Bennett and Secretary, Department of Social Services (Social services second review)
[2016] AATA 899
•14 November 2016
Bennett and Secretary, Department of Social Services (Social services second review) [2016] AATA 899 (14 November 2016)
Division
GENERAL DIVISION
File Number(s)
2015/5131
Re
Reabekkah Bennett
APPLICANT
And
Secretary, Department of Social Services
RESPONDENT
DECISION
Tribunal Deputy President Dr P McDermott RFD
Date 14 November 2016 Place Brisbane I set aside the decision under review and substitute it with a decision that the applicant was qualified for disability support pension on 19 March 2015.
.............................[sgd]...........................................
Deputy President Dr P McDermott RFD
CATCHWORDS
DISABILITY SUPPORT PENSION – cancellation – severe intellectual impairment – continuing inability to work – ability to work in the future but not within two years of cancellation – decision set aside and substituted
LEGISLATION
Social Security Act 1991 (Cth) s 94
CASES
Freeman v Respondent, Department of Social Services (1988) 15 ALD 671
Secretary, Department of Families, Housing, Community Services and Indigenous Affairs v Harris [2010] FCA 360
Crossland and Secretary, Department of Family and Community Services [2004] AATA 864SECONDARY MATERIALS
Social Security (Tables for the Assessment of Work-Related Impairment for Disability Support Pension) Determination 2011
REASONS FOR DECISION
Deputy President Dr P McDermott RFD
14 November 2016
INTRODUCTION
Ms Reabekkah Bennett (“the applicant”) seeks a review of a decision of the Social Services and Child Services Division of the Administrative Appeals Tribunal (“the SSCSD”) dated 9 September 2015, which affirmed the decision of the Department of Human Services (“the Department”) dated 19 March 2015 to cancel her disability support pension (“DSP”).
BACKGROUND
On 16 February 2011, the applicant began receiving DSP in respect of an intellectual impairment.[1]
[1] Exhibit A, T-Documents, T23 at p. 193.
On 12 December 2014, the applicant participated in a job capacity assessment. In their report dated 7 March 2015, the job capacity assessors (“JCA”) recommended that the applicant’s learning disability be assigned 10 points under Table 7. They also recommended that the applicant’s asthma be assigned 0 points under Table 1. They assessed the applicant as having a baseline work capacity of 8 to 14 hours per week with an increased capacity of 15 to 22 hours per week after two years with intervention.[2]
[2] Exhibit A, T-Documents, T15.
On 19 March 2015, the Department of Human Services (“the Department”) cancelled the applicant’s DSP because her impairment rating was assessed as being less than 20 points. The applicant sought a review of the Department’s decision.
On 18 May 2015, an authorised review officer (“ARO”) affirmed the decision under review.[3] The applicant sought a review of the ARO’s decision.
[3] Exhibit A, T-Documents, T16.
On 9 September 2015, the SSCSD affirmed the decision under review.[4] The SSCSD assigned the applicant an impairment rating of 20 points under Table 7 and 0 points under Table 1. The SSCSD found that the applicant was capable of working 15 hours per week within two years and consequently did not have a continuing inability to work.[5]
[4] Exhibit A, T-Documents, T2.
[5] Ibid.
On 25 September 2015, the applicant lodged an application for a review of the decision of the SSCSD with this Tribunal.[6]
[6] Exhibit A, T-Documents, T1.
FACTS
The applicant is 22 years old and resides with her parents and siblings.[7] The applicant has been diagnosed with Autistic Spectrum Disorder, Level 1, subtype Asperger’s syndrome.[8]
[7] Exhibit A, T-Documents, T1 at p. 1.
[8] Exhibit A, T-Documents, T18 at p. 161.
The applicant’s activities include attending Scouts with her brother once per week and playing soccer. She requires assistance from her mother to use a computer.
In 2014, the applicant completed a course to obtain a Childcare Certificate III. This course involved both theory and practical components. The applicant completed the practical component of 120 hours by attending a childcare centre three days per week. She was unable to complete the course on a full-time basis because of fatigue and the stresses of supervising children. Her tasks included supervising children, cleaning, reading and facilitating crafts.
