Aoun and Department of Family and Community Services

[2000] AATA 726

DECISION AND REASONS FOR DECISION [2000] AATA 726

ADMINISTRATIVE APPEALS TRIBUNAL      )

)          No N1999/1376

GENERAL ADMINISTRATIVE  DIVISION       )          
           Re      BALANDA AOUN  
  Applicant
           And    SECETARY, DEPARTMENT OF FAMILY AND COMMUNITY SERVICES           
  Respondent

DECISION

Tribunal       Dr J D Campbell     

Date21 August 2000

PlaceSydney

Decision      The decision under review is affirmed.   
  ………………………….
  Member
CATCHWORDS:  
Social Security – Disability Support Pension – Review – Cancellation – Assessment of Impairments

Social Security Act 1991 ss 94,100 and Schedule 1B

REASONS FOR DECISION

21 August 2000               Dr J D CAMPBELL, Member     

1. Mrs B Aoun ("the Applicant") in this matter seeks a review of the decision of the Social Security Appeals Tribunal dated 24 August 1999, which affirmed the decision of the Authorised Review Officer dated 14 May 1999.  This latter decision had affirmed an earlier decision of a delegate of the Secretary of the Department of Family and Community Services ("the Respondent") dated 7 September 1998 to cancel the Applicant's disability support pension.

2. A hearing was held before the Tribunal on 17 March 2000, in which the Tribunal was assisted by an interpreter fluent in the Arabic language.  The self represented Applicant presented oral evidence to the Tribunal.  The Respondent was represented by Ms Buckley, an advocate from the administrative law section of Centrelink.

3. The following material was placed in evidence before the Tribunal:
   Material prepared pursuant to Section 37 of the AdministrativeAppeals Tribunal  Act 1975 T1 – T43 pp1 –147
   Medical Report Dr Guirgis dated 22 November 1999    Exhibit A1     
   Vocational Assessment Report Timothy Cumberland dated 15 March 2000           Exhibit A2     
   Respondent's Statement of Facts and Contentions dated      25 February 2000          Exhibit R1           
   Computer Print Out re Activities of Applicant     Exhibit R2     

issues

1. Exhibit R1 conveniently sets out the relevant issues in this matter:

   (1) Whether the applicant, Mrs Aoun, has a physical, intellectual or psychiatric impairment and that impairment is 20 points or more under the impairment tables in schedule 1B of the Social Security Act 1991; and
   (2) if so, whether or not she has a continuing inability to work because of the impairment because –

   ·     the impairment of itself prevents her  from doing any work for at least 30 hours per week  at award wages within the next 2 years; and either

   ·     the impairment of itself is sufficient to prevent her from undertaking educational or vocational training or on the job training during the next 2 years; or

   ·     such training is unlikely (because of the impairment) to enable her to do any work for at least 30 yours per week at award wages within the next 2 years.

Legislation

1. The relevant legislation is the Social Security Act 1991 ("the Act") and in particular subsections 94 (1)-(5), 100(3) and the Schedule 1B Impairment Tables.
   Background

2. The Applicant was granted a disability support pension in 1993.  In July 1998 a medical review of the Applicant's impairments was commenced.  Following the review a decision was taken to cancel the Applicant's disability support pension in September 1998 as the total impairment rating was less than 20 points and she was considered fit for work (T19).  Following the provisions of further medical evidence a decision was taken by the Authorised Review Officer on 14 May 1999 to affirm the cancellation of the Applicant's disability support pension.  This decision was further affirmed by the Social Security Appeals Tribunal in a decision dated 24 August 1999.     
   Evidence – the Applicant

3. The Applicant informed the Tribunal that she was born on 22 May 1956 in North Lebanon, educated to year 11, left school at age 13 and undertook a dressmaking course for six months, prior to working for a tailor for two and a half years.  Married at 16 years, she has four children and she lives with three of them in a home they own.  She stated that she migrated to Australia in 1976 and worked for a year in a factory making garbage lid handles.  She told the Tribunal that her husband died in 1984, that she had not remarried and has not worked since then.  The Applicant indicated that she owns a car which she and a daughter drive.

