Brook and Repatriation Commission
[2006] AATA 894
•20 October 2006
Administrative
Appeals
Tribunal
DECISION AND REASONS FOR DECISION [2006] AATA 894
ADMINISTRATIVE APPEALS TRIBUNAL )
) No Q2005/116
VETERANS’ APPEALS DIVISION ) Re STEVE BROOK Applicant
And
REPATRIATION COMMISSION
Respondent
DECISION
Tribunal Ms M J Carstairs, Member
Dr M Denovan, MemberDate20 October 2006
PlaceBrisbane
Decision The Tribunal affirms the decision under review ............[Sgd]...........
MJ Carstairs
Member
CATCHWORDS
VETERANS’ AFFAIRS – benefits and entitlements – defence service with the Royal Australian Air Force – alcohol dependence – exposure to chemical strippers and solvents - birth defect as severe stressor – no nexus between child’s death and service – inability to obtain grief counselling – alcohol dependence and alcohol-induced mood disorder held not to be defence-caused - decision affirmed
Statement of Principles concerning Alcohol Dependence or Alcohol Abuse Instrument No. 77 of 1998
Veterans’ Entitlements Act 1986 ss 68, 70, 120(4), 120B
REASONS FOR DECISION
20 October 2006 Ms MJ Carstairs, Member
Dr M Denovan, Member
BACKGROUND 1. Mr Steve Brook has made a claim upon the respondent that the conditions of alcohol abuse or dependence and depressive disorder are related to his defence service in the Royal Australian Air Force (RAAF). Mr Brook served in the RAAF between 11 March 1975 and 24 October 1980 and this period is defence service under s68 of the Veterans’ Entitlements Act 1986.
2. During part of his service, Mr Brook was posted to the stripping bay at Propeller Flight 2 AD at the Richmond Airbase, where he was exposed to the use of various chemicals in the course of his duties. These chemicals included Gamlen Cold Tank Cleaner, an immersion paint remover; Gamlen Solvent 260, a degreasing agent based on hydrocarbons; and Gamlen Solvent 267, a degreasing agent, based on trichloroethylene.
3. Mr Brook has been diagnosed as suffering from alcohol dependence as well as an alcohol induced mood disorder. Mr Brook relates his continuing alcohol problems to the death of his infant son, who suffered a primary malignant sacrococcygeal tumour. The baby died within an hour of birth on 5 December 1979.
4. Mr Brook believes that the baby’s birth defect was the result of his exposure to chemicals in the RAAF. He asserts that thereafter, he experienced a worsening of alcohol dependence and alcohol induced mood disorder.
5. On 13 February 2004 the respondent refused Mr Brook’s claim for alcohol dependence and for depression. We note for the record that Mr Brook informed us that he does not wish to pursue an application for the condition of asthma.
ISSUES
6. The issue that arises in this case, therefore, is whether Mr Brook’s psychiatric conditions are defence-caused within s70 of the Veterans’ Entitlements Act.
7. In particular, Mr Brook contends that the death of his son was a severe stressor that was related to his defence service in the sense that either his own exposure (or his wife’s exposure through laundering his clothes) to chemicals in the RAAF caused the fatal birth defect, and this led to Mr Brook increasing his dependence on alcohol when dealing with his grief. Mr Brook acknowledges that he drank alcohol excessively from the time he enlisted in the RAAF; thus his case rests upon a worsening of his alcohol related problems following the baby’s death.
DIAGNOSIS
8. Before looking at the question of causation, it is necessary for us to be satisfied on the question of the diagnosis of Mr Brook’s condition.
9. Dr J Pickering, consultant psychiatrist, diagnosed Mr Brook as suffering from Alcohol Dependence with Physiological Dependence, indicated by tolerance of alcohol and by Mr Brook experiencing withdrawal symptoms in the absence of alcohol - those symptoms including anxiety and hand tremors. Dr Pickering concluded that Mr Brook did not have any separate anxiety or depressive condition, but, rather, he suffers from Alcohol-induced Mood Disorder with Depressive Features with Onset during Intoxication (T4, folio 50).
10. Dr R Kingswell took a similar history to that taken by Dr Pickering, and agreed that Mr Brook had commenced drinking on joining the RAAF and increased his consumption rapidly thereafter, with Mr Brook particularly reporting an increase in consumption after the death of his son. Mr Brook was consuming 20-30 standard drinks per day at the time that Dr Kingswell saw him. Dr Kingswell concurred with Dr Pickering’s diagnosis of alcohol dependence and alcohol induced mood disorder.
11. We were satisfied, on the basis of these agreed reports, that the correct diagnosis of Mr Brook’s condition was alcohol dependence and alcohol-induced mood disorder.
12. It seems to us therefore that the two medical conditions are inter-related. If Mr Brook’s alcohol dependence is found to be related to his defence service, then the condition of alcohol-induced mood disorder would follow from the acceptance of the primary condition. On the basis of the medical evidence from two specialists we were satisfied that Mr Brook does not suffer from any separate psychiatric condition, that is, any condition unrelated to his alcohol consumption. Specifically, he does not suffer from depressive disorder as claimed (T4, p9) or from ‘generalised anxiety disorder’, as identified by his general practitioner at the time of the claim (T4, p9).
13. Given the state of the medical evidence, we examined Mr Brook’s claim as being for the primary condition of alcohol dependence, for which there is a Statement of Principles, namely No. 77 of 1998 for Alcohol Dependence or Alcohol Abuse.