CONTENTIONS
Applicant’s contentions
The applicant contends that she had an impairment at the date of cancellation of her DSP, namely Asperger’s syndrome, which was fully treated, diagnosed and stabilised. The applicant contends that the impairment attracts at least 20 points under Table 7 of the impairment tables. In making this submission the applicant relies upon the expert opinion of Dr Winnie Yu Pow Lau, Clinical Psychologist, in her report dated 19 August 2015.[9]
[9] Exhibit A, Supplementary T-Documents, ST1 at p. 3.
The applicant contends that she has a continuing inability to work or undertake a training activity for 15 hours or more per week during the next two years. The applicant relies upon the psychological report prepared by Mr Hugh Walker, Provisional Psychologist, and Dr Michelle Garnett, Clinical Psychologist, on 29 October 2015 who stated that the applicant’s occupational capacity was reduced due to her low adaptive functioning. They reported that the high social, occupational and sensory demands of employment lead to clinical anxiety, stress and exhaustion due to the condition.[10] The applicant also relies upon then opinion of Dr Lau in her letter dated 6 November 2015 that the applicant’s work capacity is 12 hours per week and that, because of the neurological basis of her condition, her work capacity is unlikely to change significantly in the next two years.[11]
[10] Exhibit A, Supplementary T-Documents, ST2 at p. 18.
[11] Exhibit C, Letter of Dr Winnie Yu Pow Lau dated 6 November 2015.
The applicant contends that a training activity is unlikely to enable her to do any work independently of a program of support within the next two years. In support of this contention the applicant relies upon the report of Mr Walker and Dr Garnett dated 29 October 2015 which provides that it is likely that she will require ongoing support to work given her low adaptive functioning skills even with reduced levels of stress and anxiety.[12]
[12] Exhibit A, Supplementary T-Documents, ST2 at p. 19.
Respondent’s contentions
The respondent concedes that the applicant suffered from a permanent intellectual impairment at the date her DSP was cancelled. The respondent concedes that the applicant’s Asperger’s syndrome should be assigned an impairment of 20 points under Table 7 of the Impairment Tables.
The respondent contends that the applicant’s asthma condition should be assigned 0 points under Table 1 of the Impairment Tables.
The respondent contends that the applicant does not have a continuing inability for work. In support of this contention the respondent relies upon the job capacity assessment dated 7 March 2015 which reported that the applicant had a capacity to work 15 to 22 hours per week within two years with intervention.[13]
[13] Exhibit A, T-Documents, T15 at pp. 149-150.
The respondent also referred to the opinion of Mr Walker and Dr Garnett in their report dated 29 October 2015 that they were reluctant to state that the applicant could never achieve a capacity to work 15 hours per week and that the applicant’s occupational capacity should be reviewed after 12 months of engagement in psychotherapy for stress and anxiety.[14]
[14] Exhibit A, Supplementary T-Documents, ST2 at pp. 18-19.
The respondent contends that the applicant can achieve a work capacity of 15 hours or more per week within two years if the recommendations, strategies and interventions identified by the JCA and the applicant’s treating practitioners are implemented. The respondent contends that an appropriate workplace environment would also enable the applicant to increase her work capacity.
LEGISLATIVE FRAMEWORK
Section 94 of the Social Security Act 1991 (Cth) (“the Act”) sets out the criteria necessary to qualify for DSP. Whether or not the applicant has satisfied the criteria is to be assessed at the date that the original decision was made to cancel her DSP, that being 19 March 2015.[15]
[15] See Freeman v Respondent, Department of Social Services (1988) 15 ALD 671 at 674.
The first criterion, set out under s 94(1)(a) of the Act, requires that the applicant has a physical, intellectual or psychiatric impairment.
The second criterion, set out under s 94(1)(b) of the Act, requires that the impairment be assigned an impairment rating of 20 points or more. This test is completed by reference to the Impairment Tables set out in Pt 3 of the Social Security (Tables for the Assessment of Work-Related Impairment for Disability Support Pension) Determination 2011 (“the Determination”).
Section 6(3) of the Determination provides that an impairment can only be assigned an impairment rating if the condition causing the impairment is permanent and the impairment is likely to persist for more than two years. Section 6(4) of the Determination provides that a condition is permanent if it is fully diagnosed, treated and stabilised, and is likely to persist for more than two years.
