Christopher Derry and Repatriation Commission
[2013] AATA 431
[2013] AATA 431
Division VETERANS' APPEALS DIVISION File Number
2012/2205
Re
Christopher Derry
APPLICANT
And
Repatriation Commission
RESPONDENT
DECISION
Tribunal Dr Kerry Breen, Member
Date 26 June 2013 Place Melbourne In accordance with section 42D of the Administrative Appeal Tribunal Act 1975 the Tribunal remits the reviewable decision to the respondent for reconsideration.
[sgd]........................................................................
Dr Kerry Breen, Member
VETERAN’S ENTITLEMENTS – claim for defence caused post-surgical deformity – injury or disease – physical ailment or defect – insufficient material to make a decision – remittal to respondent pursuant to s 42D of the Administrative Appeals Act 1975.
Legislation
Veterans Entitlement Act 1986, section 5D
Administrative Appeals Act 1975, section 42D
Safety Rehabilitation and Compensation Act 1988
Cases
Repatriation Commission v Brown [1990] FCA 315
Re Felton and Commonwealth of Australia (1984) 6 ALD 296
Re Repatriation Commission and Campbell (1987) 13 ALD 598
Re Repatriation Commission and Ottaway (1990) 21 ALD 465
Repatriation Commission v Stafford (1995) 56 FCR 132
Bye and Repatriation Commission (1986) 11 ALN N276
Re Waller and Repatriation [2003] AATA 430
Secondary Materials
Robin Crekye and Peter Sutherland, Veteran’s Entitlements Law (2nd edition) Federation Press, Sydney 2008
Macquarie Dictionary (5th edition, Macquarie Library, 2009)
Oxford English Dictionary (2nd edition, Oxford University Press)
REASONS FOR DECISION
Dr Kerry Breen, Member
26 June 2013
BACKGROUND
Christopher Derry, born in 1954, served in the Australian Navy between 1971 and 1993. On 13 May 2011 Mr Derry lodged a claim with the respondent for numbness and scarring right breast. On 11 July 2011 a delegate of the respondent wrote to Mr Derry rejecting the claim.
On 27 July 2011 Mr Derry requested a review of this decision by the Veterans’ Review Board (VRB). The VRB conducted a hearing on 19 March 2012 and affirmed the decision of the delegate.
On 31 May 2012 Mr Derry applied for a review of the VRB decision by this Tribunal.
Shortly after joining the Navy, Mr Derry developed a swelling in his right breast, a condition known as gynaecomastia. He was advised to have this surgically removed. The operation took place at HMAS Albatross in June 1973. A large fibrous mass measuring 8.8 x 8.0 x 2.8 cm was removed and pathological examination showed this to be benign fibroadenosis consistent with gynaecomastia. Mr Derry made an uneventful recovery from surgery and was left with a surgical scar that initially did not bother him unduly.
In 1986 Mr Derry injured his right shoulder during a Services football match, experiencing a dislocation of the shoulder. He then suffered recurrent dislocations and required three operations on the right shoulder between 1986 and 2010. The respondent has accepted the injury to his right shoulder as defence-caused. As part of the rehabilitation process following the initial dislocation and the subsequent surgery, Mr Derry has had physiotherapy treatment. He was advised by a physiotherapist to take up swimming, which he now does regularly.
Mr Derry contends that the physiotherapy treatment has led to increased muscle bulk in his shoulders and that this has led to his surgical scar becoming deformed and a source of embarrassment to him. He has made a claim to the respondent seeking to have the deformity surgically corrected.
The respondent contends (a) that the scarring has not been aggravated by right shoulder exercise; and (b) the scar is not a disease or injury as required under the Veterans’ Entitlement Act 1986 (the Act).
THE ISSUES
The issues for the Tribunal to determine are:
(a)What is the diagnosis of the condition on which Mr Derry’s claim is based?
(b)Is this condition a disease or injury as required under the Act?
(c)If it is either a disease or an injury, is the condition defence-caused?
THE EVIDENCE
Mr Derry gave oral evidence and provided the Tribunal with four colour photographs of his physical appearance in his younger years.
Mr Derry stated that after the operation for gynaecomastia he was initially not troubled by the scar and he regarded it as a badge of honour. He stated that in recent times he has become much more aware of the scar, as he feels it has become more visible and has become a deformity. He would like to have it surgically improved. He has not sought an appointment with a surgeon to discuss this possibility. [Mr Derry told the VRB that he thought that the change in the appearance of the scar commenced after his second operation on his right shoulder in 1994.]
