Dangerfield and Repatriation Commission - [2000] AATA 1150

DECISION AND REASONS FOR DECISION [2000] AATA 1150

ADMINISTRATIVE APPEALS TRIBUNAL )

) No N1999/1788

GENERAL ADMINISTRATIVE DIVISION        )
           Re      Ronald Edward Dangerfield
  Applicant
           And    The Repatriation Commission
  Respondent

DECISION

Tribunal Ms SM Bullock, Senior Member

Date22 December 2000
PlaceSydney

Decision Pursuant to section 43 of the Administrative Appeals Tribunal Act 1975 the Tribunal: 1. Affirms that part of the Veterans' Review Board decision of 3 September 1999, which accepted the Applicant's conditions of generalised anxiety disorder and alcohol abuse as war-caused. 2. Sets aside that part of the decision under review relating to the assessment of the rate of pension and substitutes its decision that the Applicant's Disability Pension be assessed at 80 per cent of the General rate to operate from and including 24 January 1998.

...........…...[sgnd]...................
Ms SM Bullock
Senior Member
Catchwords
VETERNANS' AFFAIRS – Disability Pension – Whether Reasonable Hypothesis raised – Injury or Disease – War-caused – Assessment – Special rate
Legislation
Veterans' Entitlements Act 1986 ss, 5D, 13, 24, 119, 120, 120A
Cases
Repatriation Commission v Cooke (1998) 52 ALD 1
Repatriation Commission v Deledio (1998) 83 FCR 82
Fitzmaurice v Repatriation Commission (1989) 19 ALD 279
Repatriation Commission v Gosewinckel [1999] FCA 1273
Forbes v Repatriation Commission [2000] FCA 328
Banovich v Repatriation Commission (1986) 69 ALR 395
East v Repatriation Commission (1987) 16 FCR 517
Repatriation Commission v Bey (1997) 79 FCR 364
Cavell v Repatriation Commission (1988) 9 AAR 539
Repatriation Commission v Keeley [2000] FCR 532

REASONS FOR DECISION

Ms SM Bullock, Senior Member

This is an application for review to the Administrative Appeals Tribunal ("the Tribunal") by Mr Ronald Edward Dangerfield, ("the Applicant") of a decision of the Veterans' Review Board ("the Board") dated 3 September 1999, which accepted generalised anxiety disorder and alcohol abuse as being war-caused pursuant to section 9 of the Veterans' Entitlements Act 1986 and assessed Disability Pension at 40 per cent of the General rate with effect from and including 24 January 1998 (T2).
A hearing was held before the Tribunal in Sydney on 31 October 2000. Mr Dangerfield was represented by Mr M Vincent of Counsel and the Respondent, the Repatriation Commission, was represented by Ms S Breuer, Advocate with the Department of Veterans' Affairs. Mr Dangerfield provided oral evidence to the Tribunal, as did Dr A Dinnen, Consultant Psychiatrist. The Tribunal took into evidence documents lodged pursuant to section 37 of the Administrative Appeals Tribunal Act 1975 ("T Documents" – T1-T11) and the following evidence:
Exhibit Number     Description Date
A1      Letter ("To Whom It May Concern") from Mr GW Ragg, Director/General Manager, Western Earthmoving Pty Ltd           Received 24 May 2000
A2      Report by Dr A Dinnen, Consulting Psychiatrist, with attachments including Emotional Behavioural Worksheet (1 May 2000)     3 August 2000
R1      Report by Dr J Chen, Consultant in Occupational Medicine    26 May 2000
R2      Report by Mr BG O'Keefe, Consulting Historian 30 May 2000
R3      Report by Dr NJ Schultz, Consultant Psychiatrist         1 June 2000
R4      Report by Dr NJ Schultz, Consultant Psychiatrist         5 October 2000
R5      Report by Mr D Cipriani, Clinical Psychologist   27 June 2000
R6      Mr Ronald Edward Dangerfield's Record of Service Card       undated

Issues

At hearing, the Respondent accepted that Mr Dangerfield meets the diagnostic criteria for generalised anxiety disorder as set out in the Statement of Principles, Instrument Number 48 of 1994, as amended by Instrument Number 275 of 1995. The Respondent also accepts that Mr Dangerfield meets the diagnostic criteria for psychoactive substance abuse in the form of alcohol abuse.
The issues to be decided in this matter are:

Whether or not Mr Dangerfield's conditions of generalised anxiety disorder and alcohol abuse are war-caused pursuant to section 9 of the Veterans' Entitlements Act 1986; and if so, whether or not the assessment of Mr Dangerfield's Disability Pension at 40 per cent of the General rate is correct;
If Mr Dangerfield's pension is assessed at 70 per cent or more of the General rate, is he qualified for payment of pension at the Special rate.

Legislation

The relevant legislation in this matter is the Veterans' Entitlements Act 1986 ("the Act"), particularly sections 5D, 9, 13, 24, 119, 120 and 120A.
Section 5D of the Act deals with the definition of injury and diseases.
Section 9 of the Act deals with war-caused injuries or diseases and provides:
"
9 War-caused injuries or diseases
(1)Subject to this section, for the purposes of this Act, an injury suffered by a veteran shall be taken to be a war-caused injury, or a disease contracted by a veteran shall be taken to be a war-caused disease, if:
(a)the injury suffered, or disease contracted, by the veteran resulted from an occurrence that happened while the veteran was rendering operational service;
…"

Section 13 of the Act deals with eligibility for pension.
Section 119 of the Act, which is not set out here, reflects that the decision making process under the Act is of an administrative nature rather than judicial and also allows decision-makers to take into account matters such as the effects of the passage of time, and the absence or deficiency in records.
Mr Dangerfield rendered operational service in the Royal Australian Navy from 15 February 1955 to 2 November 1955, in Korea. The standard of proof for Mr Dangerfield's operational service is that of the reasonable hypothesis, applying subsections 120(1) and 120(3) of the Act. As relevant, subsections 120(1) and (3) of the Act provide:
"
120Standard of proof
(1)Where a claim under Part II for a pension in respect of the incapacity from injury or disease of a veteran, or of the death of a veteran, relates to the operational service rendered by the veteran, the Commission shall determine that the injury was a war-caused injury, that the disease was a war-caused disease or that the death of the veteran was war-caused, as the case may be, unless it is satisfied, beyond reasonable doubt, that there is no sufficient ground for making that determination.
Note:This subsection is affected by section 120A.
…
(3)In applying subsection (1) or (2) in respect of the incapacity of a person from injury or disease, or in respect of the death of a person, related to service rendered by the person, the Commission shall be satisfied, beyond reasonable doubt, that there is no sufficient ground for determining:
(a) that the injury was a war-caused injury or a defence-caused injury;
(b)that the disease was a war-caused disease or a defence-caused disease; or
(c)that the death was war-caused or defence-caused;
as the case may be, if the Commission, after consideration of the whole of the material before it, is of the opinion that the material before it does not raise a reasonable hypothesis connecting the injury, disease or death with the circumstances of the particular service rendered by the person.
Note: This subsection is affected by section 120A.
…"

Section 120A of the Act deals with Statement of Principles and requires that an assessment of the reasonableness of an hypothesis must be undertaken in accordance with any Statement of Principles issued by the Repatriation Medical Authority or any relevant determination or declaration under the Act. Section 120A as relevant states:
"
120A Reasonableness of hypothesis to be assessed by reference to Statement of Principles
(1)This section applies to any of the following claims made on or after 1 June 1994:
(a)a claim under Part II that relates to the operational service rendered by a veteran;
(b)a claim under Part IV that relates to:
(i)the peacekeeping service rendered by a member of a Peacekeeping Force; or
(ii)the hazardous service rendered by a member of the Forces.
Note 1: Subsections 120(1), (2) and (3) are relevant to these claims.
Note 2: For peacekeeping service, member of a Peacekeeping Force, hazardous service and member of the Forces see subsection 5Q(1A).
(2)If the Repatriation Medical Authority has given notice under section 196G that it intends to carry out an investigation in respect of a particular kind of injury, disease or death, the Commission is not to determine a claim in respect of the incapacity of a person from an injury or disease of that kind, or in respect of a death of that kind, unless or until the Authority:
(a)has determined a Statement of Principles under subsection 196B(2) in respect of that kind of injury, disease or death; or
(b)has declared that it does not propose to make such a Statement of Principles.
(3)For the purposes of subsection 120(3), a hypothesis connecting an injury suffered by a person, a disease contracted by a person or the death of a person with the circumstances of any particular service rendered by the person is reasonable only if there is in force:
(a)a Statement of Principles determined under subsection 196B(2) or (11); or
(b)       a determination of the Commission under subsection 180A(2);
that upholds the hypothesis.
Note: See subsection (4) about the application of this subsection.
(4)Subsection (3) does not apply in relation to a claim in respect of the incapacity from injury or disease, or the death, of a person if the Authority has neither determined a Statement of Principles under subsection 196B(2), nor declared that it does not propose to make such a Statement of Principles, in respect of:
(a)       the kind of injury suffered by the person; or
  (b)       the kind of disease contracted by the person; or
  (c)       the kind of death met by the person; as the case may be.
          …"

