subsequent letter to Mrs Alicier, it is apparent that she considered that some of the results did not reflect Mrs Alicier’s true abilities. I am therefore not satisfied that that descriptor is met, whether on the basis of this evidence or on the basis of the other medical evidence before the Tribunal, including Dr Tutton’s report, for the reasons stated above.
In any event, even if it were met, I am not satisfied based upon the evidence before the Tribunal that Mrs Alicier needs “frequent (at least once a day) assistance and supervision” as required for the assignment of 20 points under Table 7. Although Mrs Alicier relied upon the report of Dr Tat in that regard, I give little weight to that report for any purpose, for various reasons. In the immediate context, I note, as submitted by the respondent, that Dr Tat failed to consider whether difficulties encountered by Mrs Alicier might be attributable to cognitive impairment resulting from her craniopharyngioma (to which Table 7 might apply), rather than resulting from her mental health condition. I consider that Dr Tat’s diagnosis of PTSD lacked rigour, being overly based on self-reporting by Mrs Alicier. Furthermore, her failure to comply with the Guideline lessens the weight I am prepared to give to her evidence, in view of her oral evidence that she sees herself as an advocate for her patients; I do not accept her subsequent evidence by which she sought to ameliorate that evidence. In my view her evidence does not provide “impartial assistance” of the kind contemplated by the Guideline (see para 3.1, which is set out below).
Nor am I prepared to find that Mrs Alicier requires frequent assistance and supervision on the basis of Ms Ozturk’s letter of 11 April 2012; leaving aside its date, it was written in the context of supporting the carer visa application of Mrs Alicier’s daughter.
There is a lack of corroborating evidence of sufficient probative value by which I could be satisfied that Mrs Alicier needs frequent assistance and supervision. Further, the evidence before the Tribunal establishes that she has lived alone and cared for her son and cares for her toddler. Given s 6(1) of the Determination, Mrs Alicier’s submission that she has cared for her son and cares for her toddler out of necessity does not alter the conclusion that that descriptor for 20 points under Table 7 is not met, based upon the evidence before the Tribunal. Nor am I satisfied that that descriptor, or the descriptor in paragraph (g) (concerning visuo-spatial function) were met at the time Mrs Alicier sought an unlimited portability period. I consider that, taken at its highest and leaving aside the uncertainties raised by Ms Carey, the evidence before the Tribunal warrants an impairment rating of 10 points under Table 7, which I note is the opinion of Dr Armstrong.
It is convenient at this point to address Mrs Alicier’s criticism of Dr Armstrong’s evidence, although it is interesting to note that Mrs Alicier nevertheless relied upon favourable aspects of Dr Armstrong’s report, particularly with regard to the assignment of an impairment rating under Table 5. In that regard, Mrs Alicier, while seeking to rely upon the Tribunal’s decision in Ljubovic, did not go so far as to adopt its reasoning. As the respondent submitted, the Tribunal’s reasoning in Ljubovic is liable to criticism, particularly the conclusion that the report prepared by the clinical psychologist in question was not “evidence” (at [22]). That conclusion appears to have been predicated on the fact that the psychologist in question, like Dr Armstrong, is an employee in the Department’s Health Professional Advisory Unit.