The third criterion, set out under s 94(1)(c)(i) of the Act, requires that the applicant have a continuing inability to work. Section 94(2) provides that a person has a continuing inability to work because of an impairment if:
(aa) in a case where the person's impairment is not a severe
impairment within the meaning of subsection (3B) or the person
is a reviewed 2008-2011 DSP starter who has had an
opportunity to participate in a program of support--the person
has actively participated in a program of support within the
meaning of subsection (3C), and the program of support was
wholly or partly funded by the Commonwealth; and
(a) in all cases--the impairment is of itself sufficient to prevent the
person from doing any work independently of a program of
support within the next 2 years; and
(b) in all cases--either:
(i) the impairment is of itself sufficient to prevent the person
from undertaking a training activity during the next 2 years;
or
(ii) if the impairment does not prevent the person from
undertaking a training activity--such activity is unlikely
(because of the impairment) to enable the person to do any
work independently of a program of support within the next
2 years.
I am not required to have regard to para (aa) if I am satisfied that the applicant has a severe impairment, in other words, a 20 point rating under a single Impairment Table.[16]
[16] See Social Security Act 1991 (Cth) s 94(3B).
Greenwood J in Secretary, Department of Families, Housing, Community Services and Indigenous Affairs v Harris [2010] FCA 360 explained at [13] that s 94(2) involves a staged enquiry of the applicant’s circumstances both at the date of the application (or in this instance, the date of cancellation) and in a forward-looking way over a period of two years.
The first stage requires consideration of whether the impairment is of itself sufficient to prevent the applicant from undertaking any work independently of support within the two years following the cancellation of the applicant’s DSP.
Section 94(5) provides that the reference to “any work” is work that is for at least 15 hours per week on wages that are at or above the relevant minimum wage and exists in Australia. It does not extend to work that is unlawful or contravenes workplace health and safety legislation.[17] Section 94(3)(b) provides that the availability of work in the applicant’s locally accessible labour market is to be disregarded in determining whether the applicant has a continuing inability to work.
[17] See Crossland and Secretary, Department of Family and Community Services [2004] AATA 864 at [34].
In Harris, Greenwood J at [29] interpreted the phrase “any work” in s 94(2)(a) of the Act as being qualified by reference to work which the particular applicant is capable of performing without the need for retraining by reason of their existing skills and experience.
Section 94(5) provides that the reference to a “program of support” means a program that is designed to assist persons to prepare for, find or maintain work, and is either funded by the Commonwealth, or is considered similar to a program that is designed to assist persons to prepare for, find or maintain work and that is funded by the Commonwealth.
Section 94(4) of the Act provides that the applicant is doing work “independently of a program of support” if the applicant is unlikely to need a program of support to do the work. Alternatively, the applicant is treated as doing work “independently of a program of support” if she is likely to need a program of support provided occasionally or that is not ongoing to do the work.
In Harris, Greenwood J summarised the appropriate test under s 94(2)(a) at [92] as:
Does the impairment of itself considered in isolation from other matters that may influence the person’s attitude to working (such as motivational matters and the like) have such an impact on the person’s capacity for work that it prevents him or her from doing at least 15 hours of work per week that exists anywhere in Australia for persons with such an impairment judged in a normal or open workplace in that part of the labour market relevant to the person’s skills and experience (recognising that such work includes less skilled or unskilled work with no regard to discretionary suitability on the part of the claimant), on wages that are at or above the relevant minimum wage, being work which the person is by reason of his or her existing work skills and experience capable of performing without retraining, independently of a relevant program of support designed to assist the person in preparing for, finding or maintaining such work.
The second stage requires consideration of whether the applicant’s impairment is, of itself, sufficient to prevent her from undertaking a training activity during a two year period from the date of cancellation. If the impairment does not prevent the applicant from undertaking a training activity, consideration must also be given to whether such an activity is unlikely (because of the impairment) to enable her to do any work independently of a support program within the relevant two year period.
Section 94(5) of the Act provides that the reference to a “training activity” means education, pre-vocational training, vocational training, vocational rehabilitation and/or work-related training. It is irrelevant whether or not the activity is designed specifically for people with impairments. Section 94(3)(a) of the Act provides that the availability of a training activity to the applicant is also irrelevant.
