Collins and Repatriation Commission
[2003] AATA 458
•22 May 2003
Administrative
Appeals
Tribunal
DECISION AND REASONS FOR DECISION [2003] AATA 458
ADMINISTRATIVE APPEALS TRIBUNAL )
) No N2001/1345
VETERANS’ APPEALS DIVISION ) Re MICHAEL COLLINS Applicant
And
REPATRIATION COMMISSION
Respondent
DECISION
Tribunal Ms S M Bullock, Senior Member
Dr P D Lynch, MemberDate22 May 2003
PlaceSydney
Decision The decision under review is affirmed. ...............................................
Ms SM Bullock Presiding Member
CATCHWORDS
VETERANS' AFFAIRS - Entitlement - Disability Pension - Defence Service - Diagnosis -
Reasonable Satisfaction - Paranoid Personality Disorder
LEGISLATION
Veterans' Entitlements Act 1986 (Cth) - ss70, 120, 120B
AUTHORITIES
Repatriation Commission v Budworth (2001) 116 FCR 200
Benjamin v Repatriation Commission (2001) 64 ALD 411
Benjamin v Repatriation Commission (2001) 70 ALD 622
Repatriation Commission v Smith (1987) 15 FCR 327
Repatriation Commission v Gosewinckel (1999) 59 ALD 690
REASONS FOR DECISION
22 May 2003 Ms S M Bullock, Senior Member
Dr P D Lynch, Member1. This is an application for review to the Administrative Appeals Tribunal (“the Tribunal”) by the Applicant, Mr Michael Collins, of a decision of the Repatriation Commission, the Respondent, made on 10 January 2001 (T2) as affirmed by the Veterans’ Review Board on 9 July 2001 (T11).
2. A hearing was held before the Tribunal in Sydney on 3 December 2002. Mr Collins was self-represented and provided oral evidence. The Repatriation Commission was represented by Ms T McConnell, Departmental Advocate. Documents were lodged and taken into evidence pursuant to section 37 of the Administrative Appeals Tribunal Act 1975 (“T-Documents”, T1-T13). Also taken into evidence are the following exhibits:
Number
Description
Date
R1
Respondent’s Statement of Facts & Contentions
25 November 2002
R2
Report by Dr G Vickery, Psychiatrist
27 March 2002
R3
Department of Defence Documents in relation to Mr Collins
Various
ISSUES
3. The issues to be determined in this matter are:
(a) What is the correct diagnosis of Mr Collins’ psychiatric condition?
(b)Is Mr Collins’ correctly diagnosed psychiatric condition caused by his defence service?
(c) Is Mr Collins qualified to receive a Disability Pension?
SERVICE
4. Mr Collins served in the Royal Australian Air Force (“RAAF”) from 19 August 1980 until 24 November 1995 and this constitutes eligible defence service (Exhibit R3, p1).
LEGISLATION
5. A determination in this matter requires consideration of the provisions of the Veterans’ Entitlements Act 1986 (“the Act”).
6. The standard of proof required to be applied in relation to Mr Collins’ defence service [section 70 of the Act] is that of reasonable satisfaction as dealt with in subsection 120(4) of the Act. It is the same standard of proof which must be applied to a determination in relation to the correct diagnosis of Mr Collins’ psychiatric condition.
7. The Tribunal is also required to apply the provisions of section 120B of the Act in reaching a determination and must make a decision to its reasonable satisfaction in accordance with any Statements of Principles made by the Repatriation Medical Authority or any other relevant declaration or determination made pursuant to the Act.
STATEMENT OF PRINCIPLES
8. The Tribunal considers that the relevant Statement of Principles is Instrument Number 144 of 1995 as amended by Instrument Number 14 of 1997 concerning Personality Disorder.
EVIDENCE OF MR MICHAEL COLLINS
9. Mr Collins told the Tribunal that he was born in Yorkshire, Great Britain on 25 February 1948. Mr Collins told the Tribunal that he had a normal upbringing in an average family. Mr Collins told the Tribunal that he left school at age approximately 15 years obtaining the equivalent of the New South Wales School Certificate. He stated that he was poor at Mathematics and had moderate skills in the subjects of English and Reading. After leaving school, Mr Collins was an apprentice Wool Sorter undertaking this work for approximately four years. Mr Collins then worked in various positions such as in a bakery, as a Storeman and, just prior to immigrating to Australia, he worked as an hotel worker working in the kitchen undertaking catering duties. Whilst undertaking this work he was promoted, and earned an additional two pounds in wages per week.
10. Mr Collins came to Australia on 1 April 1978 having married in Great Britain prior to arriving. In Australia, Mr Collins worked in a number of catering positions, for example, working at the former TAA terminal at the Sydney Airport. He joined the RAAF on 19 August 1980, commencing as a Cook’s Assistant. Initially he had thought he would be a driver but was advised to work as a Cook’s Assistant . He decided to undertake the catering work because he thought it would be a steady job which would help him with his financial commitments and mortgage. In 1982/3, Mr Collins decided that he would attempt to re-muster to the Transport Division. He realised that to achieve this end he would need to improve his Mathematics and English skills.
11. Mr Collins obtained permission to attend night classes at the Penrith TAFE to undertake English and Maths adult classes commencing at 6:30pm. Mr Collins stated that his shift was from 6:00am until 2:00pm which fitted in neatly with attending TAFE in the evening. On his second week of attending night classes, Mr Collins’ RAAF shift was changed to that of night shift. This put a stop to his attending night school. He sought to change this but was unsuccessful. Mr Collins told the Tribunal that he had attended an appointment in Sydney when his “IQ” was tested. He did not know the precise results, but understood that he had not done very well.
12. Mr Collins stated that he again tried subsequently to re-muster to another section in about 1984 but he was unsuccessful. He also tried unsuccessfully to re-muster to a General Hand position but this was not approved. Mr Collins stated that in fact he tried to re-muster on many occasions because he wanted to leave catering. He wanted to improve his standard of education, he stated, so that he could progress from cooking potato chips to undertaking work such as a Storeman or General Hand. The difficulty with him achieving a re-muster always came back to the need for him to improve his educational standards. He was told that he needed a higher standard of education to re-muster but was frustrated in any attempts to improve his education. His night shifts militated against him attending evening school.