4. In describing a normal day's activities to the Tribunal, the Applicant stated that she does the cooking, the washing and the shopping and shares the cleaning activities and the vacuuming. Each member of the household makes their own bed.  Often she sleeps during the day or visits a neighbour for a cup of coffee.  In 1999 she said that she, accompanied by her son, visited Lebanon, having previously been there in 1990.   

5. The Applicant described the following medical history of her medical conditions to the Tribunal:

   (a) Cervical Spine:              Car accident in 1983.  In hospital overnight.  Husband very ill at the time.  Experiences pain in neck posteriorly which radiates into the back of the head, giving her severe headaches.  There is no other pain radiation.  The pain is worse when she sits for a long time, and prior to sleeping and often is present on waking.  She is not a good sleeper, and uses panadeine for the headaches.  She is able to sit for one to one-and-a-half hours and can drive for a half to three-quarters of an hour.  She does not experience any trouble with cleaning, but her arms feel weak when lifting, and she experiences some difficulty with hanging out the washing and drying her hair.  She has not had any other accidents.

   (b) Lumbar back pain:       Experiences pain in the central aspect of her lower back when standing for fifteen to twenty minutes.  To relieve the pain, she will lie down, take some tablets and watch television.  There is no radiation of the pain, but she does experience difficulty in bending her knee, with climbing stairs and walking for greater than twenty to thirty minutes.  Relief for the back pain is obtained by bending forward.

   (c) Right ear:   Finds it difficult to hear.

6. In response to questions asked in cross-examination the Applicant stated that she had travelled by train for forty minutes in coming to the Tribunal; that she experiences neck ache as opposed to headache; and that she organises the payment of family bills.  The Applicant, while acknowledging that the death of her husband was a cause of great sadness to her and that she was treated by a psychologist until the early 1990s, stated that apart from feeling sad at times, she is coping well and does not believe she has any continuing mental health problems.  Similarly she stated that she has no gynaecological problems, but she does experience some pain intermittently in her right shoulder, particularly when she is tired.       
   Medical Evidence

7. In her medical history described in the medical review form dated 23 July 1998, the Applicant stated that she had difficulty while sitting for too long (sometimes), standing  (often), walking (all the time), and driving (often) and she only uses public transport sometimes.  Further she stated that she had difficulty with lifting, bending, carrying and operating appliances (all the time) and that she has some difficulty remembering, sleeping and caring for others (all the time)

8. In a treating doctor's report dated 22 July 1998, Dr Guirgis described the Applicants conditions and their associated clinical features as:

   "(a) Lumber spinal stenosis on top of chronic mechanical derangement caused by lumber discopathy.  Long term and fluctuating.
   (b) Chronic mechanical derangement of the neck caused by cervical discopathy and spondylois.  Long term and fluctuating.
   (c) Chronic epicondylitis of the right elbow and patello-femoral degenerative joint disease in both knees.  Long term and stable.
   (d) Chronic pain syndrome.  Long term and stable."

1. As a consequence of his examination, Dr Guirgis considered that the Applicant was not fit to return to any full time or part time work for more than two years.  Further the Applicant's impairment would affect her ability to work in that she would be unable to work full days because of endurance problems and would be unable to lift, carry or move objects (T16 pp 79/80).