Mr Derry attributes the change in the scar’s appearance to the increase in muscle bulk in his upper body. He attributes this increase in muscle bulk to the regular swimming that a physiotherapist advised him to undertake as part of the management of his right shoulder condition. Before being given this advice, he was not a strong swimmer but he now swims 60 laps of the pool twice a week. He stated that while he was serving in the Navy, he was granted a daily pass to enable him to swim for 45 minutes each day.
Mr Derry was questioned by counsel for the respondent, Mr Gerry Purcell, about his degree of embarrassment over the scar. Mr Derry stated that he usually swam in a heated pool at around 8.30 pm and that there were other people present at that time.
The medical evidence
Mr Derry was seen by an orthopaedic surgeon, Dr Richard McArthur, on 17 November 2011. Dr McArthur wrote a report dated 12 December 2011 addressed to Mr Bruce Turner, Senior Advocate, RSL, who represented Mr Derry at the time. In the report, Dr McArthur wrote (in regard to the surgical scar) Following this procedure Mr Derry stated that he was always concerned at the cosmetic appearance of his right anterior chest and this was particularly so when he went swimming when his fellow sailors would ‘poke fun’ at him about his appearance .
Dr McArthur described the scar on the right anterior chest as follows: There was a 10cm transverse scar below the nipple extending to the anterior axillary fold with loss of the adjacent subcutaneous soft tissue. Further on, he wrote The depression on the right anterior chest wall is accentuated when he exercises his shoulder by contracting the pectoralis major (muscle).
Dr McArthur’s report is silent on the central issues of whether the appearance of the scar has changed over time, and if it has changed, what factors might have contributed to the change. Dr McArthur concluded his report in the following terms: Mr Derry, in my opinion, would benefit from a consultation with a senior plastic surgeon, who has experience in reconstruction breast tissue following mastectomy.
In making his application to the respondent, Mr Derry provided a Disfigurement and Social Impact Medical Impairment Assessment dated 22 June 2011 that had been completed by his general practitioner, Dr Yeo. In answer to question 1, Does any condition cause him embarrassment in public places?, Dr Yeo ticked the box Yes and wrote R upper chest deformity esp at gym or on beach swimming. In answer to question 2, Describe the effect on his appearance, behaviour and body movements when in public, Dr Yeo wrote Large scar with partial defect of R pectoralis. In answer to question 3, Comment on his emotional reaction to these changes of appearance, behaviour or body movements, Dr Yeo wrote Anxiety regarding his appearance Reluctance to expose upper body.
At the request of the respondent, Dr Geoff Markov, a specialist in rheumatology and internal medicine, saw Mr Derry on 16 November 2012. Dr Markov provided two medical reports and gave oral evidence to the Tribunal by telephone.
In his first medical report dated 10 December 2012, in response to a question posed by the respondent in the letter of instruction, Dr Markov wrote: The correct diagnosis is post-surgical deformity of the right chest wall. In the same paragraph Dr Markov wrote: The deformity has been present ever since the operation and is unchanged.
In response to a question posed in the letter of instruction about the aetiology of the condition, Dr Markov wrote:
In Mr Derry’s case the aetiology is the previous surgical resection of the benign breast lump. I do not believe there is any increase or exaggeration of the deformity as a result of the exercise required for post-operative physiotherapy for his right shoulder. In my opinion, Mr Derry’s muscle mass is normal and not unduly enlarged. There does not appear to be any difference between the right and left side of the body in respect to muscle bulk or general physique.
Dr Markov took eleven digital colour photographs of Mr Derry’s upper torso and these accompanied his first written report. The Tribunal’s assessment of these photographs and its comparison with the four earlier photographs provided by Mr Derry is discussed below in paragraph 42.
Prior to the hearing, the respondent invited Dr Markov to comment on the four photographs that Mr Derry had submitted. In a supplementary report, addressed to the respondent and dated 30 January 2013, Dr Markov made a number of remarks to qualify his earlier report. These included (a) It is however possible to say that Mr Derry looks much more slender in these photographs than he did when I met him in person in November 2012 which suggests the typical weight gain which occurs as people age and (b) Mr Derry’s contention is that the scar has become more noticeable (and thus more embarrassing) over the decades. Even if this were true, there is no reason to ascribe this increased noticeability to the physiotherapy exercises required following his right shoulder surgery.