13. Mr Collins believed that he obtained his Cook’s Corporal Stripes in about 1986 for which he had to sit exams. Mr Collins explained to the Tribunal that she was later told that if he transferred to the Transport Division, he would lose his stripes and would have to start in that particular career path all over again. Consequently, Mr Collins decided to stay with catering as otherwise he would have lost promotional achievements and also remuneration. Another factor impacting on his decision to stay in catering was that a colleague in the Transport Division had told him that that Division was going to be disbanded.
14. Mr Collins stated that he spoke to his Commanding Officer who was very understanding and sympathetic about his difficulties trying to improve his educational standards and in trying to re-muster. Mr Collins further stated that other Corporals and Sergeants in the catering section did not understand his particular situation. He felt that he was placed under a great deal of pressure by these Officers because he was not able to improve himself. He became stressed and depressed. He described these Superior Officers as “bullies”.. He found that he was working double shifts commencing in Richmond in 1985 and then in Williamtown up until 1990 through until 1995. Mr Collins noted that there were a few good Corporals in Williamtown but unfortunately for him, they left. The new Corporals posted to Williamtown checked his work “every two seconds” (Transcript, p20). Mr Collins stated that he gave these Corporals no reason to check up on his work as he believed he was undertaking his job 100 per cent.
15. In late 1989, Mr Collins was transferred to Tindal in the Northern Territory. Mr Collins stated that he liked Tindal but there were a few difficulties he experienced with the Flight Sergeants and the Warrant Officers who did not like English people. Later during his service at Tindal, a Sergeant, with whom he had had experienced difficulties at Williamtown, was transferred also to Tindal. Mr Collins tried not to be concerned about this, but he was again allocated to night shift and experiencing similar problems as those experienced at Richmond and Williamtown. Mr Collins was again refused further education, having applied to do courses at the TAFE College in Katherine. When he asked about attending such classes, he was told that with his shift work it would be impossible for him to undertake any formal schooling.
16. It was while in Tindal that Mr Collins separated from his wife in 1995 and divorced later that year. Mr Collins and his ex-wife have three children, Natasha now aged 21, Andrew 19 and David 13. The children live with their mother.
17. Describing the work at Tindal, Mr Collins stated that he was short staffed and again there was a lot of pressure on him. He described one particular incident with a female Aboriginal Catering Assistant who came to him at the beginning of a shift stating that she would be unable to work because she had a sore leg which was bandaged up. Mr Collins stated that he told the assistant to go home. When Mr Collins subsequently asked for relief staff to replace the ill assistant, he was told that he would just have to work short staffed. A few weeks later, Mr Collins received a letter from “the Aboriginal Council” complaining about his having made racial remarks towards the ill assistant. There was also an issue of Mr Collins not providing the assistant with light duties. In Mr Collins’ view, there were not any light duties in catering, because it was always extremely busy in the dining room or in the kitchen. There were approximately 200 people coming in for various meals and it was not possible for someone to do light duties in that environment. Mr Collins stated that all he had told the ill assistant was that she should “just go home and go to your doctor and get a certificate”.. From that, he was criticised for making racial remarks and not liking Aboriginal people. He later said in evidence that probably he might have been critical but he could not remember exactly what he said. He was told that there would be a Court appearance of some type in relation to this complaint but this never occurred. Mr Collins was subsequently returned to the Richmond base in New South Wales and ordered to go to an Alcohol Rehabilitation Centre.
18. Mr Collins was specifically questioned about his interaction with the Superior Officer to whom he had made a request for additional staff because of the illness of one of his assistants. When the Senior Officer told Mr Collins that there would be no additional relief staff made available, Mr Collins stated that he was angry. He did not actually swear at the Officer but said words to the effect:
“ You sit in your office all day, you’re doing nothing about it…I’m working out there.... I’m short of staff, you’ve got 60 people coming up from down below….I’ve got to split me – I’ve got to collect meal money...I’m not very good at adding up with maths….I’m short staffed, I’ve got to stay on that door,…checking meal passes, checking money, change….” (Transcript, p24)
19. Mr Collins stated that the Senior Officer was unsympathetic and was rude to him so Mr Collins slammed the door in the Senior Officer’s face and walked out (Transcript, p51). Mr Collins stated that he did not attack the Officer personally but rather it was attacking his method of command. He noted that he did argue about certain staff issues and about jobs which had to be done. He might have said something along the lines of:
“ The way you command people it makes me very angry because you’re not a commanding – you’re not a person who should be leading people”. (Transcript, p51)
After that incident, Mr Collins was given three days to leave Tindal to return to Richmond.
20. Towards the end of Mr Collins’ RAAF service, he was threatened with losing his Corporal’s stripes. He told the Tribunal there were other stresses during his RAAF service including the death of his mother in England in 1994 just prior to all his RAAF difficulties. Mr Collins had to take long service leave of one month to enable him to go and see his mother’s grave.
21. In 1994/1995, Mr Collins stated that he also lost his job as a Cook’s Assistant because Cooks’ Assistant positions were “disbanded” (Transcript, p25). Mr Collins was made a Steward but only paid the wages of a Cook’s Assistant, he told the Tribunal. Mr Collins was told that he could not obtain an increase in his wages because he had not completed the Corporal Steward’s Course. Mr Collins told the Tribunal that he could not understand why he had to undertake a further course when he was already doing the work of a Steward. Mr Collins noted that at this time he was working with civilian Stewards who were earning more money than him. He did not like the fact that he was a Corporal being told what to do by a non-ranking civilian person or lower-ranking person who had a Steward qualification. He found this situation very embarrassing. He again tried to re-muster to a different section but was unable to do so. Mr Collins further noted in relation to re-mustering that while he had been in Tindal, he had tried to re-muster to become a Drill Instructor who drills servicemen on parades. He spoke to a Superior Officer, who he respected, about this and was told that he would be suitable to undertake such duties as he was very smart, clean and had a clear voice. He underwent a physical examination and was found to have no problems either with his physical or mental health. He filled out the necessary paperwork, provided the medical reports and got no reply at all. He became angrier and angrier each day working as a Steward and when he asked about his application to become a Drill Instructor, he was told that no one knew anything about it and that he was going to stay as a Steward.