2. In an examining medical officers report dated 31 August 1998, Dr Roberts made the following comments

   This 42 year old lady last worked 20 years ago in a factory; she stopped work after a few months for personal reasons.  She had previously worked as a dressmaker in Lebanon before she emigrated in 1976.  She is single and has 4 adult children,  She was granted DSP in 1993 because of multiple joint problems.
   She states that she still has neck and back pain and that this dates from a car accident in 1983.  She is no longer on any medication and had not had any active treatment for years.  She did see a specialist, Dr M Guirgis many years ago but did not require any surgery.  She states that she saw him recently and complained of left leg pain and that he told her there was no treatment for this.  She is able to care for herself and does all her own housework, cooking and shopping (her children are all employed) but that it takes her all day.  She is able to drive and occasionally she uses public transport.
   At examination she looked well and was in no distress.  She was an alert and cooperative historian who spoke excellent English.  Her gait and posture were normal and she sat comfortably during the interview and rose easily from her chair.  She refused to lie flat on her back and complained of severe pain when asked to bend forward, backward and sideways.  She was able to squat without difficulty but complained of severe back pain when asked to walk on her toes.
   She scores zero permanent impairment rating for her reported back, neck and right elbow pain (Tables 5.2, 5.1, and 3).  There are no temporary impairments.  The medical evidence provided today appears to have been largely obtained from old records rather than from a recently obtained history and physical examination as there are marked inconsistencies between the information provided by Dr Guirgis and that obtained from the customer at today's interview.  It is clear that there has been a remarkable improvement in her condition in the last few years as she is off all treatment and functioning well.  She is fid for a wide variety of unskilled to semiskilled jobs provided she lifts no more than 15kg weight.  There is no medical reason why she cannot retrain. (T18. p98)

3. In radiology reports dated 20 October and 7 October 1998, Dr Critoph, a consultant radiologist stated

   CT SCAN LOWER LUMBAR SPINE
   Angled slices and a vertical stack were performed through the lower 3 lumbar discs and photographed at bony and sort tissue windows.

   The spinal canal is fairly tight at the L4/5 disc level and there is hypertrophy of the lligamentum flavum.  I cannot see a definite posterior disc bulge however the extra dural fat is noted to be compressed and this is proberly the level causing symptoms.
   The appearances of the L3/4 and lumbosacral disc appear normal with plenty of extra dural fat and no definite disc bugles.  No extra spinal soft tissue abnormality is seen. 
   The facets appear normal.
   Impression: ligamentum flavum hypertrophy at the level of the L4/5 is associated with spinal canal diameters being at the lower limits of normal with compression of the extra dural fat.  (Image 6 with arrows). (T20 p106).

   CT CERVICAL SPINE
   A vertical stack of thin slices was performed from mid C3 to include the C7 disc and inclusive vertebra and photographed at bony and soft tissue windows.

   There is a small bony projection posteriorly from the posterior part C3 vertebral

   body however the intervertabral canal does not appear to be significantly

   narrowed by this and there are no visible posterior disc bugles.

   There is no visible intra spinal soft tissue abnormality and the other bony appearances are normal. (T21 p107)

4. In a further medical opinion dated 28 October 1998 Dr Habib as a consequence of his examination of the Applicant on 27 October 1998 made the following comments

   Impression/Opinion:
   Mrs Aoun suffers from degenerative spondylitis of the cervical and lumbar spine.  Clinically she has partial C5,C6 nerve root irritation (Nerve Conduction Studies of the upper extremities dated August 1993) and L5 neuropathy.
   Her condition has deteriorated over the years.
   Her condition is aggravated by the simple everyday activities that involve bending, lifting or maintaining a certain neck or back posture for any length of time.
    In my opinion Mrs Aoun is permanently unfit for work. (T22 p109)

5. As a consequence of a further examination of the Applicant on 23 October

1998, Dr Guirgis stated the following opinions and made the following assessment of the impairments.

OPINION:
The above clinical picture is consistent with the ongoing effects of post-traumatic mechanical derangement of the cervical & lumbar areas of the spine.  This was caused by musculo-ligamentous sprain|strain with initial mid-cervical and lower lumbar intervertebral disc involvement.  This had triggered the early onset of osteospondylosis & aggravated its effects.  This was particularly significant because of the presence of congenital canal stenosis in the lower lumbar area and the changes at the L4 – L5 added more to the compromise of the spinal canal.

On top of the underlying chronic physical problems the whole picture became complicated by the development of organic changes of chronic pain syndrome at the local level, at the involved spinal cord level and at the cerebral level.