SUBMISSIONS
Mr Purcell invited the Tribunal to amend the diagnosis of Mr Derry’s condition to the diagnosis proffered by Dr Markov, namely, post-surgical deformity of the right chest wall. Mr Purcell argued that the Tribunal needed to examine carefully whether the diagnosed condition was a disease or an injury, consistent with the Act. Mr Purcell cited pages 26-29 and pages 34-35 of the book Veterans’ Entitlement Law (2nd edition), a decision of the Federal Court (Repatriation Commission v D W Brown [1990] FCA 315) and a decision of this Tribunal (Re Felton and Commonwealth of Australia (1984) 6 ALD 296). Mr Purcell invited the Tribunal to consider their relevance. Mr Purcell argued that the claimed condition did not come within the definition of a disease as provided for in the Act. He argued further (on the basis that Mr Derry was in effect claiming for an aggravation of an injury) that as aggravation of a pre-existing injury was excluded under s 5D of the Act, Mr Derry’s claim must fail. Mr Purcell concluded by contending that Mr Derry’s surgical scar has possibly become more noticeable, but if this was so, it was due to weight gain and was not related to physiotherapy and hence was not related to military service.
Mr Derry submitted that as his shoulder injury had been accepted as defence-caused, and as in his view it was the physiotherapy for that condition that had led to the worsened appearance of his chest wall scar, the respondent should accept liability for corrective surgery for the scar.
Mr Derry did not argue that the original disease (gynaecomastia) that led to surgery, and the subsequent right chest wall scar, was defence-caused.
CONSIDERATION
Diagnosis of the condition
Mr Derry has been consistent in his description of the condition for which he has lodged a claim. When he first lodged a claim with the respondent on 13 May 2011, his claim was for incapacity for numbness and scarring of right breast. (During the hearing, Mr Derry stated that he was not claiming for the numbness.) However, in the written decision of the respondent’s delegate, dated 11 July 2011, the delegate wrote I am satisfied that the appropriate medical diagnosis for the claimed condition is gynaecomastia with numbness & scarring right-breast.
In his application to the VRB for a review of the delegate’s decision, Mr Derry wrote:
I did not actually lodge a claim for the gynaecomastia or the numbness and scarring of the right breast, but for the repair of the subsequent deformity of the area of surgery, due to the continual muscle building required to aid me in the recovery of a right shoulder injury which is recognised as related to service. The deformity causes me a great deal of embarrassment and I am extremely self-conscious of it. I am only claiming for repair of the deformity, not for an ongoing pension as I believe that the problems will be negated if the deformity is removed.
In his application for review lodged with this Tribunal on 28 May 2012, Mr Derry wrote I feel that the wrong decision was made as the area concerned is definitely no longer just scarring but is an ugly major deformity.
Although other terminology appears in the delegate’s initial decision and in the VRB’s decision, the Tribunal accepts that the diagnosis proffered by Dr Markov, namely post‑surgical deformity of the right chest wall is the preferable diagnosis of the condition which Mr Derry claims to be defence-caused. The Tribunal notes that Mr Purcell supported this diagnosis.A diagnosis of deformity is also implied in the final paragraph of Dr McArthur’s report. Dr McArthur advised Mr Derry to consult a senior plastic surgeon, who has experience in reconstruction breast tissue following mastectomy.
Is this condition an injury or a disease?
Disease and injury are defined in s 5D of the Act as follows:
“Disease” means:
(a)any physical or mental ailment, disorder, defect or morbid condition (whether of sudden onset or gradual development); or
(b)the recurrence of such an ailment, disorder, defect or morbid condition; but does not include
(c)the aggravation of such an ailment, disorder, defect or morbid condition; or
(da temporary departure from
(i)the normal physiological state; or
(ii)the accepted ranges of physiological or biochemical measures; that results from normal physiological stress (for example the effect of exercise on blood pressure) or the temporary effects of extraneous agents (for example, alcohol on blood cholesterol levels).
“Injury” means any physical or mental injury (including the recurrence of a physical or mental injury) but does not include:
(a)a disease; or
(b)the aggravation of a physical or mental injury.