22. With many events happening during 1994/1995, Mr Collins described feeling like he was in a cyclone which was becoming more intense. There were problems at work with him being watched all the time, he was watched by the Stewards, by the Warrant Officers and the Flight Sergeants. Mr Collins described himself as being under constant surveillance every time he filled out a form or put the salt on the table. He believed work he did was changed, for example, the salt was moved. He was even watched when he mopped or polished the floors. While Mr Collins acknowledged his duties were part and parcel of a Steward’s duties, his concern was that he was watched day and night. Mr Collins was having difficulty undertaking the Menus for the Officers’ Mess because there were words he could not spell and again he was frustrated in his attempts to improve his educational standards. Mr Collins stated that by 1994 he believed he was becoming very distracted. He reiterated that he felt as if he was bashing his head against a brick wall in that he was unable to re-muster and even if he was able to be promoted to a Sergeant or pass his exams, it would be still very difficult for him because of the reports he had about his behaviour.
23. Mr Collins was referred to a report by a Psychologist made on 26 July 1994 (T3, p28, 29) which noted:
“….Given Michael’s extremely limited ability it was concluded that he was unable to understand what was expected of him, rather than deliberately avoiding responsibility or manipulating others. He [the assessing psychologist] recommended that the member be removed from supervisory tasks by being made unsuitable in Rank. However, because of evidence that he had been poorly reported throughout his career he was placed on Air Force Office Warning…
…. He seems convinced that the personal adversity he has suffered has justified his reaction, coping style and behaviour. Therefore I would not expect that he will be able to challenge himself or implement the changes required to manage his situation more effectively. This notwithstanding, he has been encouraged to attend further counselling when he returns from the UK on the 08 AUG 94”.
24. It was further noted by the Psychologist that as early as 1992, Mr Collins was subject to a Formal Warning. He was also counselled extensively regarding: poor staff relations; derisive treatment of staff; poor attitude; inability to work unsupervised or complete tasks; aggressiveness; mood swings; excessive use of foul language; failure to attend PT sessions; poor team work; poor decision making; arrogance towards supervisors and a lack of interest. When he did not respond to counselling an adverse report was raised in relation to him, it was noted (T3, p28). Mr Collins stated that by the time he consulted the Psychologist on 8 July 1994, he was quite down, confused and was mislaying things and not listening. He believed that by that time he was of concern to the authorities because he was not listening to anyone and they were not listening to him. He therefore agreed with the Psychologist’s findings in that report.
25. In 1992, Mr Collins did recall receiving a Formal Warning but did not recall having any extensive counselling as was reported (T3, p28). He stated that he undertook his job professionally and could manage well unsupervised. Mr Collins did not consider himself aggressive but only putting across his point of view. Mr Collins told the Tribunal that he tried to carry out orders but noted that he could not do this successfully if he did not have adequate staff. Mr Collins acknowledged that the way he explained his situation to his superiors may have been interpreted by them to be aggressive, but he was not meaning to be so. In relation to the issue of failing to attend a “PT session”, Mr Collins noted that he had failed one of his physicals and as a result had to go back and undertake further physical training. He re-did the physical training successfully, which he understood had the consequence of him not having to undertake any further physical training because he was fit. When Mr Collins was ordered by the Flight Sergeant to attend PT training, he refused the order stating he did not need to continue because he had passed his physical test. He later said that he would undertake jogging for his exercise. Documents subsequently indicate that Mr Collins had satisfactory aerobic fitness and was to continue undertaking regular exercise (T3, p41).
26. Mr Collins noted that his work colleagues accepted a lot of what went on around them and got on well with the Officers. They did not say anything or make any complaints. During 1994 and 1995, Mr Collins noted that he was charged on a number of occasions including for drinking a can of beer at the Officers’ Mess but he successfully defended that charge. Mr Collins stated that there were others also on duty at that time who were drinking but were not charged. This was yet another example of how he was “picked on”.. He was also charged with being absent without leave but again this charge was incorrect.
27. In relation to his consumption of alcohol, Mr Collins stated that he commenced consumption of alcohol when aged approximately 18 years when he was in England and he would drink six or seven pints of beer per week. He would not drink during the actual working week. On weekends, he would drink 12 cans of beer on a Friday and Saturday night. He would have a binge drinking session approximately once per month when he went to a disco and at barbecues. He would not drink too much when he was driving the car. Mr Collins was referred to his Service Medical Notes which reported that he had a major “blackout” at Richmond. Mr Collins stated that this was not a blackout, it was just that he was “drunk”. Mr Collins denied having experienced blackouts in the United Kingdom after discos, but agreed that sometimes after attending such venues he would find himself in various places without any recollection as to how he got there. Furthermore, in relation to reports in the service documents of Mr Collins having alcohol withdrawal symptoms such as headaches, nausea and being tremulous, he recalled that when having a medical for a possible re-muster, he told the Medical Officer that he had a few headaches and perhaps that was the origin of the assumption that he was having alcohol withdrawal symptoms.
28. Further records note that Mr Collins admitted to being sick after consuming four or five pints of beer (T3, p19).. Mr Collins agreed that this would occur when he had consumed too much alcohol. Mr Collins disagreed that in 1987 he drank six to nine schooners of beer in a session (Transcript, p61). Mr Collins did agree that he became a regular drinker at age 21 but disagreed with other notes which recorded his consumption of 12 to 13 pints of beer per day. He also denied that he told Dr Babu that he drank ten to 12 stubbies of beer every night (T3, p19). Mr Collins did not deny continuing to drink after Dr Krabman had told him on two occasions to cease alcohol consumption. Mr Collins agreed with Dr Krabman’s report that he had told the doctor that he needed to drink to relax. Mr Collins noted that he was stressed at that time because of his divorce and was definitely drinking more. He denied that this was excessive drinking or that it impacted upon him for example by arriving late for duty.
29. Eventually Mr Collins completed the Steward’s Course and this resulted in his pay increasing. He was still a Corporal however and reported that he was still being constantly watched.
30. It was “news" to Mr Collins that he was an alcoholic as was reported in various documents and in his consultations with doctors and health professionals. Mr Collins stated that he was drinking because of stress but was not an alcoholic. In the latter part of his service, he was sent for consultations with various doctors including a neurologist and a psychiatrist. He saw a Psychologist in Darwin who talked to him about whether or not he hated “black people”.. He initially refused rehabilitation for his alcohol problems but eventually was an in-patient in an alcohol rehabilitation program. He stated that his participation in the program required him to consult a counsellor and he was given puzzles to do fitting various shapes together. Mr Collins attended Alcoholics Anonymous for six months but he could not stand these meetings. Mr Collins stated that he was not an alcoholic and he now does not consume alcohol at all.