I advised the patient to continue with conservative treatment. Surgical treatment will not dramatically alter the current clinical presentation due to the presence of chronic pain syndrome and should only be considered if there was evidence of progressive neurological deficits.
From the total impairment point of view according to Schedule 1B of the Impairment Schedule to Social Security Act 1991, I would estimate that the patient had total body impairment percentages as follows:

• Cervical spine (Table 5.1) 5%.  Loss of about quarter of normal range of movement.

• Lumbar spine (Table 5.2) 20%.  Loss of about half of normal range of movement.

• Sciatic pain occurring frequently: present some of the time when walking (Table 6) 5%.

• Chronic pain and dysfuntion in the arms (table 3) 5%.  Shoulder, elbow or wrist pain or limitation, as may be expected with epicondylitis or painful arc syndrome.

  The patient remains unfit to be involved in activities that would stress the spine or arms.  She is permanently unfit for work in her pre-injury duties as an unskilled process worker/labourer/machine operator as defined by the law.  The patient is unfit for rehabilitation or training for sedentary light work due to the development of the chronic pain invalid personality syndrome.
  (T23 pp111 – 112)

1. On 5 November 1998, Dr Roberts, the examining medical officer, consequent to a review of the further medical information provided by the Applicant, stated the following opinions:

   This 42 year old lady was examined on 31 August 1998 for review of her  DSP eligibility.  She was found to be fit for work, with nil impairment rating for various reported conditions.

   She has provided FME in the forms of reports form Dr M Guirgis and from her GP Dr Habib.  Both these doctors mention the customer's reported back and neck pain and Dr Guirgis has made inappropriate use of the (now obsolete) 1993 Whole Body Impairment tables.  I note that Dr Habib has stated that the Xrays and CT scans of the lumbar spine "are suggestive of L4-5 discopathy with degenerative changes".   

   It is interesting that the customer has finally had some new Xrays done; the medical evidence provided for all her previous examinations has been > 10 years old.  She is now 42 and such degenerative changes as have been described in the reports are to be expected at her age.  I have examined the customer on 2 separate occasions and have noted that her gait and mobility are quite normal on informal examination although she refuses to cooperate when she is asked to bend in any direction or to straight leg raise.  She does not have any clinical evidence of either cervical or lumbar nerve root irritation and in fact the reported nerve conduction studies do not correlate with reported symptoms.

   In summary this new medical evidence does not provided any information which would cause the original assessment to be altered in any way.  I suggest that if the customer wishes to pursue her DSP claim more energetically then she should be examined by an independent orthopaedic surgeon.  The file can then be reviewed in the light of the surgeon's report.
   (T25 pp114)

2. In his medical report dated 8 February 1999, Dr Silva, a consultant orthopaedic surgeon detailed the following findings at clinical examination, his impressions of the radiological findings and his diagnosis and opinion

   The cervical, dorsal and lumbar curves were normal and cervical spine mobility was full and there was no evidence of cervical radiculopathy in the upper limbs and there was no neck tenderness or neck muscle spasm.  She had some callosities and work staining in both hands.

   The lumbar curve was normal and there was no lumbar muscle spasm or tenderness and there was a large non-organic element during the examination of the lumbar spine.  On forward flexion as well as lateral flexion, her fingertips reached the knees with a complaint of back pain and extension was full and rotational movements were also full.  Straight leg raising was full in the seated position and she initially declined to lie down complaining of back pain but later agreed to lie down until I did the straight leg raising which was restrained to 70 degrees bilaterally.  There was no neurological deficit in the lower limbs and the lower limbs were essentially normal.

   The plain X-rays of the lumbar spine and the CT Scans of the lumbar spine of 2.10.98 failed to reveal any disc protrusion but there was some mild canal stenosis at L4/5 from ligamentum flavum hypertrophy.

   The cervical spine X-rays of 7.10.98 revealed anterior longitudinal ligament calcification at C6/C7 but the CT Scans of the cervical spine failed to reveal any disc protrusion.