The concept that the surgical deformity represents an injury is not one that appeals to the Tribunal, even though certain surgical and dental procedures have been deemed to create injuries in veterans (Repatriation Commission v D W Brown [1990] FCA 315; Re Felton and Commonwealth of Australia (1984) 6 ALD 296). Mr Derry has not contended that the initial surgery has caused an injury that now troubles him. Instead he has contended that the treatment advised for a series of operations on his right shoulder has led to the condition of post-surgical deformity of a scar that previously did not concern him.
The Tribunal has therefore considered whether the condition of post-surgical deformity of the right chest wall represents a disease as defined in the Act. The terms ailment and defect, which are included in the definition of disease under the Act, warrant examination. The Oxford English Dictionary (2nd edition) (accessed online) describes an ailment as an illness, typically a minor one. The Macquarie Dictionary (5th edition) describes an ailment as a morbid affection of body or mind; indisposition. The Oxford Dictionary describes a defect as a shortcoming, imperfection or lack, while the Macquarie Dictionary describes defect as a falling short; a fault or imperfection; want or lack, especially of something essential to perfection or completeness. Ailment is defined in the Safety Rehabilitation and Compensation Act 1988 as any physical or mental ailment, disorder, defect or morbid condition (whether of sudden onset or gradual development).
To the Tribunal’s knowledge, the precise meaning of the terms ailment and defect have not been the subject of close consideration by this Tribunal or the courts. In Re Waller and Repatriation [2003] AATA 430, this Tribunal said: The words ‘disorder, defect or morbid condition’ denote matters of some substantial departure from the normal structure and functioning of the human body or mind. The word “ailment”… may denote something less. A number of decisions of this Tribunal and a decision of the Full Federal Court indicate that the definition of disease is to be approached quite broadly (Re Repatriation Commission and Campbell (1987) 13 ALD 598, Re Repatriation Commission and Ottaway (1990) 21 ALD 465, Repatriation Commission v Stafford (1995) 56 FCR 132 ).
In the view of the Tribunal, Mr Derry’s post-surgical deformity of the right chest wall could be described as either a physical ailment or a physical defect and thus be considered a disease for the purposes of the Act. This view is based on several factors. There is a physical abnormality or defect present in Mr Derry’s right chest wall (the abnormality is clearly visible in the photographs taken in 2011). Diseases are routinely identified and diagnosed through the expression of symptoms. In Mr Derry’s instance, the symptoms include distress in the form of embarrassment and a reluctance to expose his chest in public. The opinion of Dr McArthur suggesting that the deformity (defect) is amenable to surgical repair is an additional factor pointing to the notion of Mr Derry’s condition being a physical ailment or physical defect and hence a disease.
The Tribunal’s view of the post-surgical deformity of the right chest wall as a physical ailment or defect gains some support via the existence of, and the wording of, the standard form that the respondent issued, and that Dr Yeo completed; viz Disfigurement and Social Impact Medical Impairment Assessment (see para 16). The existence of such a form, at the very least, implies that some forms of disfigurement (or deformity) are regarded by the respondent as conditions or diseases under the Act. That Mr Derry’s disfigurement might be regarded as being towards the lower end of a scale of deformity should not distract a decision maker from applying the law correctly.
However, the Tribunal acknowledges that the state of the medical evidence is such as to make the foregoing comments about physical ailment or a physical defect tentative at best. The Tribunal will return to the desirability of obtaining further medical evidence in paragraph 45. The Tribunal also acknowledges that there is no evidence before it from a relevant surgical specialist to confirm or deny Dr McArthur’s view that surgical intervention for the defect might be appropriate.
Is the condition defence-caused?
A question arises from the following words in s 5D of the Act: “Disease”…does not include (c) the aggravation of such an ailment. In the view of the Tribunal, this wording is intended to refer to the aggravation of a pre-existing ailment (for example, the pre‑existing shoulder injury that Mr Derry experienced). While it could be construed that Mr Derry’s claimed post-surgical deformity of the right chest wall has been aggravated by the consequences of physiotherapy and physiotherapist-advised exercise; such a construction would imply that Mr Derry had a pre-existing deformity. As the Tribunal apprehends Mr Derry’s contention, he is alleging that the physiotherapy has caused the claimed condition of post-surgical deformity of the right chest wall to develop de novo; i.e. he is claiming for the deformity and not for the original surgical scar. Accordingly, there is no issue arising as to aggravation.