CONSIDERATION
Does the applicant have a physical, intellectual or psychiatric impairment?
I am satisfied that on the date of cancellation, 17 March 2015, the applicant had an intellectual impairment, namely Asperger’s syndrome, as well as a physical impairment, namely asthma, for the purposes of s 94(1)(a) of the Act.
Does the applicant’s impairment attract 20 points or more under the Impairment Tables?
Physical impairment
I am satisfied that the applicant’s physical impairment is permanent for the purposes of s 6(4) of the Determination and can be assigned an impairment rating under the Impairment Tables.
The relevant Impairment Table is Table 1, which is applicable where the person has a permanent condition resulting in functional impairment when performing activities requiring physical exertion or stamina.
The material before me indicates that there the applicant’s physical impairment has no functional impact on activities requiring physical exertion or stamina. Therefore, the physical impairment attracts 0 points under Table 1.
Intellectual impairment
I am satisfied that on the date of cancellation the applicant’s intellectual impairment was fully diagnosed and treated by an appropriately qualified medical practitioner for the purposes of s 6(5) of the Determination. There is a significant amount of corroborating evidence of the condition. On 18 February 2011, the applicant’s treating doctor, Dr B. Lee, completed a DSP medical report in which he diagnosed the applicant as having an intellectual impairment.[18] On 21 March 2011, Ms Charlette Yaako-Khanania, Registered Psychologist, diagnosed the applicant as, based on the WAS-IV, having a low average range general cognitive ability; a borderline ability to sustain attention, concentrate and exert mental control; and a low average range ability in processing simple or routine material without making errors.[19] On 27 April 2015, Dr Lau, Clinical Psychologist, reported that the applicant meets the diagnostic criteria for Autism Spectrum Disorder (ASD), Level 1, subtype Asperger’s syndrome.[20] This opinion was referred to in the report of Mr Hugh Walker, Provisional Psychologist, and Dr Michelle Garnett, Clinical Psychologist, dated 29 October 2015.[21]
[18] Exhibit A, T-Documents, T4.
[19] Exhibit A, T-Documents, T5 at p. 44.
[20] Exhibit A, Supplementary T-Documents, ST1 at p. 1.
[21] Exhibit A, Supplementary T-Documents, ST2.
I am satisfied that on the date of cancellation the applicant’s impairment was fully stabilised for the purposes of s 6(6) of the Determination. The applicant has undertaken reasonable treatment for the condition.
I am satisfied that the applicant’s impairment will persist for more than two years. Dr Lau reported on 6 November 2015 that Autism Spectrum Disorder is a lifelong developmental condition.[22]
[22] Exhibit C, Letter of Dr Winnie Yu Pow Lau dated 6 November 2015.
For the reasons set out above, I am satisfied that the applicant’s intellectual impairment is permanent for the purposes of s 6(4) of the Determination and can be assigned an impairment rating under the Impairment Tables.
The relevant Impairment Table is Table 7, which is applicable where the person has a permanent condition resulting in functional impairment related to neurological or cognitive function. Table 7 provides that a rating of 20 points will be assigned where:
(1) The person needs frequent (at least once a day) assistance and supervision and has severe difficulties in at least one of the following:
(a) memory;
Example 1: The person is unable to remember routines, regular tasks and instructions.
Example 2: The person has difficulty recalling events of the past few days.
Example 3: The person gets easily lost in unfamiliar places.
(b) attention and concentration;
Example 1: The person is unable to concentrate on any task, even a task that interests the person, for more than 10 minutes.
Example 2: The person is easily distracted from any task.
(c) problem solving;
Example: The person is unable to solve routine day to day problems (such as what to do if a household appliance breaks down) and needs regular assistance and advice.
(d) planning;
Example: The person is unable to plan and organise routine daily activities (such as an outing to the movies or a supermarket shopping trip).
(e) decision making;
Example: The person is unable to prioritise and make complex decisions and often displays poor judgement, resulting in negative outcomes for self or others.
(f) comprehension;
Example: The person is unable to understand basic instructions and needs regular prompts to complete tasks.
(g) visuo-spatial function;
Example: The person is unable to perform many visuo-spatial functions, such as reading maps, giving directions (including to the person’s house) or judging distance or depth (resulting in stumbling on steps or bumping into objects).