31. Responding to various reports from Medical Officers or health professionals that he had a difficulty controlling his anger, Mr Collins did not agree that he had such a problem. When he lost his temper, he told the Tribunal, it was for good reason such as occurred when he was short staffed. Mr Collins stated, “if I didn’t like what I was told then I wouldn’t agree with it”.. Furthermore in relation to his alcohol rehabilitation program, he did not like that and he left because of that. He did not like the place, he was not an alcoholic and he wished to leave. He did not want to be involved in that program in the first place and he agreed that he did refuse to answer questions if he thought they were stupid. Mr Collins did not agree that he was suspended from the program, he just left of his own accord.
32. It got to a point where Mr Collins came to the conclusion that he could not stand the RAAF any more. It was driving him “around the twist”.. He said he could not re-muster, he had lost his job, he had lost his wife and children, lost the house, lost the car and he was not thinking straight. When he left the Rehabilitation Centre he went back to work at Richmond and again he was watched incessantly when he was anywhere near the beer or alcohol, undertaking any work in the Sergeants’ or Officers’ Mess. He was watched like a hawk in case he might have been consuming alcohol. He was hounded and hounded, was isolated and ended up being given a bucket and mop to clean the floors and windows at the Accommodation Centre. Mr Collins stated that there were trumped up charges, for example, being late to a shift in circumstances where his rostered duty was changed without anyone telling him. While Mr Collins agreed that there were adverse reports on him towards the end of his career, he did not agree that when his performance was criticised, he blamed others or would not accept responsibility. Mr Collins’ point was that he was victimised by being given menial tasks, being watched constantly and being allocated double shifts and night shifts. With the amount of pressure he was under, Mr Collins felt that there was nowhere to turn. Mr Collins disagreed that the problems causing him to be reported or warned were initiated because of his use of foul language or refusing to comply with programs or instructions. He stated that a number of charges were dropped because it was proven that the allegations were false.
33. Finally, Mr Collins had had enough and he signed a document to leave the RAAF agreeing with a number of charges. He believed he could not win. He did not necessarily understand the paperwork and it was just given to him to sign so that he could “get the hell out of there”. By the time of his discharge, Mr Collins stated that he was confused and “not right in the head”. Thus he was faced with a situation in his career in the RAAF where initially he was promoted and considered to be polite, clean and tidy and never alcohol-affected to a situation where there were a number of adverse reports and charges on his record. He also had to deal with civilian workforce, which he found demeaning and embarrassing. He was supposed to have told the civilians what to do but often that did not happen.
34. Since leaving the RAAF, Mr Collins has improved his Maths and English skills but has been unsuccessful in seeking employment with Police Service and Correctional Services. He improved himself by undertaking past Public Service exams and believes that he has improved in “leaps and bounds” since 1995. Mr Collins was accepted for enrolment in Charles Stuart University in relation to being trained as a Police Officer, but when the Police Service considered Mr Collins’ RAAF service, he was no longer able to proceed with this course nor employment. Mr Collins had given permission for the Police Service to check his records.
35. Looking back over his career, Mr Collins opined that he could get along 100 per cent with the majority of people. He did not however like being verbally attacked by anyone and would always defend himself. As he had said before, other work colleagues did not defend themselves and just took what was given by the RAAF, instead of fighting the system or they just left of their own accord. Mr Collins explained that his mates had advised him not to react, but for whatever reasons, he often did not take their advice and stood up for himself.
36. Mr Collins was referred to the report of Consultant Psychiatrist, Dr Robinson, who opined that Mr Collins was unable to accept that any of his behaviour contributed to his difficulties in the RAAF. Mr Collins stated that he would not follow orders if they were issued by civilians but he did accept and follow other orders. Dr Robinson had also noted that Mr Collins blamed the RAAF entirely for his lack of educational opportunity and for the failure of his marriage. All Mr Collins could say was that he was so stressed and that that was causing him to get into trouble. He became very angry because he believed that he was working like a slave. He noted that a civilian had reported him as being lazy and an alcoholic and his view was that he was not an alcoholic and certainly not lazy. He noted that there had even been comments by colleagues who told him that considering what he was experiencing, then he must not be liked.
EVIDENCE OF MARGARET THOMAS
37. Ms Thomas is the ex-wife of Mr Collins. She provided a statement dated 28 February 2001 (T10). Ms Thomas opined that her husband’s problems with the RAAF were “not all due to his personality and paranoia” as was suggested by Dr Robinson. She noted that Mr Collins wished to improve his education and his attempt at night school was frustrated by his shift being changed to night shift. Ms Thomas believed that the shift changes were vindictive and further opined that Mr Collins was deliberately hindered in his attempts to gain a better education, yet this was used against him when he tried to re-muster.
38. Concerning “problems with the Aboriginal women”, these were blown out of all proportion and in any event the “Aborigines”, in Ms Thomas’ view, had certain “impunity” being able to get away with a great deal which was not necessarily correct.
39. Ms Thomas knew that Mr Collins was charged with a number of offences and she accepted what he had told her in that his supervisors were deliberately making life difficult for him.. Ms Thomas noted that Mr Collins’ demeanour changed from a sunny disposition to being “dark and moody” when they arrived in Katherine. Ms Thomas was also aware that one charge against her ex-husband was fabricated. This related to Mr Collins being charged with arriving late to a shift in the Officers’ Mess. She had driven him to work on that particular occasion arriving at 10:50pm prior to an 11:00pm shift.
40. Ms Thomas reported that Mr Collins was not and never was an alcoholic and she was shocked to hear that it was considered that he was an alcoholic. Ms Thomas wrote:
“I believe that he was advised to agree that he was an alcoholic as a means to get out of all the trouble. While in a state of shock due to conditions at work, his marriage breakdown and the separation from his family, and the Aborigines accusations he would have been vulnerable to any bad advice or suggestions made without understanding their possible implications and repercussions”. (T10, p86)
EVIDENCE OF DR G S ROBINSON, CONSULTANT PSYCHIATRIST
41. Dr Robinson provided a report dated 27 November 2000 (T5). Dr Robinson noted that Mr Collins blamed the RAAF for the failure of his marriage, the fact that he is unemployed since leaving the RAAF and for not allowing him to better his education.. Dr Robinson further noted that Mr Collins reported that he rarely leaves his flat, has no friends and does not know his neighbours. He is constantly tired and is depressed and has at times thought about suicide. Mr Collins has had a poor sleep pattern since 1993 and has a lack of routine.