Section 24 of the Act deals with qualification for the Special rate of pension and as relevant provides:
"
24 Special rate of pension
(1)       This section applies to a veteran if:
(aa)the veteran has made a claim under section 14 for a pension, or an application under section 15 for an increase in the rate of the pension that he or she is receiving; and
(aab)the veteran had not yet turned 65 when the claim or application was made; and
(a)       either:
(i)the degree of incapacity of the veteran from war-caused injury or war-caused disease, or both, is determined under section 21A to be at least 70% or has been so determined by a determination that is in force; or
(ii)the veteran is, because he or she has suffered or is suffering from pulmonary tuberculosis, receiving or entitled to receive a pension at the general rate; and
(b)the veteran is totally and permanently incapacitated, that is to say, the veteran's incapacity from war-caused injury or war-caused disease, or both, is of such a nature as, of itself alone, to render the veteran incapable of undertaking remunerative work for periods aggregating more than 8 hours per week; and
(c)the veteran is, by reason of incapacity from that war-caused injury or war-caused disease, or both, alone, prevented from continuing to undertake remunerative work that the veteran was undertaking and is, by reason thereof, suffering a loss of salary or wages, or of earnings on his or her own account, that the veteran would not be suffering if the veteran were free of that incapacity; and
(d)       section 25 does not apply to the veteran.
(2)       For the purpose of paragraph (1)(c):
(a)a veteran who is incapacitated from war-caused injury or war-caused disease, or both, shall not be taken to be suffering a loss of salary or wages, or of earnings on his or her own account, by reason of that incapacity if:
(i)the veteran has ceased to engage in remunerative work for reasons other than his or her incapacity from that war-caused injury or war-caused disease, or both; or
(ii)the veteran is incapacitated, or prevented, from engaging in remunerative work for some other reason; and
(b)where a veteran, not being a veteran who has attained the age of 65 years, who has not been engaged in remunerative work satisfies the Commission that he or she has been genuinely seeking to engage in remunerative work, that he or she would, but for that incapacity, be continuing so to seek to engage in remunerative work and that that incapacity is the substantial cause of his or her inability to obtain remunerative work in which to engage, the veteran shall be treated as having been prevented by reason of that incapacity from continuing to undertake remunerative work that the veteran was undertaking.
(2A)     This section applies to a veteran if:
(a)the veteran has made a claim under section 14 for a pension, or an application under section 15 for an increase in the rate of the pension that he or she is receiving; and
(b)the veteran had turned 65 before the claim or application was made; and
(c)       paragraphs (1)(a) and (1)(b) apply to the veteran; and
(d)the veteran is, because of incapacity from war-caused injury or war-caused disease or both, alone, prevented from continuing to undertake the remunerative work (last paid work) that the veteran was last undertaking before he or she made the claim or application; and
(e)because the veteran is so prevented from undertaking his or her last paid work, the veteran is suffering a loss of salary or wages, or of earnings on his or her own account, that he or she would not be suffering if he or she were free from that incapacity; and
(f)the veteran was undertaking his or her last paid work after the veteran had turned 65; and
(g)when the veteran stopped undertaking his or her last paid work, the veteran:
(i)if he or she was then working as an employee of another person—had been working for that person, or for that person and any predecessor or predecessors of that person; or
(ii)if he or she was then working on his or her own account in any profession, trade, employment, vocation or calling—had been so working in that profession, trade, employment, vocation or calling;
for a continuous period of at least 10 years that began before the veteran turned 65; and
(h)       section 25 does not apply to the veteran.
(2B)For the purposes of paragraph (2A)(e), a veteran who is incapacitated from war-caused injury or war-caused disease or both, is not taken to be suffering a loss of salary or wages, or of earnings on his or her own account, because of that incapacity if:
(a)the veteran has ceased to engage in remunerative work for reasons other than his or her incapacity from that war-caused injury or war-caused disease, or both; or
(b)the veteran is incapacitated, or prevented from engaging in remunerative work for some other reason.
…"

Statement of Principles

Applying the principles arising out of Repatriation Commission v Keeley [2000] FCR 532, the Tribunal considers the appropriate Statement of Principles are those in force at the time of the primary decision made by the Repatriation Commission on 12 June 1998 (T7). Accordingly the relevant Statements of Principles used by the Tribunal are:

Instrument Number 48 of 1994 as amended by Instrument Number 275 of 1995 concerning Generalised Anxiety Disorder.
Instrument Number 5 of 1994 concerning Psychoactive Substance Abuse or Dependence.

Background

The following information is provided by way of background and the facts contained within are not in dispute.

Mr Dangerfield was born on 3 December 1933. He is married with three children.
Mr Dangerfield served in the Royal Australian Navy from 7 June 1951 to 2 December 1957. As detailed previously his operational service in Korea was from 15 February 1955 to 2 November 1955 (T3).
On 24 April 1998, Mr Dangerfield lodged a claim for "alcohol abuse" and "anxiety and depression" with the Department of Veterans' Affairs ("the Department") (T4).
On 12 June 1998, a delegate of the Repatriation Commission ("the Commission") refused Mr Dangerfield's claim for anxiety disorder and alcohol dependence (T7).
On 6 July 1998, Mr Dangerfield lodged an application for review to the Board in respect of the Commission's refusal to accept generalised anxiety disorder and alcohol dependence as being war-caused. Mr Dangerfield noted in his application for review that the delegate did not take into account all the relevant information when refusing his claim (T8, p50).
On 16 July 1998, a Commission Review Officer decided that no review would be undertaken under section 31 of the Act (T9).
On 3 September 1999, the Board set aside the Commission's decision of 12 June 1998 and substituted its own decision that the conditions of generalised anxiety disorder and alcohol abuse were war-caused and pension should be assessed at 40 per cent of the General rate with effect from and including 24 January 1998 (T2).
On 24 November 1999, Mr Dangerfield lodged an application for review to the Tribunal noting that the Board had underassessed the rate of his Disability Pension (T1, p3).

Evidence of Mr Dangerfield

Mr Dangerfield told the Tribunal that he was educated to Year Two at High School and left school before obtaining the Leaving Certificate. He joined the Navy aged 17 years and six months. Initially, Mr Dangerfield received basic training in seamanship. After enlistment, he went to HMAS AUSTRALIA receiving further training in relation to "basic engine/boiler room" procedures including basic safety procedures. Mr Dangerfield told the Tribunal he was also instructed on defence and action station procedures and emergency practices. He did not experience action stations in reality until he commenced operational service in February 1955.
Mr Dangerfield was engaged to be married in June 1954 and subsequently married in December 1954, before commencing operational service.
Mr Dangerfield explained to the Tribunal that he had been at sea for approximately 2 years before undertaking operational service. During his naval service he was rated as a stoker.
Mr Dangerfield described his duties as involving work in the engine/boiler room, maintenance of equipment and ongoing mechanical repairs. He was under supervision. Most of his duties were undertaken below decks. His shift would be four hours on followed by eight hours off or four hours on with twelve hours off. If on this latter shift, Mr Dangerfield was also required to undertake repair duties during the 12 hours off.
The quarters on board ship when on operational duty were cramped and Mr Dangerfield told the Tribunal that he slept on a hammock, which had to be stowed away during the day. He was not used to such cramped conditions, having come from a home which was situated on a large block of land.
Mr Dangerfield described for the Tribunal a number of incidences in Korea when he was serving in HMAS CONDAMINE. While Mr Dangerfield knew that this was a peacekeeping mission, he stated the ship was frequently at "battle stations". He did not know whether the battle or action station was a practice procedure or if it was in fact an actual action station situation. Working below decks, Mr Dangerfield was informed of action stations by way of voice pipes. He was obviously not able to see what was going on above deck.
In the early part of his mission to Korea, while in the Formosa Strait, Mr Dangerfield had been told that a British freighter, which also had been in the Formosa Strait some two miles away from his location, had been fired upon. Mr Dangerfield agreed he had told the Board that this incident had occurred in early March 1955. Reference made to the actual log of events for HMAS CONDAMINE, in early March 1955, revealed that HMAS CONDAMINE did not enter the Formosa Strait until 16 March 1955. Mr Dangerfield told the Tribunal he found it very difficult being accurate with dates involving particular past events as well as more recent occurrences. He agreed that he was in Hong Kong at the time when the freighter had been bombed. Mr Dangerfield stated that he always tried to provide the most accurate information he could but was often unable to remember precisely. On occasion he may have provided misleading information but this was not done knowingly. Nevertheless it was from Hong Kong that Mr Dangerfield was embarking on the next stage of HMAS CONDAMINE's journey into the Formosa Straight.