The Tribunal is of the view that the answer to the question of whether a condition is defence-caused depends upon whether the link between an accepted defence-caused injury (to the right shoulder) and a new physical ailment/defect can be established on the balance of probabilities. For this to be so, the decision maker would have to accept the contentions of Mr Derry (expressed here in the words of the Tribunal) (a) that he was required to, or was advised to, undertake physiotherapy as a necessary part of the treatment/preventive management/rehabilitation of the shoulder injury, which itself is defence-caused; (b) that the physiotherapy undertaken, or the steps advised by a physiotherapist and followed by Mr Derry, led to a considerable build-up of the muscle bulk of his chest and shoulders; and (c) that the increased muscle bulk has led to a change in his surgical scar resulting in post-surgical deformity.
Mr Derry was not represented at the hearing and did not call any witnesses to give evidence. He did provide the Tribunal with Dr McArthur’s report. In the view of the Tribunal, Dr McArthur’s opinion is of little evidentiary value to the propositions summarised in paragraph 37. At best, it gives some weight to the notion that the scar is unsightly and should be looked at by a plastic surgeon.
While the respondent relies heavily on the medico-legal report of Dr Markov, the Tribunal is very reluctant to accept much of Dr Markov’s evidence. Dr Markov does not have the relevant experience to provide expert evidence about a surgical scar and has had little experience in post-surgical physiotherapy. In his first report, Dr Markov concluded that the scar that he saw was unchanged since the surgery in 1973, without explaining how he reached that conclusion. In his second report, having now seen photographs of Mr Derry taken in the 1970s, he was still reluctant to accept Mr Derry’s complaint that the scar had changed. Dr Markov wrote: Mr Derry’s contention is that the scar has become more noticeable (and thus more embarrassing) over the decades. Even if this were true… (Tribunal’s emphasis).
Dr Markov went on to attribute any change in the scar to weight gain associated with advancing age together with the process of contracture of the scar. He appears not to have sought objective evidence of weight gain. (In response to Dr Markov’s second report, and before the hearing, Mr Derry submitted a letter, received by the Tribunal on 16 April 2013, that included independent evidence that his weight in October 1982 was 82.5 kg and in April 1992 was 82 kg. He wrote that his current weight was 81.8 kg.)
Dr Markov appeared to the Tribunal to be very inclined to discount any effects of physiotherapy by emphasising that the Mr Derry’s shoulders appeared symmetrical. Although he was aware that Mr Derry swam regularly, he did not enquire into why this was so. Thus, it appears that Dr Markov had not turned his mind to the possibility that regular swimming had symmetrically increased the muscle bulk of Mr Derry’s shoulders and chest.
The four photographs provided by Mr Derry were taken when he was aged approximately 19, 20, 20 and 25 years. Dr Markov observed in his second report that Mr Derry looks much more slender in these photographs than he did when I met him in person in November 2012. The Tribunal has examined the eleven digital photographs taken by Dr Markov in November 2012 and compared these with the photographs of the younger Mr Derry. In the Tribunal’s view, in the first three of the earlier photographs, Mr Derry appears considerably more slender than he appears in recent photos taken by Dr Markov. In the 2011 photographs, Mr Derry is clearly much larger in the upper torso. In addition, his physique is more consistent with his statement about regularly swimming long distances than it is with the proposition of Dr Markov, namely that the change in appearance is due to weight gain due to increased body fat.
In his second report, Dr Markov appeared to be sceptical about the degree of embarrassment experienced by Mr Derry, as he noted that Mr Derry continued to swim and to attend a gymnasium regularly. In his oral evidence, Dr Markov observed that embarrassment was a subjective matter and that he could not assess Mr Derry’s feelings. In any case, the Tribunal notes that Mr Derry’s local medical practitioner reported that embarrassment was linked to swimming at the beach. The Tribunal observes that spending time at the beach is a different scenario to swimming 60 laps of a heated pool in the evening.
Dr Markov’s specialty is appropriate for the purposes of providing a medico-legal report in relation to Mr Derry’s shoulder condition. In the view of the Tribunal, Dr Markov was not an appropriate expert to comment on surgical scarring and post-operative physiotherapy. Indeed, when questioned by the Tribunal, Dr Markov conceded this point and named plastic surgery as the appropriate specialist field.