42. Dr Robinson opined that if Mr Collins had been alcohol dependent in the past, then that dependence is in sustained remission. There was no evidence to diagnose a major depressive illness or an anxiety disorder. Dr Robinson further opined that Mr Collins fulfilled the criteria in the American Psychiatric Associations’ Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (“DSM-IV”) for paranoid personality disorder. The condition of paranoid personality disorder was not caused by his work at the RAAF, Dr Robinson concluded. Dr Robinson reported that:
“… Mr Collins has an external locus of blame. He blames the RAAF entirely for his lack of educational opportunities. He blames the RAAF entirely for his marriage failing. He appears quite unable to accept that any of his behaviours contributed to his difficulty in the RAAF, although it is clear from his history that in many cases he was given warnings that he would be charged if he did not follow orders, he still did not follow orders. There is evidence in the history that his personality style preceded his Service in the RAAF.
..." (T5, p66)
43. Dr Robinson did not provide an assessment under the “Guide to the Assessment of the Rates of Veterans’ Pensions” (“the Guide”) as he did not consider that Mr Collins has a major psychiatric disorder.
EVIDENCE OF DR G VICKERY, PSYCHIATRIST
44. Dr Vickery provided a report dated 27 March 2002 (Exhibit R2). Dr Vickery noted that at interview, Mr Collins was relatively relaxed. He was seated comfortably with good eye contact, normal speech and spontaneity. Mr Collins was cooperative, responsive and in Dr Vickery’s opinion, displayed some insight into his life situation. Dr Vickery concluded that there was no evidence of “clinically significant anxiety state, depressive disorder, paranoia, thought disorder, hallucinations, delusional or gross cognitive impairment”.. There was furthermore no evidence of clinical psychopathology, psychiatric injury or disorder.
DOCUMENTARY EVIDENCE
dr p krabman
45. Dr Krabman provided a report as part of an “Employment Standard Review” dated 27 June 1995 (T3, p7,8). Dr Krabman noted that Mr Collins had come to attention of 3 Hospital in December 1994 when he was referred for assessment by his superiors after an emotional outburst at work, which Mr Collins claimed was precipitated by stress. At that time, it was noted that he was experiencing multiple personal problems with work, family, finances and accommodation, having separated from his wife and children in 1993. Dr Krabman noted that Mr Collins’ problems were exacerbated by his poor coping skills. It was further noted that a Psychologist’s report in July 1994 concluded that Mr Collins’ personal resources are extremely limited and that he uses denial and avoidance, with very few alternative resources to call upon. While in 3 Hospital, Mr Collins expressed anger at his situation blaming those around him and the RAAF without seeking any constructive solutions. There was a great deal of input from the Base Psychologist and Chaplains in addition to 3 Hospital but it was believed that Mr Collins did not take any steps to deal with his problems.
46. It was further reported that Mr Collins dealt with his stress by consuming significant amounts of alcohol which he had done since at least 1987 when it was noted in his medical documents a high daily intake of alcohol. He initially refused the recommended rehabilitation treatment for his alcohol problem but subsequently attended rehabilitation from 1 February 1995 until 24 February 1995, when he was “suspended” from the course due to disruptive and belligerent behaviour in group sessions. While Mr Collins left the rehabilitation course prematurely, Dr Krabman noted that he had gained insight from that course and had not returned in 1995 to drinking nor did he intend to do so. It was also noted that he had made significant steps towards resolving his family and financial problems. A neuropsychological assessment undertaken in March 1995 did not reveal any alcohol-related brain damage, but a low level of intelligence. Dr Krabman opined that while Mr Collins was at that time doing well, because of his limited personal coping skills and history of personal and interpersonal difficulties, there was a significant risk of further decompensations in the face of personal stressors, and perhaps a return to drinking.
clinical formulation - alcohol rehabilitation
47. Arising out of Mr Collins' alcohol rehabilitation, a report thought to be prepared on 28 February 1995 provided information concerning Mr Collins' family history, education, financial, social and drinking histories (T3, pp18-21). It was noted that Mr Collins had a number of adverse occurrences while on service. In this regard Mr Collins was placed in cells at Richmond in 1984 but not charged for being insubordinate to a Corporal. He had two parking fines in 1994 in Richmond and Windsor. He also admitted to a service charge and had other charges on 20 May 1986 when he was found guilty of assault of a Superior Officer but not guilty in relation to a charge of disobeying of a lawful command. On 14 May 1993 Mr Collins was found guilty of disobeying of lawful command. It was concluded in this report that Mr Collins in February 1995 met the criteria of alcohol dependence and required inpatient treatment.
SUBMISSIONS
48. Mr Collins submitted that there would have been no issue with the RAAF if he had been able to re-muster, as he wanted. He was victimised and this placed him under extreme pressure. Furthermore, the RAAF was not sympathetic when his mother died. Everything he said or tried to communicate to the RAAF personnel was ignored. He stated that there was no consideration of his psychological and other welfare issues. All he had wanted to do and tried to do was to better himself, improve his standard of education and serve well.
49. As a consequence of all his problems and particularly the RAAF not providing him with the opportunity to improve his education by blocking his attendance at night school, causing him to have to deal with staff shortages and not listening to him, in the end he became very stressed and confused, which led to all of his problems just getting on top of him, he contended. Thus Mr Collins noted that losing his job as a Cook’s Assistant, losing his stripes, losing his mother and losing respect of other staff brought him to the conclusion that he lost everything because of the RAAF negligence in assisting him to solve his problems (Transcript, p71). At that point, it was Mr Collins' opinion that the RAAF simply tried to “sweep matters” under the carpet and send him off to various doctors and health professionals for his medical problems. Mr Collins submitted that he did not have medical problems, but work problems. Mr Collins considers himself a well-disciplined man with a good attitude. He would not, however, take any nonsense from anyone, he stated. Mr Collins stood up for his staff and for himself and because of this, the consequence was, Mr Collins submitted, that he was victimised. The mounting pressures of all of these issues then caused him to lose concentration, he became confused and he lost the will to continue. Mr Collins stated that he came to a point where he could see no way out and felt that he was trapped with no other option except to resign.