Mr Dangerfield described action stations wherein he was closed or locked-in the boiler room. He was often anxious and worried because he knew that if the ship was seriously hit, the engine and boiler rooms were extremely dangerous places to be located, especially with the threat of machinery which was under great pressure and would be highly dangerous if damaged or exposed to water. Mr Dangerfield described his feelings of stress. He understood that he could be drowned and unable to get out of the engine room in the event of conflict. While he had undertaken some training in his early years in the Navy, it was still a shock to him when he first experienced action stations during his operational service. Mr Dangerfield described his feelings at the time of being very anxious, experiencing a raised heart rate, dry mouth and profuse perspiring.
When at action stations, Mr Dangerfield described being locked in for approximately four to five hours. He thought that there were about five to seven action stations in the nine months he was in Korean waters. His first action station occurred within the first few weeks of his operational service at the time when HMAS CONDAMINE entered the Formosa Strait, which was on 16 March 1955. Another anxious time occurred for Mr Dangerfield when he was told there was an enemy MIG aeroplane in the vicinity. He told the Tribunal that he did not verify the presence of the plane with anyone, noting that he was young at the time and did not think to check with the captain. He told the Tribunal that he simply believed what he was told by the older men and he was very scared. He heard about the presence of the plane after leaving action stations.
A further stressful event for Mr Dangerfield occurred when HMAS CONDAMINE was caught in a typhoon after leaving Japan. The typhoon lasted for five days and Mr Dangerfield told the Tribunal that he expected that the ship would sink and everyone on board would drown. They were expected to work on 10 to 12 hour shifts because so many of the crew were unable to attend to their duties because they were extremely sea sick. Mr Dangerfield, who had never been sea sick before, also experienced illness but was able to keep on working. On this occasion, working in the boiler room, there was no fresh air, and the ship was lurching and falling deeply into the ocean waves. Mr Dangerfield knew and was afraid that if the ship submerged, the boiler room with all its machinery under pressure would "go first". Mr Dangerfield described feeling very "up-tight", he was worried about himself, his survival and his wife and felt that he might never see her again. Mr Dangerfield told the Tribunal that he thought "It was the end".
Mr Dangerfield was referred to a report of Consulting Historian, Mr B O'Keefe, which indicated that the MIG fighters were not near HMAS CONDAMINE. Mr Dangerfield stated that he could not remember exactly when the MIG fighter incident occurred but believed he knew about the air battle before he went into the "danger zone" of the Korean waters.
Mr Dangerfield denied being affected by the climate or the conditions during his operational service but stated that he was affected by being locked up in tight confined spaces in the engine room or boiler room during action stations. Mr Dangerfield stated that the bells would ring before action stations and that he did understand the different degrees of readiness, such as the third and first degree of readiness. Mr Dangerfield explained, however, that different parts of the ship could be at different stages of readiness and that it was not uncommon for one part of the ship to have been on the third degree of readiness and the lower deck to be on the first degree of readiness.
The worst event in HMAS CONDAMINE occurred when Mr Dangerfield was locked in the very small diesel room alone for action stations. He dreaded this experience and noted that he could be locked in the small room containing the diesel generator for two or three hours.
When questioned as to why he did not record any stressful events, namely: being locked up at action stations; the MIG fighter incident; the firing on the British freighter; and, the typhoon, Mr Dangerfield replied that he simply did not know that he was required to record any information about these stressful events.
Mr Dangerfield was questioned about his alcohol consumption. He stated that prior to enlistment, the only alcohol he consumed was approximately one glass of beer once per month when he visited his relatives. Upon enlistment, Mr Dangerfield was still under the legal drinking age of 21 and thus was prevented from legally consuming alcohol. This was the situation for the first eight months of his service. Two years later when assigned to HMAS AUSTRALIA, he began to consume alcohol. In his Alcohol Questionnaire signed on 21 April 1998, Mr Dangerfield reported that he started drinking in 1955, drinking one or two cans of beer because of stress (T4, pp 35,36). Mr Dangerfield told the Tribunal that on service and afterwards, he drank alcohol because it made him feel better, it made him feel "good". After service in Korea, his drinking changed considerably and he noted that this was in an attempt to help him cope with his anxiety. After service Mr Dangerfield drank to excess and wrote that he was now an alcoholic. In April 1998, he was consuming up to 20 schooners of beer per day in addition to consuming scotch whisky. Mr Dangerfield noted that an advocate, possibly from the Vietnam Veterans' Association assisted him in completing the Alcohol Questionnaire.
On service in Korea, there was a ration of beer, at times, of one 26 fluid ounce bottle of beer. It was issued at 4 or 5 pm always with the cap taken off. There was no issue of beer during action stations. Mr Dangerfield estimated that 50 per cent of the time the alcohol ration was available and he took his issue on every occasion. Although the bottle top was taken off, many men had brought their own bottle tops from home and used them to seal the bottles. Mr Dangerfield told the Tribunal that he often could arrange to receive an additional issue because he would trade other articles for beer.
When on shore leave, Mr Dangerfield would find a bar and preferred to drink alone. In Japan for example, he would drink up to three or four bottles of beer in addition to a number of one fluid ounce whisky nips. Mr Dangerfield estimated that during operational service, 50 per cent of the time was on shore. He was limited in the amount of alcohol he could consume because of his finances and also the available time during which he could drink. Thus, Mr Dangerfield would cease drinking when he ran out of money or time. The alcohol helped him relax and he felt better able to deal with situations around him.
Back in Australia in HMAS PLATYPUS, Mr Dangerfield would stay one night in three on board. There was a period when serving in HMAS PLATYPUS when Mr Dangerfield was "dry" because he had the opportunity of working longer hours and increasing his earnings. This was at a time when extra finances were helpful in establishing his home and family. This period of being "dry" lasted only a short time and it was Mr Dangerfield's habit when off duty from HMAS PLATYPUS to stop on the way home at the Watsons Bay Hotel at about 4 pm and then spend an hour before catching the train to Fairfield. At that time, Mr Dangerfield did not drink at home.
When he served in HMAS WARRIGO, Mr Dangerfield returned to drinking six to eight schooners of beer per day. When he left the Navy, Mr Dangerfield stated that it took him five years to find a job where he could consume alcohol with impunity. Having purchased a backhoe, Mr Dangerfield became a contractor, contracting mainly to Western Earthmoving. Mr Dangerfield estimated that 80 per cent of his work was with Western Earthmoving over a period of 20 years. The culture of this work place was that it was common practice to drink before, during and after work. Mr Dangerfield increased his alcohol consumption because his finances had improved and it was part of the work culture. His already well-established alcohol habit became entrenched, he told the Tribunal. During his better times at Western Earthmoving, Mr Dangerfield would earn $1800.00 per week after tax. Over a two year period, from commencement of work at the company, Mr Dangerfield increased his alcohol consumption from six to eight schooners per day to 20.
In approximately 1965, Mr Dangerfield was involved in two motor vehicle accidents because of his drinking. He was charged with negligent driving on both occasions.
Mr Dangerfield used to work 54 hours per week but would not work if the weather was bad. If he did have time off work it was not because of illness or drinking but because of the poor weather.
At the end of 1995, the work situation changed as new work place regulations came into existence with the establishment of WorkCover. Mr Dangerfield explained that the significance of this event was that there were now strict rules and regulations, the application of which were monitored to ensure that workers did not consume alcohol while working.
Prior to the introduction of WorkCover, Mr Dangerfield stated that he noticed that the more he drank alcohol the better he felt. He believed that he had acquired an alcohol habit on naval service and that it increased after service.
In 1995, Mr Dangerfield noticed that offers of work began to "drop off" and he believed that was related to his alcohol consumption. However, no one had actually said anything to him as to why work assignments were reducing and he never asked. Towards 1996, Mr Dangerfield was only working two days per week. He was losing money because of the need to maintain the backhoe and ultimately decided, with his wife, that the business was no longer viable. He did try to contract to other companies but no one retained his services. In the end, Mr Dangerfield made a financial decision to close the business. Mr Dangerfield stated that he was not "sacked", but the "writing was on the wall". While acknowledging there may have been a recession in the earthmoving industry, and this could have affected the work flow, Mr Dangerfield stated that this did not apply to his situation. On Mr Dangerfield's observation, other contractors were still receiving work.
In a letter from Mr G W Ragg, Director/General Manager of Western Earthmoving, it was reported that Mr Dangerfield had worked as an operator and a subcontractor with the company for a period "of approximately 25 years between 1965 and 1996" (sic) and that at one stage during this period the consumption of alcohol in the workplace was tolerated. In later years, Mr Ragg reported that WorkCover regulations combined with the company's policy instigated a total ban on consumption of alcohol in the work place. It was Mr Dangerfield's inability to adhere to these regulations and policies which resulted in the reduction in work provided to him and eventually led to no work being provided to Mr Dangerfield at all (Exhibit A1).
When Mr Dangerfield first ceased employment, his alcohol consumption increased slightly. Now he walks to a local club in the morning from 10am, returns home at lunchtime to make his own lunch and then returns to the club in the afternoon staying from about 3pm to 5pm. There are about 20 drinking friends who Mr Dangerfield may see from time to time in the club. He currently consumes approximately 10 schooners of beer per day. This occurs over a six to seven day cycle, however, Mr Dangerfield stated that he also drinks at home on two occasions each week.
Mr Dangerfield has not attended Alcoholics Anonymous or received any counselling to assist him with reducing or ceasing his alcohol consumption.
Mr Dangerfield first consulted Dr Law, Consulting Psychiatrist, in 1998 and would see him every three to six months. He still experiences dryness in his throat, sweating, increased heart rate, and feels anxious. Mr Dangerfield further described suffering flash backs and dreams of his service back in Korea and stated that he is an extremely poor sleeper. On average, Mr Dangerfield sleeps three hours per night from 9pm to midnight. He stated that he wakes up when the alcohol wears off. He has been a poor sleeper for the last ten to 12 years, but there has been a worsening of his sleeping habits in the last five years where previously he might sleep up to two hours longer. Mr Dangerfield told the Tribunal that he could not remember what normal sleep is.
Dr Law had initially prescribed the antidepressant medication Zoloft but as Mr Dangerfield could not notice any improvement he ceased taking this medication. He told the Tribunal that alcohol is his medication. Mr Dangerfield has not consulted Dr Law for some time but told the Tribunal he has the option of returning to treatment with Dr Law and probably will do this. Mr Dangerfield acknowledged that he had been advised by many doctors, including Dr Law, to either cut down or cease alcohol consumption all together. Mr Dangerfield stated that if he does not consume alcohol he becomes "very cranky".
Mr Dangerfield told the Tribunal that he is unable to read because of poor concentration and inability to recall previous pages. He has no other social activities apart from going to the club. Mr Dangerfield described this as an activity to get him out of the house rather than having social contact with the 20 or so drinking friends at the club.
At home, there is only Mr and Mrs Dangerfield. They may talk once per day and sleep in separate rooms. This has been the situation for the past eight or ten years. "We go our separate ways", Mr Dangerfield stated. The conversations revolve around day to day activities, their financial arrangements and discussions about their daughter who is very ill with a serious renal problem. Mr Dangerfield sees his daughter and grand-daughter approximately every fortnight. He worries about his daughter and her future and also the future of his grand-daughter. Mr Dangerfield explained to the Tribunal that he and Mrs Dangerfield decided for economic reasons to stay together. It was also important to maintain the relationship for the sake of their grand-daughter in the event of their daughter's health deteriorating further. Mr Dangerfield has another daughter in Perth and a son in Sydney.
Around the house, Mr Dangerfield is able to undertake small jobs such as mowing the lawns, fixing taps and the like. He is able to care for himself, wash and bathe, prepare his own lunch and undertake other activities of daily living without difficulty.
Medical evidence
Dr S K Law, Consultant Psychiatrist
The Tribunal has been provided with six reports by Dr Law in relation to Mr Dangerfield, namely 11 May 1998 (T5); 9 November 1998, (T10, p54); 10 November 1998, (T10, p55); 5 July 1999 (T2, p14); 30 August 1999 (T2, p16); and an Emotional and Behavioural Worksheet completed on 10 August 1999 (T2, pp17, 18). Dr Law diagnosed Mr Dangerfield's conditions as service-related anxiety disorder and alcohol abuse (T2, p16). On 9 November 1998, Dr Law opined:
"His anxiety symptoms actually first occurred (that is, the clinical onset) during the time he was posted to Korea, and the symptoms persisted and fluctuated in intensity since then, until this date.
His heavy drinking since the time of military service until this date has been his own attempt (just like "self medication") to curtail the anxiety symptoms by resorting to the use of alcohol. Alcohol is indeed a "medicine", available without a prescription.
He does not suffer from other conditions that would preclude a diagnosis of anxiety disorder (such as thyrotoxicosis)." (T10)