   DIAGNOSIS AND OPINION: The car accident over 14 years ago probably caused myofascial spinal strain and that appears to have largely resolved.  There is no evidence of radiculopathy in the neck and back and going on the state of her hands she is probably capable of work with some restrictions on heavy lifting of over 10 – 15 kilograms and frequent bending.  She is unlikely to require surgery, continuing orthopaedic attention, physiotherapy, injections or further manipulation.  She told me that she has been a widow for over fourteen years and the only job she did were the duties of a factory hand in 1977 for less than one year.  As far as prognosis is concerned, she is likely to continue to complain of neck and back pain but there is no significant orthoaedic disability in those areas that would prevent her from returning to thirty hours or more of work with restrictions on heavy lifting and frequent bending. (T31 p128)

1. In a further medical report dated 22 November 1999, Dr Guirgis, as a result of the examination of the Applicant on 22 November 1999, stated the following opinions.

   The above clinical picture is consistent with chronic mechanical derangement of the cervical and lumbar areas of the spine caused by discopathic and spindylotic changes.  There were also symptoms of chronic pain/anxiety/depression.

   I advised the patient to continue with conservative treatment.  Surgical treatment will not dramatically alter the current clinical presentation due to the presence of chronic pain syndrome and should only be considered if there was evidence of progressive neurological deficits.

   From the total impairment point of view according to the Social Security Act 1991, and the Schedule 1B – TABLES FOR THE ASSESSMENT OF WORK-RELATED IMPAIRMENT FOR DISABILITY SUPPORT PENSION (1997) I would estimate that the patient had total body impairment percentages as follows:

   ·     Cervical spine functions (Table 5.1) 5%.  Loss of about one quarter of normal range of movement.

   ·     Lumbar spine function (Table 5.2) 10%.  Loss of one quarter of normal range of movement as well as back pain or referred pain: with any physical activities and with standing for about 30 minutes, and with sitting or driving for about 60-minutes.

   ·     Chronic pain (Table 20) 10%.  Mild to moderate symptoms, which are irritating or unpleasant but which rarely prevent completion of any activity.

   (Exhibit A1)

1. In a vocational assessment report dated 22 February 2000, Mr Cumberland, a vocational consultant, recommended that the Applicant undergo a full psychological  assessment to determine her suitability for work (Exhibit A2,p6)
   Submissions
   22.  The Applicant, in replying upon the medical reports of Dr Guirgis and Dr Haibib contends that she has particular impairments of cervical and lumbar spondylosis, with some partial C 5/6 nerve root irritation.  On proper assessment it is the Applicant's contention that these impairments have a total rating under the appropriate schedule 1B impairment tables of 20 points or more.  Further it is the Applicant's contention, and again relying upon the reports of Drs Guirgis and Habib, that she has a continuing inability to work and as such she meets all the qualifications necessary for the payment of a disability support pension.

1. The Respondent submits that the Applicant does have particular impairments but that on proper assessment under the Schedule 1B Impairment Tables, the total rating is much less than the 20 points required.  In making such a submission the Respondent relies upon the reports of the radiologist and the medical reports of Drs Roberts and Silva.

2. Further the Respondent contends that the Applicant's impairments place minimal restrictions on her ability to work and in relying upon the opinions of Drs Roberts and Silva, submits that the Applicant does not have a continuing inability to work and for these reasons the Applicant does not meet the requirements necessary for the payment of a disability support pension.

Considerations and Findings

1. The Tribunal notes subsection 100(3) of the Act, which nominates that the Tribunal shall focus its attention on the period of time commencing with the decision to cancel the Applicant's disability support pension and for a period of three months thereafter. Obviously the Tribunal will focus its prime attention on the material leading to the decision to cancel and material adduced during the three months thereafter ("operative period"). Material relating to events/opinions that fall outside the operative period may be used by the Tribunal in circumstances which permits the Tribunal to gain a greater understanding or a clearer appreciation of the actual impairments and their effect on an individuals ability to work that are found to exist during the operative period.