50. Mr Collins told the Tribunal that whatever the doctors said about his aggression, Mr Collins stated that he was not aggressive. Mr Collins acknowledged that he did have some memory loss, but that was towards the latter part of 1995 when he was in the situation where he believed he had lost everything. He had also been told that he would not make any other rank and therefore he considered he was "just nothing. I was just a robot".. He was taking orders from lower ranking Officers and civilians. Mr Collins was given menial jobs and was in a situation in which, he contended, the RAAF just forgot about him and hoped that he would disappear. The only assistance given to him was from the doctors and that was not what he really needed or wanted.. Mr Collins wanted education and to re-muster, instead of the situation in which he found himself of going round and round in circles. Mr Collins had the dream of being a proud member of the RAAF, not for a short period but for 20 years or more. Mr Collins wore his badge and the uniform with pride as a proud airman but in the end it destroyed him, Mr Collins told the Tribunal.
51. Mr Collins acknowledged that he had never been placed in a war zone but this did not detract from the fact that he suffered from a great deal of worry and stress from the neglect by the Air Force. He was told at the end of his time in the RAAF that he was better off leaving rather than trying to fight the various situations confronting him, including the racial complaint which had been made about him and for which he though there would be a Court case at some stage. The stress that he suffered was not visible like a wheelchair, but it was there nevertheless and had severe consequences for him. Mr Collins noted that when letters was sent to him they would on occasions be opened and when he questioned this, there was the excuse given that it had been opened by someone with a similar name of "Collinson." Furthermore, while there were charges against Mr Collins, other situations where he had been abused or treated incorrectly by Superior Officers did not come to attention and those Officers got away with it, Mr Collins submitted. Mr Collins just had to accept the charges and do his best to tell the truth.
52. In relation to Mr Collins being aggressive, Mr Collins noted that he could not do anything else but defend himself, particularly in a face of abuse about his origins from England. Mr Collins stated that if someone was victimising a person then there is no choice and one has to take "your own laws into your own hands with certain people".. Mr Collins admitted that he may well have contributed to the difficulties by becoming aggressive but should not have to take responsibility for matters where he was being victimised or treated unfairly. The RAAF contributed to his illness while he was there, Mr Collins categorically concluded. When considering his actions of, for example, putting his hand up to pull a Corporal's hand from the door or his poor memory, Mr Collins' final submission is that he was not ill prior to entering the Air Force but following enlistment, just reacted to the stressful situations around him and inappropriate or wrongful actions of those working with him. Mr Collins concluded that by the time he left the RAAF, he was ill and deserved a Pension. While he was inside the RAAF, it was fully responsible for his health and care and in Mr Collins’ view, the RAAF had neglected him in all the circumstances.
53. Ms McConnell for the Respondent submitted that the first issue for the Tribunal is to determine the diagnosis of the conditions suffered by Mr Collins. Ms McConnell referred the Tribunal, as cited in the Respondent’s Statement of Facts and Contentions (Exhibit R1), to the Full Federal Court decision in Repatriation Commission v Budworth (2001) 116 FCR 200 in which the Court determined that the key issue relating to the standard of proof in relation to diagnosis of a claimed injury or disease, is that this matter must be decided to the reasonable satisfaction of the decision-maker in accordance with subsection 120(4) of the Act. The Full Federal Court in Repatriation Commission v Budworth (supra) approved of the decisions in Benjamin v Repatriation Commission (2001) 64 ALD 411 and also in Repatriation Commission v Gosewinckel (1999) 59 ALD 690. Furthermore, Ms McConnell noted that the "reasonable satisfaction" standard of proof has been held to be the civil standard of proof or the balance of probabilities as held in Repatriation Commission v Smith (1987) 15 FCR 337.
54. Ms McConnell noted that in relation to alcohol abuse or dependence, Dr Robinson had opined that Mr Collins may have been alcohol dependent in the past but certainly he was in sustained remission when he was examined by Dr Robinson. Ms McConnell submitted that in terms of alcohol dependence, the evidence did not fit with this condition. When Mr Collins made his claim, it was for stress and depression and during his evidence he talked of victimisation. Ms McConnell stated that there is no Statement of Principles for victimisation. Dr Robinson had ascertained that the diagnosis of Mr Collins' condition is paranoid personality disorder. The Respondent’s primary contention, however, is based on Dr Vickery's opinion, which is that Mr Collins has no psychiatric disease.
55. Ms McConnell noted that when the Tribunal is deciding whether or not the claimant suffers from a disease, it must be established if a Statement of Principles exists and if so, the veteran’s circumstances must be tested against that Statement of Principles in accordance with section 120B of the Act. While the statutory criteria in such Statements of Principles are couched in medical language, Ms McConnell submitted that the Tribunal is not performing a medical diagnostic task in making its decision, but rather is performing an administrative task based on the material before it. Ms McConnell submitted that the Tribunal can not decide that a claimant's disease falls within any particular Statement of Principles unless it has probative material and is satisfied the criteria in the Statement of Principles are met. It was a matter for the Tribunal, Ms McConnell submitted, on the evidence before it including Mr Collins' oral evidence at hearing, as to whether or not he meets the diagnostic criteria for personality disorder as defined in the Statement of Principles and arising out of DSM-IV.
56. If the Tribunal determined that it was reasonably satisfied that the correct diagnosis of Mr Collins' psychiatric condition is personality disorder then there are two possible factors which are:
“1...
(a)suffering a catastrophic experience that immediately preceded an enduring personality change to the level of disorder; or
(b) inability to obtain appropriate clinical management for personality disorder
...
4...
"enduring personality change" means a psychiatric condition that is present for at least two years immediately following exposure to catastrophic stress; where
(a)the catastrophic stress must be so extreme that it is not necessary to consider personal vulnerability in order to explain its profound effect on the personality; and
(b)the personality change is characterised by a hostile or distrustful attitude towards the world, social withdrawal, feelings of emptiness or hopelessness, a chronic feeling of “being on edge” as if constantly threatened, and estrangement
..."