Dr Law further reported that a liver test undertaken on 7 June 1999, recorded markedly elevated gama GT levels. On 10 August 1999, Dr Law completed an Emotional and Behavioural Worksheet using Chapter Four of the Guide to the Assessment of Rates of Veterans' Pensions (Fifth Edition) ("the Guide") and assessed Mr Dangerfield's level of impairment from his generalised anxiety disorder and alcohol abuse at 44 points (T2, pp17, 18).
Dr A Dinnen, Consultant Psychiatrist
Dr Dinnen produced a report of 3 August 2000, noting that in preparing this report he had examined Mr Dangerfield and also had available to him Departmental documents, service details and reports from Dr Law and the Board's decision. Dr Dinnen assessed Mr Dangerfield as having an impairment rating of 42 points. He opined that Mr Dangerfield had a moderately severe disability and did not consider it likely that he would be able to work "up to 8 hours per week" because of his chronic anxiety and heavy drinking (Exhibit A2). Dr Dinnen concluded that Mr Dangerfield was financially secure and:
"…has no real interest or motivation to return to work at this time…."
At the hearing, Dr Dinnen stated that he had not taken a detailed history but it was clear to him that Mr Dangerfield's service was stressful. Dr Dinnen further advised that he did not know that during the period of operational service of nine months Mr Dangerfield was only in Korean waters for a period of approximately 2 weeks. However, this knowledge did not cause him to change his view about the stress experienced by Mr Dangerfield nor its consequences for Mr Dangerfield's health. Dr Dinnen opined that it was not necessarily the quantity or frequency of stressful events but indeed the quality of the stressful event or events, which could lead to the development of an anxiety disorder. Dr Dinnen noted that in his view, there were severe stresses experienced by Mr Dangerfield and they produced typical signs of anxiety such as sweating, dryness in the mouth, shortness of breath and increased heart rate as reported by Mr Dangerfield.
While noting that his report had been principally prepared in relation to the assessment of Mr Dangerfield's psychiatric condition, Dr Dinnen felt he knew enough of the history to confirm that Mr Dangerfield experienced stressful service. Further, Dr Dinnen noted that what is stressful to one person may not necessarily be stressful to another. Dr Dinnen opined that training in action stations, or in safety and emergency procedures would not necessarily prevent stress. Such training may assist but that is dependent on the person and the circumstances. Dr Dinnen used the example of himself being a resident medical student when on Casualty duty in hospitals. Dr Dinnen experienced stress every time the telephone rang in Casualty although he had been trained to deal with this situation. Despite training, knowledge and experience, Dr Dinnen still finds that the telephone can raise his level of anxiety.
The stresses which Mr Dangerfield described and Dr Dinnen relied upon as meeting the definition of a stressful event in the relevant Statement of Principles for Generalised Anxiety Disorder, included Mr Dangerfield's experience of first being at action stations in the Formosa Strait. At that time, Mr Dangerfield was in the boiler room and could not see what was happening above deck. Dr Dinnen noted that not all people would develop an anxiety disorder in the conditions Mr Dangerfield experienced but had no hesitation in opining that at action stations, one is in a heightened state of arousal which can then become chronic and lead to, in Mr Dangerfield's case, an established psychological response of generalised anxiety disorder. Further, the inability to sleep more than two or three hours at a time and having broken sleep as described by Mr Dangerfield, can also lead to long term sleep problems.
Dr Dinnen opined that a more stressful experience for Mr Dangerfield would have been that of being locked up in the small diesel generator room for two or three hours. Such an experience as described by Mr Dangerfield would very understandably lead to feelings of being trapped and at risk, particularly given the high pressured generators whose operation was not only hot but loud. Being alone, not knowing what was happening around him and seemingly having no control over the situation, is a very clear example of a stressful event in which a person's response would be anxiety and stress. Feelings of being trapped, at risk and panicking as described by Mr Dangerfield are real responses to a threatening situation, Dr Dinnen stated.