If so, in my view that conclusion was misconceived. It is difficult to understand what might preclude such a report from being properly characterised as evidence. Read in context, perhaps what the Tribunal intended to say was that it did not consider that any weight should be given to that evidence, whether on the basis that the psychologist in question was not “independent” or on the basis of the nature of that evidence (see at [22]-[24]).
Even so, the fact that a witness is employed by a party, particularly a respondent, does not preclude the Tribunal from taking into account their evidence. The real issue is whether they have “special knowledge or experience in an area that assists the [Tribunal] to reach the correct or preferable decision” (see para 1.1 of the Guideline). As the Guideline states, compliance with the matters referred to in the Guideline “may be relevant to determining the weight that will be given to evidence from the person” (para 1.6).
In that regard, paragraph 3.1 of the Guideline provides that a person giving evidence based on his or her special knowledge or experience in an area “has an overriding duty to provide impartial assistance to the [Tribunal] on matters relevant to the person’s area of knowledge and experience” and “is not an advocate for a party to a proceeding”. Contrary to the reasoning in Ljubovic, those provisions cannot be taken to preclude a person with such knowledge or experience from giving evidence in the Tribunal merely because they are employed by a party or are otherwise not “independent”; rather, if they do give evidence, they, like any other person to whom the Guideline applies, must comply with those obligations. If they do not do so, or their evidence properly gives rise to an inference that they have not done so, then such failure will bear upon the weight that may properly be given to their evidence.
Indeed, it is specifically envisaged in the Guideline that a person to whom the Guideline applies and who gives evidence before the Tribunal may have “a pre-existing relationship with the party who has engaged them”, in which case they are required to disclose that fact (see paragraph 5.2).
The weight to be given to evidence given by a member of the Department’s Health Professional Advisory Unit will of course also depend on other matters, such as their qualifications, the relevance of their qualifications in the context of the matters addressed in their evidence and the rigour of their reasoning.
The probative value of such evidence may also be affected by its derivative nature. In her report, Dr Armstrong stated that:
“The aforementioned recommendations are based on [the] documents and reports referred to … I have not personally examined the client. I acknowledge that I have an overriding duty to provide impartial assistance to the Tribunal. No matters of significance have been withheld from the Tribunal.”
I am satisfied that Dr Armstrong complied with her duty as prescribed in paragraph 3.1 of the Guideline. What is of greater significance is the fact that, as stated by Dr Armstrong in her report and confirmed in her oral evidence, she did not examine Mrs Alicier. That is perhaps another basis upon which the Tribunal in Ljubovic might be said, reading para [22] in context, to have doubted the probative value of such reports prepared by members of the Department’s Unit. Such evidence involves an analysis of medical evidence; one might say that such evidence constitutes an opinion of other opinions.
The fact that such evidence is not based upon a clinical assessment of the claimant may well limit or lessen its probative value in any given case (see Tamua and Secretary, Department of Social Services [2016] AATA 757 at [74]); but that is not to say that such evidence cannot be of assistance to the Tribunal. Such evidence may well assist the Tribunal in its assessment of other evidence, despite its derivative nature, provided that the former complies with the matters referred to in the Guideline and the person who has prepared the report is appropriately qualified.
However, that does not obviate the need for the Tribunal to make its own assessment of the evidence the subject of reports prepared by members of the Department’s Health Professional Advisory Unit - if the Tribunal properly forms the view that medical evidence upon which the person has relied in the report lacks probative value or is otherwise deficient, such a report may be of little or limited assistance. Conversely, the Tribunal may prefer evidence the subject of such a report even if it was given little weight in the report. Every case will depend upon the nature of the evidence before the Tribunal, although the probative value of reports prepared by the Unit is necessarily affected to some degree by the lack of clinical assessment of the claimant in question.
In any event, my conclusions in this proceeding as to the appropriate impairment ratings under each of the relevant Tables have been reached based upon my assessment of the primary medical evidence before the Tribunal, so nothing turns on the issue I have just addressed.
Mental Health Function (Table 5)
Mrs Alicier submitted that her “mental health condition” resulted in severe functional impairment warranting an impairment rating of 20 points under Table 5 of the Impairment Tables; in particular, she submitted that she has severe difficulties with most of the matters the subject of the descriptors establishing severe functional impact under the Table, specifically the descriptors in paragraph (b) (social/recreational activities and travel), paragraph (c) (interpersonal relationships), paragraph (e) (behaviour, planning and decision-making) and paragraph (f) (work/training capacity). Mrs Alicier relied particularly on her evidence and that of Dr Tat.