57. Considering the issue of catastrophic experience dealt with in Factor 1 (a), Ms McConnell submitted that this must be something extreme, such as being in combat. Ms McConnell acknowledged that the problems experienced by Mr Collins were significant and stressful, such as his inability to re-muster, difficulty in furthering his education, possible victimisation problems, bereavement when his mother died and losing his stripes. In this regard, Ms McConnell submitted that Mr Collins losing his stripes, while stressful, did not constitute a catastrophic event. Furthermore, this event came about through Mr Collins’ wrongful behaviour and as such were wilful acts. The death of Mr Collins' mother and not been able to re-muster caused the Respondent to express some sympathy with these difficulties, but these events also did not meet the required catastrophic experience which, in Ms McConnell's submission, included such possibilities as been tortured, being the victim of terrorism, or being in combat and did not cover Mr Collins' difficulties in trying to improve himself through education or re-mustering.
58. In relation to Factor 1(b) concerning an inability to obtain appropriate clinical management for his personality disorder, Mr Collins admitted that he obtained a great deal of medical assistance but it was not medical assistance that he wanted, it was educational assistance. Ms McConnell contended that Exhibit R3 with its 715 pages of Mr Collins' records indicated that he was offered appropriate clinical management. Mr Collins refused much of the treatment but this does not constitute a lack of ability to obtain appropriate clinical management. Ms McConnell further contended that an inability to obtain appropriate clinical management would only apply in cases where the injury or disease should have been diagnosed, that is that a reasonably competent medical practitioner should have diagnosed it and it was not so diagnosed. Alternatively, it would apply if the injury or disease was not treated with the skill and expertise that would have been expected to have been given to a civilian at that time, and had the appropriate treatment that would have been given to a civilian at that time been given, the injury or disease would not have progressed or worsened to the extent that it did. For personality disorder, Ms McConnell submitted in her Statement of Facts and Contentions, that the appropriate clinical management would include therapy, group therapy, counselling, behaviour therapy such as relaxation training and possibly drug therapy appropriate to that type of personality disorder. Furthermore, Ms McConnell submitted that clinical management means a treatment regime designed to cure, control or lessen the severity of a condition following its clinical onset. Refusal of an offer of proper treatment does not constitute an inability to obtain appropriate clinical management, Ms McConnell submitted. It is necessary that the inability to obtain appropriate clinical management for the personality disorder is causally related to the particular nature of Mr Collins' service.
59. In relation to the Respondent's primary submission based on Dr Vickery's opinion that there is no psychiatric condition, Ms McConnell noted that Dr Vickery opined that Mr Collins showed no clinically significant anxiety, depressive disorder, hallucinations or psychiatric injury or disorder. Ms McConnell submitted that based on Mr Collins' evidence, he shows very little insight into his own performance, behaviour, skills or relationships with other people generally. His submission to the Tribunal is that he was a well-disciplined airman. Looking at his service documents (Exhibit R3, pp17,18), there is a summary of Mr Collins' events while on service including foul language, assaults, disobedience, formal warnings, unsuitability reports, suspension from the alcohol rehabilitation program and a recommendation finally that he not be re-mustered within the Air Force (Exhibit R3, p19). Ms McConnell submitted that the Respondent would disagree that Mr Collins was a well-disciplined airman. It was from 1986 when he was in Tindal that he started to have the problems and continually not meet the standards required by the RAAF.
60. Ms McConnell submitted that Respondent had some sympathy with Mr Collins in terms of his difficulties since leaving the RAAF and not being able to obtain employment. But the Respondent has no discretion, nor did the Tribunal, to make a determination other then in accordance with the law. In Ms McConnell's submission, whether or not there is diagnosis made of personality disorder or Mr Collins is found to have no psychiatric incapacity, Ms McConnell submitted that Mr Collins does not have entitlement for a Disability Pension under the Act.
FINDINGS
61. In reaching decision in this matter, the Tribunal has taken into consideration the oral and documentary evidence, the submissions, the legislation and the case law.
62. The Tribunal finds that Mr Collins provided evidence to the best to his recollection.
63. It is essential before dealing with any qualification which Mr Collins may or may not have for a Disability Pension, for the Tribunal to determine to its reasonable satisfaction what is the correct diagnosis of Mr Collins' claimed condition. There are a number of possible diagnoses that have been advanced from a variety of sources. In this regard, the Tribunal notes that while Mr Collins served in the RAAF, there was a diagnosis of alcohol dependence or abuse. Subsequently, Dr Robinson diagnosed Mr Collins as suffering from a paranoid personality disorder derived from the diagnostic criteria contained within DSM-IV. On the other hand, Dr Vickery could not diagnose any psychiatric condition, be that personality disorder, anxiety disorder, depressive disorder or any other psychiatric injury or disorder. While Dr Robinson diagnosed paranoid personality disorder, he had opined that this was not related to Mr Collins’ RAAF service.
64. On the oral evidence and from medical expert opinion, the Tribunal is reasonably satisfied that alcohol dependence is not a diagnosis which can be sustained applying the diagnostic criteria contained within the Statement of Principles. While there was a period in the RAAF when Mr Collins was drinking heavily and undertaking counselling and rehabilitation, this appears to be situational and short lived and was not, it seems, an issue just prior to his leaving the RAAF when it was noted that he had ceased alcohol consumption. Certainly Mr Collins' evidence and that of his ex-wife is clear that he is not alcohol-dependent, as supported by Dr Robinson and Dr Vickery. Dr Robinson was of the view that if there was alcohol dependence it was in sustained remission. At the time of Mr Collins' claim, the Tribunal is of the view that it cannot be reasonably satisfied that a diagnosis of alcohol dependence can be sustained.