In relation to the stressful event related by Mr Dangerfield when HMAS CONDAMINE experienced a typhoon near Japan, Dr Dinnen noted that he had not discussed this situation with Mr Dangerfield. However, Dr Dinnen opined that in such circumstances when people are extremely sea sick, afraid for their lives and with the ocean raging around them, that this is a very traumatic situation.
In relation to Mr Dangerfield's level of alcohol consumption, Dr Dinnen opined that this was Mr Dangerfield's way of self-medicating to try and deal with the level of tension on service. Dr Dinnen concluded that the anxiety condition had its onset first and alcohol consumption followed as a response. Dr Dinnen was not aware of Mr Dangerfield being paid in beer while working at Western Earthmoving but acknowledged that those circumstances and the culture of work at this company would only serve to compound Mr Dangerfield's already existing alcohol problem, which developed on service as a response to his anxiety.
Dr Dinnen acknowledged the conclusions of Dr N J Schultz, Consultant Psychiatrist, who discussed the complex interrelationship between generalised anxiety disorder and alcohol abuse. Further, both doctors opined that alcohol abuse and anxiety disorders often coexist and can become secondary to each other. As Dr Schultz reported, alcohol may be used to relieve anxiety symptoms and similarly, alcohol withdrawal can cause anxiety symptoms. Dr Schultz had opined that the inception of Mr Dangerfield's problems may be traced to his period of naval service and perhaps in Korea but did not agree that the period of service was responsible for the continuation of alcohol abuse and anxiety problems. When Dr Dinnen was questioned as to Dr Schultz's conclusion that Mr Dangerfield's current problems were due to his "lack of will power", Dr Dinnen strenuously disagreed with this proposition stating that the actual aetiology of Mr Dangerfield's generalised anxiety disorder and alcohol abuse came from his naval service in Korea. Dr Dinnen opined that these were established psychological illnesses and for Dr Schultz to suggest the issue of "lack of will power" was the cause of the problem, was to suggest a new field of psychological theory. Dr Dinnen concluded that Dr Schultz was a "little green" and his conclusions did not address the ongoing psychological disease of generalised anxiety disorder with all its complexities.
Turning to the assessment of Mr Dangerfield's psychiatric conditions, Dr Dinnen reported Mr Dangerfield's current symptoms as feeling up tight, having shaking hands, sleeping three hours a night, dreaming, avoiding attending activities or reunions and consuming eight to ten schooners of beer per day (Exhibit A2).
Dr Dinnen stated that he believed Mr Dangerfield was truthful and did not exaggerate his symptoms. He stated that the general difficulty in assessing Mr Dangerfield is that because of the effect of alcohol including memory loss, this does mask the severity of Mr Dangerfield's symptoms. For Subjective Distress, Table 4.1, Dr Dinnen opined that the appropriate rating is 10 but indicated that he would be comfortable with Dr Law's rating of 15, given Dr Law's status as Mr Dangerfield's treating doctor. Dr Dinnen stated that the impairment rating of three points assigned by Dr Schultz and Mr Cipriani did not adequately address the level of symptomatology Mr Dangerfield experienced. Further, the rating of six provided by the Board was similarly inadequate.
In relation to Manifest Distress, Table 4.2, Dr Dinnen considered that the appropriate rating is 15 points. Mr Dangerfield has symptoms all the time but again the effects of alcohol mask the actual severity, nevertheless the symptoms are unremitting.
For Domestic Situation, Table 4.5, Dr Dinnen did not consider that the rating assigned by Dr Schultz identified the level of estrangement between Mr and Mrs Dangerfield. While they were still living in the same house, the quality of Mr and Mrs Dangerfield's relationship was extremely poor and they were in reality living separate lives. This is not a close family relationship and a rating of six is considered appropriate by Dr Dinnen.
In relation to Current Therapy, Table 4.8, Dr Dinnen gave a rating of three, while Dr Law, Dr Schultz and Mr Cipriani rated this category as five points. Dr Dinnen noted medication is not provided, however, Mr Dangerfield's self medicates with alcohol. Mr Dangerfield has been seeing a psychiatrist regularly and needed this form of treatment.
Concerning Mr Dangerfield's work situation, Dr Dinnen had assigned a rating of five from Table 4.4 and the Tribunal notes Dr Dinnen's concern that while Mr Dangerfield is unable to work eight hours because of his condition, there may be other factors such as his being financially secure and not motivated to return to work. which prevent him from working.
For the other tables in Chapter Four of the Guide, Dr Dinnen relied on the ratings contained in his Emotional and Behavioural report attached to Exhibit A2.
Dr S K Law, Consultant Psychiatrist
Dr Law is Mr Dangerfield's treating psychiatrist, though Mr Dangerfield has not consulted him for some months. Dr Law diagnosed Mr Dangerfield as having an anxiety disorder and alcohol dependence on 11 May 1998 (T5) but later changed the diagnosis of alcohol dependence to alcohol abuse in a report of 30 August 1999 (T2, p16). Dr Law clearly places the inception of the anxiety condition during the time Mr Dangerfield was posted to Korea and concluded that the symptoms have persisted and fluctuated in intensity ever since.
Dr Law undertook an assessment of Mr Dangerfield's generalised anxiety disorder and alcohol abuse on 10 August 1999 and assessed Mr Dangerfield as having an impairment rating under Chapter Four of the Guide of 44 points.
Dr M J Schultz, Consultant Psychiatrist
On 1 June 2000, Dr Schultz reported that the correct diagnosis for Mr Dangerfield's condition is generalised anxiety disorder and substance abuse in the form of alcohol abuse. The aetiology of the conditions could have occurred on Mr Dangerfield's service in Korea but Dr Schultz opined that the continuance of the conditions was, as previously detailed, a result of Mr Dangerfield's lack of will power.
Dr Schultz provided a further report on 5 October 2000 in which, having been provided with the report of Consulting Historian, Mr O'Keefe, he interpreted this historical material as indicating that Mr Dangerfield was not exposed to any great stress during his operational service and accordingly opined that it was likely that Mr Dangerfield would have developed anxiety and alcohol problems in his life regardless of whether or not he had entered the Navy. Dr Schultz opined that as HMAS CONDAMINE spent only limited periods of time in dangerous waters and was not involved in action stations frequently, the link of the psychiatric conditions to war service was less likely. Dr Schultz concluded that Mr Dangerfield did not satisfy the Statements of Principles for either Generalised Anxiety Disorder or Psychoactive Substance Abuse.
Dr Schultz further concluded that Mr Dangerfield was unlikely to improve in his conditions because of a lack of motivation to do so. In the event that Mr Dangerfield became motivated to cease the consumption of alcohol, Dr Schultz opined that it was likely that Mr Dangerfield would be able to work 20 hours each week (Exhibit R3). Dr Schultz concluded that the correct impairment rating for Mr Dangerfield's anxiety disorder and alcohol abuse is 26 points.
Dr j Chen, Consultant in Occupational Medicine
Dr Chen, in a report of 26 May 2000 (Exhibit R1), noted that in addition to the conditions of generalised anxiety disorder and alcohol abuse, Mr Dangerfield suffers from thoraco-lumbar spondylosis with lumbar degenerative disk disease, osteo-arthritis of both knees, breathlessness (possibly due to asthma or reactive airways disease) and hypertension. Dr Chen opined that Mr Dangerfield's lower back condition would not prevent him from continuing to work as an earthmoving contractor driving a backhoe but could limit his ability to work full-time. In relation to osteo-arthritis of both knees, Dr Chen further opined that this would probably limit Mr Dangerfield's ability to work full-time as an earthmoving contractor, and because of his knee condition Mr Dangerfield would only be able to work at a maximum of four to six hours, five days per week. He would not be able to maintain his own machinery and would have difficulty performing prolonged trunkal bending. Mr Dangerfield's respiratory condition would not prevent him from continuing to work as an earthmoving contractor. However, his abuse of alcohol and inability to restrain from drinking alcohol before and during work would pose a danger to Mr Dangerfield safely operating machinery and would effectively disqualify him from driving. Dr Chen concluded that given Mr Dangerfield's skills, experience and qualifications, his accepted conditions of generalised anxiety disorder and alcohol abuse alone would currently prevent him from working as an earthmoving contractor for more than eight hours per week (Exhibit R1).
Mr D Cipriani, Consultant Clinical Psychologist
In a report on 27 June 2000, Mr Cipriani opined that Mr Dangerfield's report of experiencing three or four calls to action stations per month was not consistent with the available historical evidence. While Mr Dangerfield may have experienced mild symptoms of anxiety at times, Mr Cipriani concluded that it was highly unlikely that this resulted in generalised anxiety disorder. Further, in relation to the beer ration supplied to Mr Dangerfield, Mr Cipriani did not consider that this would have resulted in alcohol abuse or dependency. Mr Cipriani noted that Mr Dangerfield's son abused alcohol between the ages of 18 and 25 and underwent drug and alcohol rehabilitation; this suggested to Mr Cipriani that Mr Dangerfield may have a genetic predisposition to alcoholism which manifested itself under the influence of social or environmental factors associated with being in the Navy. Mr Cipriani concluded that there was no necessary relationship between Mr Dangerfield's increased level of drinking and operational service. He further concluded that genetic factors and social/environmental factors such as alcohol being condoned in the workplace, have been responsible for Mr Dangerfield's heavy drinking over the decades. It appeared to Mr Cipriani that the increasing level of Mr Dangerfield's drinking was not associated with any anxiety disorder, though Mr Cipriani noted Mr Dangerfield's claims that alcohol helped reduce his level of tension. Nonetheless, Mr Cipriani concluded that the level of tension and anxiety experienced by Mr Dangerfield was likely to be from a life long problem associated with maternal abandonment, deprivation and social anxiety. Mr Cipriani concluded that Mr Dangerfield was not subjected to any significant traumatic experiences during his operational service and that he appeared to have always been a shy and socially anxious individual.
Even if Mr Dangerfield had experienced a number of mild anxiety symptoms during operational service, Mr Cipriani would have expected Mr Dangerfield's level of anxiety to have returned to its usual level when no longer exposed to the stress of that service. Had Mr Dangerfield experienced severe stresses during his operational service, one would have expected the development of an adjustment disorder, acute stress disorder or post traumatic stress disorder rather than generalised anxiety disorder, Mr Cipriani opined.
Undertaking an assessment under Chapter Four of the Guide, Mr Cipriani concluded that Mr Dangerfield's impairment rating from generalised anxiety disorder and alcohol abuse is 22 points with a lifestyle rating of four points.
Mr B O'Keefe, Consulting Historian
In a report of 30 May 2000, Mr O'Keefe reported that in the period leading up to and during Mr Dangerfield's operational service, the Nationalist Chinese forces of Chiang Kai-Shek were taking an increasingly aggressive stance in protecting their territorial possessions and putting pressure on the Communist government as a prelude to their aspiration for a reconquest of mainland China. Between September 1949 and November 1954, Mr O'Keefe reported, there were 251 instances of British ships being stopped or molested off the Chinese coast of which at least 141 were caused by the Nationalist Chinese forces or their irregulars. On 19 January 1955, the British merchant ship, "EDENDALE" was hit by bombs and sunk during a raid by Nationalist Chinese aircraft at the southern end of the Formosa Strait. On 7 March 1955, just prior to Mr Dangerfield entering the Formosa Strait in HMAS CONDAMINE, two British freighters the "WESTWAY" and the "TAI SEUN HONG" were fired on and intercepted by Nationalist Chinese warships in the Formosa Strait. Mr O'Keefe concluded that Mr Dangerfield may have been referring to one of those two incidents as there were no other reports of attack on British or other vessel in the Formosa Strait or any where else in Chinese waters in that month. At the time of the attacks, HMAS CONDAMINE was in port at Hong Kong but then cleared the Formosa Strait on 16 March 1955. Following the attack on the two British freighters in March 1955, there were other incidents involving British ships in the Formosa Strait in succeeding months that year. Later in September 1955, the "WESTWAY" was again intercepted in the Formosa Strait by Nationalist Chinese forces. On 21 September 1955, a Nationalist Chinese warship fired on the "HELIKON". Attacks later in September also occurred on the "TEFKROS" and another British ship, the "DORINTHIA", was detained and later released by Nationalist Chinese forces in November 1955. These incidents did not involve casualties.
Mr O'Keefe concluded that:
"This series of incidents throughout 1955 (and before) show there was a definite danger to shipping in the Formosa Strait. It should be noted, however, that most, though not all, of the attacks were carried out on or close to the Chinese mainland, and that all of the attacks were carried out against merchant ships, with the apparent intention of deterring them from trading at mainland Chinese ports; there was no record that I could find of any attacks being made on naval vessels: In the only incident in which a naval vessel was involved – that of 22 September 1955 when the British destroyer HMAS COMUS accompanied the HELIKON – it is noteworthy that the Nationalist Chinese ships stopped its attack and allowed the HELIKON to proceed when the destroyer ordered it to cease fire…." (Exhibit R2, p4).