(h) behavioural regulation;
Example: The person is often (more than once a week) unable to control behaviour even in routine, day to day situations and may be verbally abusive to others or threaten physical aggression.
(j) self awareness.
Example: The person lacks awareness of own limitations, resulting in significant difficulties in social interactions or problems arising in day to day activities.
The applicant’s mother, Mrs Carmel Bennett, gave evidence detailing the frequent assistance and supervision she provides to the applicant. The applicant’s mother stated that the applicant has anxiety and is unable to use public transport or go shopping without assistance. She stated that the applicant had difficulty recalling recent events, was easily distracted, and required regular prompts to complete tasks. This evidence was corroborated by the report of Dr Lau dated 19 August 2015, which provides:[23]
…Reabekkah has difficulties with short-term memory, planning, taking the initiative, and prioritising impedes on her adaptive functioning. She has high levels of anxiety and does not cope with changes in her daily routine. She will require frequent assistance, i.e. more than once a day, to meet the basic demands of her daily living.
[23] Exhibit A, Supplementary T-Documents, ST1 at p. 2.
Dr Lau also gave evidence at the hearing that the applicant has severe difficulties with memory, problem solving and behavioural regulation.
In their report dated 29 October 2015, Mr Walker and Dr Garnett opined that the applicant “almost always” requires “a degree of support, prompting or reassurance” because of her “relative difficulty with working memory as well as identified difficulties with communication, organisation, planning, sensory sensitivities, coping with change, social demands, and clinically significant anxiety and stress”.[24]
[24] Exhibit A, Supplementary T-Documents, ST2 at p. 18.
Based on the evidence above, I am satisfied that the applicant requires at least daily assistance and supervision and has severe difficulties with memory. Therefore, I consider it appropriate to assign an impairment rating of 20 points to the applicant’s condition under Table 7.
Does the applicant have a continuing inability to work?
I am satisfied that the applicant’s impairment is a severe impairment within the meaning of s 94(3B) of the Act, namely, that the applicant’s impairment is of 20 points under a single Impairment Table. Therefore, I am not required to consider s 94(2)(aa) of the Act.
I am required to consider whether the impairment is of itself sufficient to prevent the applicant from undertaking any work independently of a program of support within the two years following the cancellation of the applicant’s DSP. The reference to “any work” is work that is for at least 15 hours per week on wages that are at or above the relevant minimum wage and exists in Australia.[25]
[25] Social Security Act 1991 (Cth) s 94(5).
The applicant gave evidence she participated in the child care course for three to three and a half hours per day on three days per week. She stated that when completing the practical component course “I would keep getting sick and getting cramps and stuff. I was tired all the time”. She stated that she regularly had tonsillitis and ulcers in her mouth which she attributed to stress from the role.
The applicant’s mother stated that the applicant attempted to increase her work hours to four hours per day. However, this caused the applicant migraines and rendered her unable to do anything for the following two days.
In a job capacity assessment report dated 7 March 2015, the JCA stated that the applicant had a baseline work capacity of 8 to 14 hours per week. The basis for this assessment was that:[26]
…the client experiences specific deficits in visual working memory impacting on visuo-spatial function. The client may require extra support in a workplace to follow instructions and consolidate learning. The client may require supervision during the skills acquisition phase to ensure she understands complex information and correctly performs complex procedures.
Despite the identified deficits, the client’s general cognitive ability remains within the low average range and she has a demonstrated capacity to engage in study.
[26] Exhibit A, T-Documents, T15 at p. 149.
The JCA stated that the applicant’s work capacity could be increased to 15 to 22 hours per week within two years “with disability specific intervention… to address the client’s identified barriers and in turn improve her ability to obtain and maintain employment”.[27]
[27] Exhibit A, T-Documents, T15 at p. 150.
In their report dated 29 October 2015, Mr Walker and Dr Garnett stated that the applicant would not be capable of working 15 hours per week as a child care worker. They opined that the applicant’s occupational capacity was inhibited by her low adaptive functioning and clinical levels of anxiety and stress. They reported that her high stress levels have a flow on effect in exacerbating her occupational functioning difficulties, increasing fatigue, and reducing her working memory capacity which in turn limited her ability to learn new information.[28]
[28] Exhibit A, Supplementary T-Documents, ST2 at p. 18.