THE CONTENTIONS ABOUT ALCOHOL AND EXPOSURE TO CHEMICALS
14. Mr Brook stated that he commenced drinking in 1975 when he joined the RAAF. He reported that he was drinking wine, beer and spirits - about 40 to 60 drinks per week - until the age of 21, but increased his intake to 50 to 70 drinks per week from the age of 21 to 35 years (T4 folio 16). In his claim, Mr Brook stated that he considered that alcohol was positively encouraged during service life, and he noted that alcohol was always involved in service-related sports and organised events. We noted, however, that at the time of his claim Mr Brook did not rely on any increase in his alcohol consumption being related to the death of his infant son.
15. Mr Brook however told us at the hearing that even before the baby was born he was worried about his working environment. He said he had been sufficiently concerned by his physical reactions to the chemicals to raise the matter with his superiors and seek transfer. His wife also was experiencing rashes after laundering his clothes. Unfortunately the transfer did not take place until after his son was born.
16. Mr Brook said that it was a difficult time for the family after the baby died. He said that they were not assisted with the grieving process by any counselling. Mr Brook said that the two padres assigned to his unit were unavailable to talk with him following the birth in December 1979 because they were preoccupied with Christmas commitments. Mr Brook contended that but for the lack of appropriate counselling, his alcohol dependence would not have worsened.
17. Mr Brook provided the Tribunal with a compendious array of journal and internet articles discussing the possible side effects of the chemicals to which he had been exposed during his service (exhibits A2, A3, A4). Whilst a number of the articles suggest a possible link between certain childhood illnesses, such as leukaemia, where the child is directly exposed to large doses of these chemicals, none suggest that the exposure of an adult could cause birth defects of the type experienced by Mr Brook’s son.
18. The respondent arranged for Dr P Grant, Senior Medical Officer, to examine the research material. In his report dated 8 December 2005 (exhibit R2), Dr Grant concluded, after reviewing the medical literature, that there were no reliable published studies supporting a plausible link between any of the chemical agents to which Mr Brook was exposed and the development of a sacrococcygeal malignant teratoma that the baby had been born with. His report continues:
Whereas sporadic reports of possible developmental changes are identified, these relate to non-human models exposed to high doses of a particular chemical in an experimental setting.
STANDARD OF PROOF
19. The standard of proof to be applied by the Tribunal is one of reasonable satisfaction, provided for in s120(4) of the Veterans’ Entitlements Act 1986. Section120B of the Act provides that the Tribunal must decide the issue of whether an injury or disease is defence caused in accordance with the applicable Statement of Principles, which sets out the relevant nexus to service through a number of identified factors. Relevantly, the Statement of Principles for alcohol dependence includes at factor:5(d):
experiencing a severe stressor within the one year immediately before the clinical worsening of alcohol dependence …..
20. The definition provided within the Statement of Principles for experiencing a severe stressor is :
…. the person experienced, witnessed or was confronted with, an event or events that involved actual or threat of death or serious injury, or a threat to the person’s or other people’s physical integrity, which event or events might evoke intense fear, helplessness or horror;
In the setting of service in the Defence Force… events that qualify as severe stressors include:
(i) threat of serious injury or death…..;
21. Does the death of Mr Brook’s infant son come within this factor? For it to do so, it is necessary that the matter has some similarity to the identified examples or the generic statement within the definition. The death of the baby might, taken on its own, satisfy that requirement. It is also necessary that at least one element set out in the factor relate to service. This is required by paragraph 4 of the Statement of Principles. Unless Mr Brook can point to evidence that connects the baby’s death itself to his service his claim cannot succeed, no matter how stressful the baby’s death was to himself and to his wife.
22. There is no evidence before us that points to a connection between the birth defect that caused the baby’s death and the chemicals used by Mr Brook. We have no more than Mr Brook’s assertion that there may have been a connection, without any substantiation from within reliable literature on the point. Furthermore, there is no particular evidence that indicates Mr Brook experienced clinical worsening of an alcohol condition within a year of the experience of his baby son’s death. We know from Mr Brook’s evidence that he had a well established alcohol habit for a number of years prior to the baby’s death. Mr Brook may well have increased his intake of alcohol at this time, but we have no medical evidence that this led to clinical worsening of his existing condition. Thus factor 5(d) of the Statement of Principles, relating to clinical worsening of alcohol dependence, is not raised by the evidence in this case, and the claim on that basis is not pointed to by evidence.
23. We also considered whether Mr Brook’s alternative contention - that the worsening of his condition of alcohol dependence was a result of his inability to obtain appropriate grief counselling - came within the factors provided for in the Statement of Principles. However it does not seem to us that his assertions on this could bring the matter within factor 5(e) of the Statement of Principles: inability to obtain appropriate clinical management for alcohol dependence. Mr Brook refers only to seeking pastoral help for the grief he suffered. He does not claim to have sought clinical management or treatment for his alcohol problem, and there is no evidence that had he done so, he would have been unable to obtain appropriate clinical management for that condition.
24. As the evidence does not point to any factor in the Statement of Principles being met, Mr Brook is unable to show, on the balance of probabilities, that his psychiatric conditions are connected with his service.
DECISION
25. The Tribunal affirms the decision under review.
I certify that the 25 preceding paragraphs are a true copy of the reasons for the decision herein of M Carstairs and
Dr M Denovan, MembersSigned Michelle Brazier Legal Research Officer
Date/s of Hearing 13 July 2006
Date of Decision 20 October 2006
The Applicant was self represented
For the Respondent Mr J Kelly, Departmental Advocate
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