Mr O'Keefe noted that for the entire time that HMAS CONDAMINE was on operational service, the ship carried out only two patrols in Korean waters. The patrols took place in the periods 8 to 13 May and 14 to 22 July 1955. The first patrol was on the western side of the Korean peninsula and the second on the eastern side. These patrols amounted to two weeks in Korean waters.

In relation to Mr Dangerfield's discussion of the presence of a MIG fighter, Mr O'Keefe noted that during HMAS CONDAMINE's passage through the Formosa Strait, historical records indicated that two aircraft were sighted in addition to several large junks, though several other aircraft were detected. American and what were presumed to be Chinese voices were also heard on voice channels. Mr O'Keefe noted that the only mention of action stations, defence watch or detection of aircraft in the HMAS CONDAMINE's reports of the period in question included the patrols the vessel undertook in Korean waters during May and July 1955. On 10 May 1955, an air battle took place on the western side of the peninsula while HMAS CONDAMINE was on patrol in the area. That battle involved 12 to 16 MIG fighters and eight US Air Force Sabre jets. Two or probably three MIG's were shot down in the course of that engagement, the battle took place about 100 miles north-west of the furthermost point of HMAS CONDAMINE's patrol. There is no reference of the air battle of 10 May in HMAS CONDAMINE's reports of proceedings.
In relation to the alcohol issued during Mr Dangerfield's operational service, Mr O'Keefe noted that each sailor was entitled to one 26 fluid ounce bottle of beer per day while the ship was on passage. No beer was allowed when a ship was on operations or taking part in exercises. Sailors had to buy the bottled beer and the bottle was issued with the top off so that it had to be consumed immediately and also to prevent hoarding or stockpiling.
Submissions
Mr Vincent for the Applicant noted that Mr Dangerfield was 21 years old when he proceeded on operational service in HMAS CONDAMINE. Dealing first with the entitlement matters, Mr Vincent submitted that Mr Dangerfield's conditions of generalised anxiety disorder and alcohol abuse were war-caused and that the Board's decision on 3 September 1999, should be affirmed.
Mr Vincent submitted, in relation to generalised anxiety disorder, that it has been clearly stated by Dr Dinnen and Dr Law, that the onset of generalised anxiety disorder occurred during operational service when Mr Dangerfield was in Korean waters. The actual diagnosis of the condition is not disputed but Mr Vincent noted that Mr Dangerfield clearly met the diagnostic criteria contained in paragraph four of the relevant Statement of Principles concerning Generalised Anxiety Disorder. Referring to the symptoms, he contended that Dr Dinnen reported as did Mr Dangerfield, that Mr Dangerfield had symptoms of anxiety and stress and that these feelings occurred as a result of stressful events on service. Thus, the general hypothesis, put forth by Mr Vincent, is that as a result of Mr Dangerfield experiencing stressful events on service, this led to his generalised anxiety disorder. Mr Vincent relied upon Dr Dinnen's proposition that it is not necessarily the frequency of a stressful event which will be determinate of whether or not a psychiatric condition of generalised anxiety disorder will arise. Thus, the fact there may have been only a few calls to action stations during Mr Dangerfield's service did not preclude him from developing generalised anxiety disorder. Further, Mr Vincent pointed to the fact that Mr O'Keefe, in his historical account of events during February to November 1955 in Korea, indicated that there was clearly danger to shipping in the Formosa Strait during this period. Mr O'Keefe further reported action stations involving HMAS CONDAMINE's initial passage through the Formosa Strait and also action stations when a number of aircraft were detected and Chinese voices picked up on voice channels between May and July 1955. There were also reports of British shipping being at danger of attack or indeed attacked as reported by Mr O'Keefe and Mr Vincent contended that the Tribunal should consider this in its evaluation of Mr Dangerfield's evidence.
Mr Vincent further submitted that Mr Dangerfield's reports of stressful events have been consistent and there has been no material produced to dispute either the events or Mr Dangerfield's reaction to the stressful events. Referring to Dr Schultz, Mr Vincent submitted that he had failed to grasp the point because the historical report did not dispute or refute that Mr Dangerfield was at action stations. Mr O'Keefe clearly reported that HMAS CONDAMINE was in a dangerous situation. In fact, Mr Vincent noted that Dr Schultz at page three of his report (Exhibit R3) described that there were bells ringing for action stations on HMAS CONDAMINE and that this was an anxiety-inducing occurrence. Dr Schultz also refers to Mr Dangerfield experiencing the typhoon and notes Mr Dangerfield being constantly alert and anxious. Mr Vincent referred the Tribunal to Dr Schultz's initial opinion that Mr Dangerfield's anxiety and alcohol abuse relate to his period in the Navy, perhaps in Korea, but then his view that service did not cause these conditions to continue. This opinion, Mr Vincent contended, is at variance with known psychiatric theory as was stated by Dr Dinnen. Mr Vincent concluded that the history used by Dr Schultz in fact is quite capable of supporting the fact that Mr Dangerfield experienced stressful events on service.