65. Turning to the issue of paranoid personality disorder, the Tribunal considers the Statement of Principles, Instrument Number 144 of 1995 as amended by Instrument Number 14 of 1997. The definition of personality disorder contained in the Statement of Principles is derived from DSM-IV, the same diagnostic criteria as applied by Dr Robinson in arriving at his diagnosis of paranoid personality disorder. The Tribunal is reasonably satisfied in relation to criterion (a) of the definition of personality disorder contained within the Statement of Principles, that Mr Collins' behaviour and inner experience is manifested in his interpersonal functioning both in the RAAF and subsequently [criterion (a)(iii)]. His cognition about events during service, that is, Mr Collins' way of perceiving and interpreting himself, other people and events, also deviated from the expectation of his culture, as detailed in criterion (a)(i). The Tribunal is also reasonably satisfied that Mr Collins satisfies criterion (a)(ii) as his description of his responses to some of his officers was inappropriate in the circumstances. The Tribunal is also reasonably satisfied that Mr Collins' pattern of behaviour is inflexible and operates across a broad range of personal and social situations, such as with his family and as evidenced by his lack of social relationships. Thus he meets criterion (b), in the Tribunal's opinion. In relation to criterion (c), Mr Collins' evidence, including his description of how he now conducts his life and evidence from medical and personnel records from the RAAF, indicates clinically significant distress and impairment in social situations and in his inability to work. This pattern of behaviour is enduring and stable since the latter part of his service and can be traced back to his early adulthood [criterion (d)]. In relation to criterion (e), there is no indication of any other mental or physical disorder or the direct physiological effects of a substance [criterion (f)]. Neurological examination has not revealed any evidence of organic brain damage as a result of alcohol consumption and the Tribunal also considers that the personality disorder can be identified as a paranoid personality disorder within the ICD Code 301.0.
66. The Tribunal prefers the opinion of Dr Robinson because he has, as the Tribunal is required to do, applied the DSM-IV diagnostic criteria. Dr Vickery in his report has not indicated that in arriving at his consideration of there being no psychiatric condition, that he applied the diagnostic criteria contained within the DSM-IV. Furthermore, the force of evidence available to the Tribunal both in documentary and oral evidence, supports a diagnosis of paranoid personality disorder to the Tribunal's reasonable satisfaction and the Tribunal so finds.
67. To ascertain whether or not Mr Collins' paranoid personality disorder is related to his defence service in the RAAF, the Tribunal is required to consider if either of the Factors from the relevant Statement of Principles is met, which would allow a finding on the balance of probabilities that paranoid personality disorder is connected with Mr Collins' service.
68. Factor 1(a) requires the suffering of a catastrophic experience which immediately proceeds an enduring personality change. "Catastrophic experience" is not defined in the Statement of Principles. In the Macquarie Concise Dictionary, Third Edition, “catastrophic” is the adjective from the noun “catastrophe” which means:
1. a sudden and widespread disorder. 2. a final event or conclusion, usually an unfortunate one; a disastrous end. … 4. a sudden violent disturbance, especially of the earth’s surface; a cataclysm.
69. The Tribunal notes that the New Shorter Oxford English Dictionary, Fourth Edition 1993 describes “catastrophic” as:
“catastrophic...of or pertaining to a catastrophe; disastrous, dreadful...”
Where “catastrophe” means:
“catastrophe...overturning, sudden turn...A disastrous conclusion; overthrow, ruin, calamitous fate...A revolutionary event...A sudden or widespread or noteworthy disaster; an extreme misfortune...”
70. Essentially, the Tribunal is of the view that a catastrophic experience denotes an experience that is severe, extreme and threatening. The events which come closest to being catastrophic, in Mr Collins' individual circumstances, would be the loss of his mother and the dissolution of his marriage. These events are not related to Mr Collins' service. The Tribunal cannot identify any other events which are related to service which could come within a definition of being catastrophic. The Tribunal concurs with the Veterans' Review Board’s conclusion that Mr Collins did experience a number of events during his service. Some of these events were linked to service such as the difficulties with staff or Officers and some which had only a temporal connection with the service, such as the death of his mother and the dissolution of his marriage. The loss or threatened loss of his stripes was directly related to his behaviour as indicated by the documentary evidence and Mr Collins’ own evidence acknowledging that his behaviour and attitude could have been interpreted as aggressive. The Tribunal is required to apply the law which includes the Statement of Principles.. Therefore the Tribunal is not reasonably satisfied that the evidence raises Factor 1(a) as the Tribunal does not consider the events described by Mr Collins related to his service as being catastrophic. Certainly there were events such as the death of his mother and the dissolution of his marriage which could be described as catastrophic, but these experiences are not related to Mr Collins’ service life but to his personal life.
71. Turning to Factor 1(b), which requires an inability to obtain appropriate clinical management, there are many documents from Mr Collins' personnel and medical records which indicate ongoing monitoring, attempts to counsel him, contact with a Chaplain, Psychologist, Psychiatrist and Neurologist and attempts to provide Mr Collins with rehabilitation and other psychological/psychiatric assistance. Some of these attempts by the RAAF personnel to assist him were rejected by Mr Collins and on other occasions he accepted assistance. It is the Tribunal’s view that Mr Collins was able to obtain appropriate clinical management for his personality disorder and at one stage, high alcohol use. Furthermore, there is contemporary documentary evidence including Mr Collins' own statement that by the time he left the service, he had improved and had gained some insight at that time into his difficulties. On all of the material before the Tribunal, the Tribunal is of the view that Factor 1(b) is not met.
72. Accordingly, the Tribunal is reasonably satisfied that neither Factor 1(a) nor 1(b) of the relevant Statement of Principles concerning Personality Disorder is met. Therefore, for all of the reasons expressed above, the Tribunal finds that there is no causative link between Mr Collins' paranoid personality disorder and his RAAF service. In these circumstances, pursuant to section 43 of the Administrative Appeals Tribunal Act 1975, the decision under review is affirmed.
73. Mr Collins represented himself ably at the hearing and he will no doubt be disappointed by this decision. As was attempted by the Tribunal to explain to Mr Collins at hearing and also from the Veterans' Review Board decision, decision-makers in this jurisdiction are bound by the Statement of Principles if one exists and in this case, a Statement of Principles concerning Personality Disorder does exist and its provisions must be applied. Given all of the evidence and applying the Statement of Principles and its definitions and Factors, the Tribunal could not decide otherwise than to affirm the decision under review.
I certify that the 73 preceding paragraphs are a true copy of the reasons for the decision herein of Ms S Bullock, Senior Member and Dr P D Lynch, Member.
Signed: .......................................................................................
AssociateDate of Hearing 3 December 2002
Date of Decision 22 May 2003
Counsel for the Applicant Self-Represented
Advocate for the Respondent Ms T McConnell, Departmental Advocate
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