I note that in her Statement of Facts, Issues and Contention she also submitted that the descriptor in paragraph (c) (concentration and task completion) was met for 20 points under Table 5. In her statement, she also relied upon Dr Armstrong’s statement in her report that the descriptors in paragraphs (c) and (f) “may be met at a severe impairment level”, although Dr Armstrong nevertheless concluded that an impairment rating of only 10 points was warranted under Table 5, given that in her opinion it could not be said that Mrs Alicier had severe difficulties with most of the matters warranting an impairment rating of 20 points.
Mrs Alicier also noted Professor Fabinyi’s reference to the difficulty in treating her anxiety and referred to reports from Ms Ozturk and Dr Saban concerning her treatment.
I am satisfied based on the evidence before Tribunal that Mrs Alicier’s mental health conditions, namely her anxiety and depression, are permanent for the purpose of s 6(3)(a) of the Determination and that s 6(3)(b) is also satisfied. Although Dr Tat’s diagnosed Mrs Alicier as suffering from PTSD, I am not satisfied that that is so given the unrigorous basis upon which that diagnosis was reached; in any event, the essential issue is her degree of impairment, irrespective of how one characterises her mental health conditions, although it might be inferred that Dr Tat’s conclusion that an impairment rating of 20 point is warranted under Table 5 is, at least to some extent, predicated on her diagnosis of PTSD.
In any event, whether or not that is so, for the reasons expressed above I give little weight to Dr Tat’s report; to the extent that Dr Armstrong relied upon that report in reaching her conclusions (such as in respect of the descriptor in paragraph (c), the probative value of her evidence in consonantly affected. I note that in her evidence Dr Armstrong indicated that she was somewhat uncertain about that conclusion. Furthermore, her conclusion about the descriptor in paragraph (f) involved an assumption as to the number of hours of work which does not reflect the words used in the table.
Given the deficiencies in Dr Tat’s evidence and the fact that Dr Armstrong did not examine Mrs Alicier, I am not satisfied that there is corroborating evidence of sufficient probative value (as required for the purposes of Table 5) establishing that an impairment rating of 20 points is warranted under Table 5. As the prefatory words of the Table state, her uncorroborated evidence cannot properly found a conclusion as to her degree of impairment. As might be apparent, I would have reached the same conclusion upon an assessment of Mrs Alicier’s condition as at the date she sought an unlimited portability period.
Having regard to the medical evidence before the Tribunal and Mrs Alicier’s evidence, I consider that an impairment rating of 10 points is warranted under Table 5, in that the evidence establishes that Mrs Alicier has moderate difficulties with most of the matters the subject of the enumerated descriptors. To the extent that the evidence might suggest that Mrs Alicier’s anxiety and depression have stabilised as episodic or fluctuating (such as Dr Tat’s statement in her support letter of 9 March 2015 that Mrs Alicier’s mood improves when she visits family in Turkey), the requirements of s 11(4) of the Determination do not alter the conclusion that an impairment rating of 10 points is warranted under Table 5.
CONCLUSION
For the reasons stated above, I am not satisfied that Mrs Alicier’s impairment is of 20 points or more under a single Impairment Table; accordingly, I am not satisfied that that her impairment is a severe impairment within the meaning of s 94(3B) of the Act as required by s 1218AAA(1)(b).
It is therefore unnecessary to consider whether paragraphs (c) and (d) of s 1218AAA(1) are satisfied. As the requirements of s 1218AAA(1) are conjunctive, in that all of the “qualifying circumstances” must exist in order for a written determination to be made that Mrs Alicier’s maximum portability period for DSP is an unlimited period, it follows that the decision under review must be affirmed. While the Tribunal has considerable sympathy for Mrs Alicier’s circumstances, that cannot affect its conclusion in this proceeding.

146.    I certify that the preceding 145 (one hundred and forty-five)

147.    paragraphs are a true copy of the reasons for the decision herein of:

148.    Deputy President F J Alpins

[sgd]....................................................
Associate
Dated 26 April 2017

Date of hearing

22 March 2016

Date final submissions received

23 May 2016

Representative for Applicant

Ms R Casamento, Victoria Legal Aid

Representative for Respondent

Mr J Lessing, Sparke Helmore

Division	GENERAL DIVISION
File Number	2015/1842
Re	Cansel Alicier
APPLICANT
And	Secretary, Department of Social Services
RESPONDENT

Tribunal	Deputy President F J Alpins
Date	26 April 2017
Place	Melbourne

Date of hearing	22 March 2016
Date final submissions received	23 May 2016
Representative for Applicant	Ms R Casamento, Victoria Legal Aid
Representative for Respondent	Mr J Lessing, Sparke Helmore