Considering Dr Law's reports, Mr Vincent stated that his opinion should be accepted as Dr Law has some authority as Mr Dangerfield's treating doctor.
Mr Vincent submitted that there were at least three stressful events experienced by Mr Dangerfield. Firstly, he was at action stations with all that that entailed, when travelling through the Formosa Strait in mid March 1955 and this is not disputed by any of the historical documents. Mr Dangerfield's reaction to being at action stations, locked in the boiler/engine room was that he experienced stress, he did not know what was happening above deck, he was afraid and he had symptoms of dry mouth, increased heart rate, panic and anxiety. Secondly, a further stressful event occurred with Mr Dangerfield being locked alone in the small one-person diesel generator room. Mr Vincent contended that whether the call to action stations had occurred because of actual danger or as a result of a training exercise was not apparent to Mr Dangerfield until he was able to communicate with others when allowed out of the room. In that circumstance, Mr Dangerfield again experienced anxiety, panic, fear of being drowned if the ship were hit and of being unable to control his situation. A third stressful event occurred when HMAS CONDAMINE was subject to a typhoon and again Mr Dangerfield was anxious, he in fact feared for his life and thought he would not see his wife again.
In such circumstances, Mr Vincent contended that in relation to generalised anxiety disorder, Mr Dangerfield's experiences satisfy factor 1(b) of the Statement of Principles in that he had experienced a stressful event as defined. Factor 1(b) states:
"(b) experiencing a stressful event not more than two years before the clinical onset of Generalised Anxiety Disorder; …
"stressful event" means an occurrence which evokes feelings of anxiety or stress."

Thus a reasonable hypothesis is raised connecting the circumstances of Mr Dangerfield's operational service in Korea to the condition of generalised anxiety disorder, Mr Vincent contended and there is no evidence nor facts to refute this raised hypothesis.

Turning to the condition of psychoactive substance abuse in the form of alcohol abuse, again the diagnosis of the condition is not in dispute and Mr Vincent submitted that the diagnostic criteria as detailed in the relevant Statement of Principles are met.
The onset of alcohol abuse occurred sometime during service and the diagnosis probably was confirmed just after Mr Dangerfield left the service. It is certainly the opinion of Dr Dinnen that the anxiety condition whose onset occurred during operational service then led to the development of alcohol abuse. The relevant factor in the Statement of Principles, Instrument Number 5 of 1994 concerning Psychoactive Substance Abuse or Dependence is factor 1(b) which states:
"(b) having a psychiatric condition prior to the clinical onset of psychoactive substance abuse or dependence; or…
"Psychiatric Condition" means any psychiatric illness that attracts a diagnosis under DSM-1V;…"