Discounting the professional opinion of Dr Markov does not, of itself, support Mr Derry’s contention. As the Tribunal has stressed elsewhere, medical evidence is needed to establish as accurately as possible the diagnosis of the symptoms upon which a veteran bases a claim (see Bye and Repatriation Commission (1986) 11 ALN N276). To make the correct or preferred decision in this matter, the Tribunal or decision maker should ideally receive independent evidence relevant to the three steps outlined above in paragraph 37. In summary, these steps encompass the following matters: Did regular swimming form part of the physiotherapy that Mr Derry was advised to undertake as part of recovery and/or prevention of future trouble with his right shoulder? (If information is not available specifically relating to Mr Derry then evidence as to what is usual physiotherapy advice after surgery to the shoulder should be sought.) Assuming that expert evidence supports the first step, the next question is, has the regular therapeutic swimming been the proximate cause or major contributor to an increase in bulk of Mr Derry’s musculature in the shoulders and chest? If that question is answered in the affirmative, then the final question is - has the increase in muscle bulk been the proximate cause or major contributor to the development of the post-surgical deformity of the right chest wall?
Although not directly relevant to the decision per se, it would be advisable for the respondent to ask additional questions of an appropriate surgical expert, viz is surgery commonly undertaken to correct deformity caused by such surgical scars and in Mr Derry’s case, is surgery capable of improving the appearance of the deformity and is it desirable or necessary? The last question is one that is commonly a consideration for surgeons working in the field of plastic and reconstructive surgery as the motivations of people seeking surgical correction of scars and deformity can be complex.
Having considered the state of the evidence in so far as it assists the Tribunal to determine the precise nature of Mr Derry’s condition and whether it is defence-caused, the Tribunal is not satisfied that it has sufficient relevant medical opinion to safely decide the issues at hand. On the basis of the foregoing analysis, the Tribunal has decided to remit Mr Derry’s claim to the respondent pursuant to s 42D of the Administrative Appeals Act 1975 (the AAT Act) for further consideration, with the request that the matter be further investigated pursuant to s 17 of the Act and in accordance with the steps recommended by the Tribunal in paragraphs 45 and 46.
Section 42 D of the AAT Act reads as follows:
Power to remit matters to decision-maker for further consideration
(1) At any stage of a proceeding for review of a decision, the Tribunal may remit the decision to the person who made it for reconsideration of the decision by the person.
Powers of person to whom a decision is remitted
(2)If a decision is so remitted to a person, the person may reconsider the decision and may:
(a)affirm the decision; or
(b)vary the decision; or(c) set aside the decision and make a new decision in substitution for the decision set aside.
Note:For time limits, see subsection (5).
(3)If the person varies the decision:
(a)the application is taken to be an application for review of the decision as varied; and
(b)the person who made the application may either:
(i) proceed with the application for review of the decision as varied; or
(ii) withdraw the application.
(4)If the person sets the decision aside and makes a new decision in substitution for the decision set aside:
(a)the application is taken to be an application for review of the new decision; and
(b)the person who made the application may either:
(i)proceed with the application for review of the new decision; or
(ii)withdraw the application.
Time limits
(5)The person must reconsider the decision, and do one of the things mentioned in paragraphs (2)(a), (b) and (c), within whichever of the following periods is applicable:
(a)if the Tribunal, when remitting the decision, specified a period within which the person was to reconsider the decision--that period;
(b)in any other case--the period of 28 days beginning on the day on which the decision was remitted to the person.
(6)The Tribunal may, on the application of the person, extend the period applicable under subsection (5).
(7)If the person has not reconsidered the decision, and done one of the things mentioned in paragraphs (2)(a), (b) and (c), within the period applicable under subsection (5), the person is taken to have affirmed the decision.
(8)If the person affirms the decision, the proceeding resumes.
In accordance with s 42D(5)(a) of the AAT Act the Tribunal directs that the respondent reconsider its decision and advise the Tribunal and Mr Derry of the outcome by 26 September 2013. The Tribunal may extend the specified period, upon application by the respondent, in accordance with s 42D(6) of the AAT Act.
I certify that the preceding 49 (forty‑nine) paragraphs are a true copy of the reasons for the decision herein of Dr Kerry Breen, Member. [sgd]........................................................................
Administrative Assistant
Dated 26 June 2013
Date of hearing 22 May 2013 Applicant In person Counsel for the Respondent Gerry Purcell Solicitors for the Respondent Tracey Chant, Department of Veterans' Affairs
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