1. The Tribunal in considering this matter notes the following relevant legislation, namely subsections 94(1) (in part), (2)-(5):

   94 Qualification for disability support pension

   (1)A person is qualified for disability support pension if:

   (a)the person has physical, intellectual or psychiatric impairment and

   (b)the persons impairment is of 20 points or more under the Impairment Tables; and

   (c)one of the following applies

   (i)the person has a continuing inability to work;…

   94(2)    A person has a continuing inability to work because of an impairment if  the Secretary is satisfied that:

   (a)the impairment is of itself sufficient to prevent the person from doing any work within the next 2 years; and

   (b)either:

   (i)the impairment is of itself sufficient to prevent the person from undertaking educational or vocational training or on- the- job training during the next 2 years; or

   (ii)if the impairment does not prevent the person from undertaking educational or vocational training or on-the-job training -  such training is unlikely (because of the impairment) to enable the person to do any work within the next 2 years.

   94(3) In deciding whether or not a person has a continuing inability to work because of an impairment, the Secretary is not to have regard to:

   (a) the availability to the person of educational or vocational training or      on-the-job training, or
   (b) if subsection (4) does not apply to the person – the availability to the   person of work in the person's locally accessible labour market

   94(4) For the purpose of subparagraph (2)(b)(ii), if a person has turned 55, the Secretary may, in considering whether educational or vocational training is likely to enable the person to do work, have regard to the likely availability to the person of work in the person's locally accessible labour market.
   94(5) In this section
   educational or vocational training does not include a program designed specifically for people with physical, intellectual or psychological impairments.
   on-the-job training does not include a program designed specifically for people with physical, intellectual or psychiatric impairments
   work means work   

   (a)that is for at least 30 hours per week at award wages or above, and

   (b)that exists in Australia, even if not within the person's locally accessible labour market.

2. The Tribunal observes that the Applicant has had a long history of cervical and lumbar pain, which on her description has radiated to the back of her head (cervical pain), but never down her arms or legs.  The Applicant has described adequately to the Tribunal what she can and cannot do and what aggravates the pain in the neck and lower back.  The Tribunal found the Applicant to be a frank, intelligent and reliable witness.

3. In turning to the medical evidence provided in this matter, and while noting the divergence  of medical opinions, the Tribunal in relying upon the evidence of the Applicant, the radiological reports of Dr Critoph relating to the CT Scans of the lower lumber spine and the cervical spine, the two reports of Dr Roberts, the report of Dr Silva, the report of Dr Habib (in part), and in noting the various reports of Dr Guirgis, finds that the Applicant had the following impairments with associated clinical features and that these impairments caused particular limitations to the Applicant's ability to work:

(a)Cervical Spondylosis:               Pain in back of neck, radiating up into the back of the head.  Worse on sitting for a long time (greater then one and a half hours).  Some difficulty experienced in hanging out washing and drying her hair (Applicant).  Minor changes on CT Scan (Dr Critoph).  Normal or near normal range of movement of cervical spine (Drs Roberts, Silva). No cervical radiculopathy  (Drs Roberts, Silva).  No upper limb restrictions (Applicant, Drs Roberts and Silva). Requires a work environment in which she is able to change posture (Drs Roberts, Silva).

(b) Lumbar Spondylitis:                 Pain in lower back, no radiation and worse when standing for 15 to 20 minutes; difficulties when walking for greater than twenty minutes and when climbing stairs. Pain is relieved by bending forward (Applicant).  Minor changes on CT Scan (Dr Critoph).  Normal or near normal range of movement of thoraco lumbar spine (Drs Roberts, Silva).  Requires a work environment which does not require heavy lifting or repetitive bending and with the Applicant able to change her posture as required. (Dr Silva).