Mr Walker stated at the hearing that it was unlikely that the applicant’s work capacity would increase with age. He based this opinion on the applicant having already been given assistance and intervention from a young age. He also stated that the applicant would require at least 20 cognitive behavioural therapy sessions to mitigate the effect of her anxiety on her work capacity. He estimated that this would take over a year and cost $3,400 when taking into account Medicare subsidies.
Mr Walker and Dr Garnett indicated that the applicant could potentially be capable of working 15 hours per week in the future. Part of the reasoning for this opinion is that the applicant had expressed a “strong desire and motivation to contribute to the community”.[29] Although this may have formed part of the basis for their medical opinion, I am unable to take the applicant’s motivation into account. In Harris, Greenwood J emphasised at [28] that the effect of the phrase “of itself” within s 94(2)(a) is that discretionary and motivational factors, such as the applicant’s motivation and views towards particular work, are to be disregarded.
[29] Exhibit A, Supplementary T-Documents, ST2 at p. 18.
At the hearing Mr Walker stated that he “want[s] to believe” that the applicant’s capacity for work could increase because having a career “brings purpose”. However, he thought that for her capacity to work to increase she would require significant support, particularly in relation to her adaptive functioning.
In a letter dated 6 November 2015, Dr Lau reported that the applicant’s maximum work capacity was 11 to 12 hours per week and opined that “[t]his capacity is unlikely to change significantly in the next two years considering the neurological basis of ASD”.[30] At the hearing the respondent put to Dr Lau that an increase to 15 hours per week would not be a significant increase but rather a minor one. Dr Lau responded that the additional three hours would be a significant increase given that the applicant is already “stretched to the maximum” in completing 12 hours of work per week.
[30] Exhibit C, Letter of Dr Winnie Yu Pow Lau dated 6 November 2015.
In view of the medical evidence I am satisfied that the applicant may be able to work 15 hours per week at some point in time in the future. This would be dependent upon effective intervention being made in accordance with the recommendations of the JCA and her treating medical practitioners. However, I do not consider that the applicant may be able to work 15 hours per week within two years of the date that her DSP was cancelled. I accept the evidence of Dr Lau and Mr Walker that increasing the applicant’s work capacity is a lengthy process that would take longer than two years.
I will next turn to the question of whether the applicant’s impairment is, of itself, sufficient to prevent her from undertaking a training activity during a two year period from the date of cancellation. I am satisfied that the applicant is capable of completing a training activity within the meaning of s 94(5) of the Act. I base this finding on the applicant having been able to complete a Childcare Certificate III in 2014, albeit at a part-time rate.
I am, however, not satisfied that the applicant’s participation in a training activity will enable her to work 15 hours per week independently of a support program within the relevant two year period. For the reasons set out above, the applicant would require intervention and assistance over a period which is greater than two years. I cannot be satisfied on the evidence before me that the applicant would be able to work 15 hours per week independently of a support program on or before 19 March 2017 regardless of her participation in a training activity.
CONCLUSION
On 19 March 2015, the applicant’s permanent intellectual impairment was severe under Table 7 of the Impairment Tables. I accept that the applicant may have a capacity to work 15 hours per week in the future if the appropriate interventions are made. However, I also consider that this will take longer than two years from the date that her DSP was cancelled. I am not satisfied that the applicant’s participation in the training activity will enable her to do any work independently of a support program within this period. Therefore, I find that the applicant had a continuing inability to work on 19 March 2015.
DECISION
I set aside the decision under review and substitute it with a decision that the applicant was qualified for disability support pension on 19 March 2015.
I certify that the preceding 62 (sixty – two) paragraphs are a true copy of the reasons for the decision herein of Deputy President Dr P McDermott RFD ................................[sgd]........................................
Associate
Dated 14 November 2016
Date(s) of hearing 13 April 2016 Date final submissions received 24 May 2016 Solicitors for the Applicant Mr P Cranitch, Basic Rights Queensland Inc Solicitors for the Respondent Ms B Rayment, Mills Oakley Lawyers
Key Legal Topics
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Administrative Law
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Statutory Interpretation
Legal Concepts
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Appeal
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Judicial Review
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Procedural Fairness
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Statutory Construction
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