1. In making the above findings, the Tribunal must emphasise that the Tribunal had great difficulty in coming to an understanding of much of what was stated in Dr Guirgis' various reports.  Apart from all reports being short of the necessary clinical findings to support the opinions expressed, the Tribunal considered the first report to focus on  issues about which the Applicant was not then currently complaining and that conditions nominated did not have any supporting clinical evidence to demonstrate the presence of such conditions  (Treating doctors report of 22 July 1998).  The second report dated 23 October 1998, tends to confirm the Tribunal's concerns about the first report, as the report restricts its comments to issues surrounding the cervical and lumbar spines.  Nevertheless the issue of sciatic pain is nominated, and this appears inconsistent with the Applicant's account both to the Tribunal and other doctors at that time.  Further the Tribunal notes that the assessment is made using the old Schedule 1B Impairment Tables and that Dr Guirgis does not underpin his opinion with reasoning as to the Applicant's development of the "chronic pain invalid personality syndrome".  The Tribunal notes that in consultation by other doctors at that time, there is an absence of evidence which would support such a finding, in that the Applicant was not receiving treatment for her condition, nor was she actively seeking treatment for her pain and/or any other illness.  In his third report  (22 November 1999), Dr Guirgis does not provide any detailed examination findings which lead to his opinions, and in his assessment he would appear to be mixing percentages with points, but more importantly double counting on the issue of pain.  The Tribunal further notes that this report is well outside the operative period.

2. The Tribunal, in moving to an assessment of the Applicant's impairments, finds that the only significant and continuing feature in the Applicant's conditions is the issue of pain, aggravated by particular activities which have been already nominated.  The Tribunal finds that the Applicant has a nil points rating impairment under the table 5.1 of the Schedule 1B Impairments Tables as there is normal or nearly normal range of movement of the cervical spine.  Similarly and for the same reasons the Applicant has a nil points rating under table 5.2 for the lumbar spine.  In relation to the issue of pain in the cervical spine and lower back, the Tribunal concludes that the Applicant has a 10 point impairment rating under table 20, as in the Tribunal's opinion the pain symptoms are mild to moderate symptoms, which are irritating or unpleasant but which rarely prevent completion  of any activities.

3. As a consequence of the Tribunal's findings, the Applicant while satisfying section 94(1)(a) of the Act, fails to satisfy section 94(1)(b) of the Act, in that her impairments rating of 10 points does not satisfy the requirements.

4. The Tribunal, in order to ensure completeness of the review, moves to the issue of continuing inability to work.  It is the Tribunal's view that the evidence of the Applicant and the medical opinions of Drs Roberts and Silva clearly indicates that the Applicant's impairments do not prevent her from undertaking work of a nature which is consistent with the restrictions the Tribunal has found to exist on the Applicant's work ability (ability to move posture, no heavy lifting or carrying or repetitive bending).  The Tribunal notes the opinions of Drs Guirgis and Habib, but for the various reasons outlined earlier in the decision, is unable to place any particular reliance on such opinions, for the very reasons they lack sufficient clinical detail to support their opinion (Dr Habib) and/or appear inconsistent with their earlier reports and/or the Applicant's medical history and/or other medical reports undertaken at a similar period of time.

5. The Tribunal further finds that the Applicants impairments do not prevent her from undertaking any vocational or educational or on-the-job training programs for the very same reasons expressed in terms of the Applicant's ability to work.  The Tribunal, in giving consideration to the Vocational Assessment Report provided, found it of minimal assistance in determining the issues at hand.  Similarly the Tribunal concludes that the Applicants impairments, once the training has been undertaken, are most unlikely to prevent the Applicant from doing any work within the next two years.

6. In summary, the Tribunal finds that the Applicant did not qualify for disability support pension during the operative period, as she failed to satisfy subsections 94(1)(b) and (c) of the Act, with subsections 94(2)(a) and (b) also not being satisfied (ie the Applicant did not have a continuing ability to work). In essence the Tribunal finds that the Applicant failed to meet the necessary qualifications for disability support pension at the operative period and accordingly the decision to cancel the disability support pension was correct.
   Determination

7. The Tribunal determines that the decision under review be affirmed.

I certify that the 35 preceding paragraphs are a true copy of the reasons for the decision herein of DR JD CAMPBELL.

Signed:         .....................................................................................
  Associate

Date of Hearing  17 March 2000
Date of Decision  21 August 2000
Representative for the Applicant              Self Represented

Representative for the Respondent  Marina Buckley