Mr Vincent stated that just as Dr Dinnen was strongly of the opinion that an anxiety condition caused Mr Dangerfield to consume alcohol as self medication, this view is shared by Dr Law, Mr Dangerfield's treating psychiatrist. Mr Vincent submitted that both Dr Law and Dr Dinnen discussed the link between the anxiety condition and Mr Dangerfield's alcohol abuse. Dr Dinnen noted that Mr Dangerfield was limited initially by money and opportunity in the amount of alcohol he could consume. While on shore, he would consume six to eight schooners of beer per day but he could not drink to this level on board. Further, when on shore Mr Dangerfield could only drink quantities as allowed for by the time available to him and his finances. Mr Vincent submitted that the opinions of Dr Law and Dr Dinnen should be preferred over Dr Schultz and Mr Cipriani. Further, he stated that even Dr Schultz at page eight of his report, noted the coexistence of anxiety disorder and alcohol abuse. Mr Vincent further submitted that Dr Schultz's interpretation of Mr O'Keefe's history report was misconceived and given that Mr O'Keefe indicated there was very real danger during the time of Mr Dangerfield's service in Korean waters, then a reading of Dr Schultz's report should indicate that he also could see the link between operational service and Mr Dangerfield's anxiety condition. Mr Vincent concluded that Dr Schultz's opinion does not in fact disturb the reasonable hypothesis.
Mr Vincent submitted that Disability Pension for generalised anxiety disorder and alcohol abuse should be granted from and including 24 January 1998. In relation to the assessment of the conditions of generalised anxiety disorder and alcohol abuse, Mr Vincent submitted that there was broad consistency of assessment between psychiatrists Dr Law and Dr Dinnen. He submitted the following ratings using Chapter Four of the Guide.
Subjective Distress, Table 4.1. Mr Vincent submitted that the appropriate rating is 15. It is not appropriate, Mr Vincent contended, to discount this category because of the effect of alcohol masking the symptoms, as noted by Dr Dinnen.
Manifest Stress, Table 4.2. Mr Vincent contended that 10 points was appropriate and this was consistently assessed at that rate by Dr law and Dr Schultz.
Functional Effects, Table 4.3. Mr Vincent did not consider that this category should attract a very high rating, given Mr Dangerfield's ability to function.
Occupation, Table 4.4. Mr Vincent submitted that the appropriate rating should be 8 points to reflect that Mr Dangerfield was unable to work because of his psychiatric conditions alone. All the experts agree that with his present conditions, Mr Dangerfield could not work.
Domestic Situation, Table 4.5. There is no functioning marital relationship and Mr and Mrs Dangerfield are practically estranged. There is no conflict because there is virtually no communication between the couple. Mr Vincent submitted that the appropriate rating would be 6.
Mr Vincent made no submission in relation to Social Interaction, Table 4.6.
Leisure Activities, Table 4.7. Mr Vincent submitted that Mr Dangerfield has a limited range of activities. He is medicated through alcohol and only goes out when in the pursuit of alcohol. Unless the activity involves the consumption of alcohol, Mr Dangerfield is not interested.
Finally, in consideration of Current Therapy, Table 4.8, Mr Vincent noted that Dr Law, Dr Schultz and Mr Cipriani assessed Mr Dangerfield at 5 points, which covers the need for intensive specialist psychiatric treatment on a permanent basis. Dr Dinnen considered that the appropriate rating to cover psychiatric treatment in the form of medication is 3 points. Mr Vincent submitted that the appropriate rating is 5 points.
Mr Vincent concluded that the correct combined impairment rating for generalised anxiety disorder and alcohol abuse is 44 points which is rounded to 45 points.
Mr Vincent next addressed the lifestyle rating. He noted that Chapters 4 and 22 contain tables for assessment, which had completely different purposes and there was therefore no risk of double counting points.
Personal Relationships, Table 22.1. Mr Vincent submitted that the appropriate rating is 4 or 5 points to indicate markedly to severely affected relationships with Mr Dangerfield's spouse and children.
Mobility, Table 22.2. Mr Vincent submitted that this category should be rated at nil as there was no major problems with mobility.
Recreational and Community Activities, Table 22.3. A rating of 6 points is appropriate to reflect that Mr Dangerfield is only able to engage in a few satisfying recreational activities.
Domestic Activities, Table 22.4. Mr Vincent submitted the appropriate rating is nil.
Employment Activities, Table 22.5. Mr Vincent submitted that all the evidence points to Mr Dangerfield being unable to work and that a rating of 5 points is appropriate.
Applying the processes of the Guide, Mr Vincent concluded that the appropriate lifestyle rating for Mr Dangerfield is 4 points.
An impairment rating of 44 points with a lifestyle rating of 4 produces a Disability Pension at 80 per cent of the General rate with effect from 24 January 1998, Mr Vincent contended.
Finally, Mr Vincent submitted that Mr Dangerfield was eligible for payment of pension at the Special rate from the date of cessation of employment. Because Mr Dangerfield was in receipt of a pension of at least 70 per cent, he satisfies subsection 24(1)(a) of the Act. Further, Mr Vincent submitted that it is Mr Dangerfield's psychiatric conditions of generalised anxiety disorder and alcohol abuse which alone prevent him from being able to work.
Mr Vincent submitted that there is no support for the proposition that age played a role in Mr Dangerfield's cessation of work. He had the physical capacity and desire to work but had to cease because he could not work due to his service-related conditions. Once work was no longer provided to Mr Dangerfield because of an alcohol abuse condition related to his anxiety state, he had to sell his backhoe. Therefore, Mr Dangerfield suffered a loss of remuneration as a result of his disabilities alone, causing him to give up work. Mr Vincent submitted that the ameliorating provisions do not apply to Mr Dangerfield's situation because he satisfied subsection 24(1)(c) outright. Further, the decision in Forbes v Repatriation Commission [2000] FCA 328 does not apply in Mr Dangerfield's situation.
Ms Breuer, for the Respondent, referred the Tribunal to Repatriation Commission v Bey (1997) 79 FCR 364 and East v Repatriation Commission (1987) 16 FCR 517 for support of the proposition that a hypothesis must be more than a mere possibility and must be supported by facts which prove it. It is therefore not sufficient for Mr Dangerfield to simply state that he was anxious or concerned about action stations, there must be facts to support this.
Ms Breuer further submitted that the reasoning in Fitzmaurice v Repatriation Commission (1989) 19 ALD 279 is authority for the Tribunal to consider the whole of the Board's decision, which included the issue of entitlement as well as assessment.
Turning to the specific condition of generalised anxiety disorder, Ms Breuer submitted that the Respondent accepted that Mr Dangerfield has this condition and that the diagnostic criteria contained within the relevant Statement of Principles are met. The issue was, however, the causation of the condition. Considering factor 1(b) of the relevant Statement of Principles concerning Generalised Anxiety Disorder, which requires experiencing a stressful event not more than two years before the onset and noting the definition of stressful event, Ms Breuer submitted that prior to his operational service, Mr Dangerfield had been in the Navy for about four years of which two years had been spent at sea. He had taken part in drills and training programs including action and defence stations and knew of the different degrees of readiness. In these circumstances, Ms Breuer submitted that Mr Dangerfield's experience of a stressful event could not be put at a very high level. If Mr Dangerfield had gone straight from enlistment to operational service then that context may have led the Respondent to accept the experiencing of a stressful event. However, in Mr Dangerfield's circumstances, he was prepared, had received training and was by no means new to the naval service.
Ms Breuer also contended that the historical context of Mr Dangerfield's service was further put into perspective by Mr O'Keefe. Relying on Mr O'Keefe's report, Ms Breuer submitted that Mr Dangerfield was not in any danger in the Formosa Strait. For example, in relation to the firing upon a British tanker, Mr Dangerfield was in Hong Kong at the time of what would seem to be the most likely incident. Ms Breuer asked the Tribunal to consider that Mr Dangerfield had in fact told the Board that this incident happened in early March 1955, at which time he was based in HMAS CONDAMINE in Hong Kong. Further, in relation to Mr Dangerfield's fear of being attacked while on action stations and noting Mr O'Keefe's report, Ms Breuer contended that HMAS CONDAMINE was never travelling close to land, where the greatest threat lay, maintaining a distance of some ten miles out to sea and therefore the threat of attack was remote.
Ms Breuer drew the Tribunal's attention to the proceedings from HMAS CONDAMINE, which confirmed that there were no attacks on the ship. Ms Breuer submitted that the exercise of action stations when HMAS CONDAMINE was in the Formosa Strait was only taken as a precautionary measure, "similar to putting a top on a sports car when it rains". Other later action stations procedures were just routine, Ms Breuer submitted.
In relation to Mr Dangerfield's discussion of being in danger of attack by a MIG fighter, Ms Breuer submitted that he relied on what he was told and never, as would have been expected, made enquires to confirm the truth of this occurrence. Again, Ms Breuer contended this could not be considered as a stressful event.
While noting Dr Dinnen's opinion that generalised anxiety disorder and alcohol abuse had their inception in Mr Dangerfield's naval service, Ms Breuer submitted that Dr Dinnen is looking at Mr Dangerfield's situation from a medical perspective while the Tribunal must consider the legal context of Mr Dangerfield's conditions. Ms Breuer submitted that if decision-makers took Dr Dinnen's view, then everyone who served on operational service would suffer from generalised anxiety disorder. In so submitting, Ms Breuer was not suggesting that Mr Dangerfield was not anxious or concerned but that the requirements contained within the Statement of Principles require a stricter test than merely being anxious or concerned. Ms Breuer concluded that it was indeed reasonable to be anxious in the circumstances but this level of anxiety could not support the conclusion that Mr Dangerfield's operational service produced a lifelong psychiatric condition.
Ms Breuer sought to rely upon the views of Dr Schultz and Mr Cipriani whose assessments support the view that the causal link between service and Mr Dangerfield's anxiety and alcohol abuse conditions is remote.
Further, Ms Breuer submitted that the issue of Mr Dangerfield's credit must be considered by the Tribunal. She maintained that reference to historical data indicates that the evidence does not support Mr Dangerfield's estimation of having five to seven action stations in nine months. Further, as Ms Breuer noted previously, the issue of the firing on the British freighter by the Chinese, which Mr Dangerfield submitted occurred when he was travelling through the Formosa Strait, simply was not supported by the facts. Mr Dangerfield was in Hong Kong, preparing to set off for the Formosa Strait, when this event occurred.
Taking all these matters into account, Ms Breuer submitted that factor 1(b) of the Generalised Anxiety Disorder Statement of Principles was not met and therefore no reasonable hypothesis could be said to have been raised.
In relation to the condition of alcohol abuse, Ms Breuer agreed that Mr Dangerfield satisfies the diagnostic criteria for this condition and submitted that if the Tribunal accepts that Mr Dangerfield has a war-caused generalised anxiety disorder, then under the relevant Statement of Principles for Psychoactive Substance Abuse or Dependence, Mr Dangerfield would succeed in raising a reasonable hypothesis under factor 1(b). However, in relation to factor 1(a), which requires experiencing a stressful event prior to the clinical onset of psychoactive substance abuse or dependence and continuing in that abuse or dependence post service, Ms Breuer submitted that this factor is not raised. Reference to the definition of stressful event contained within this Statement of Principles requiring the experience of an incident in which there were external stimuli such as combat resulting in psychological stress, was simply not supported by the facts in Mr Dangerfield's case. Mr Dangerfield never experienced combat during his operational service.
Mr Breuer concluded that it is the Respondent's contention that no reasonable hypothesis could be raised in relation to either generalised anxiety disorder or alcohol abuse. Accordingly, Mr Dangerfield had no entitlement to a Disability Pension for these conditions.
Turning to the issue of assessment, Ms Breuer submitted that if the Tribunal found the conditions of generalised anxiety disorder and alcohol abuse were war-caused then the following assessment would be appropriate using the procedures of Chapter Four of the Guide.
Subjective Distress, Table 4.1. Ms Breuer submitted that the 15 points as suggested by Dr Law was too high and noting the Board's rating of six and the other ratings provided by Mr Cipriani and Dr Schultz, submitted that the appropriate rating would be 3 or 6 to reflect that Mr Dangerfield is "up tight" but not constantly anxious. Further, Ms Breuer pointed to the fact that Mr Dangerfield had sat in a hearing for a day and was able to answer questions without any great level of distress.
Manifest Distress, Table 4.2. The Respondent considered that the rating of 6 is appropriate as Mr Dangerfield was not obviously manifestly distressed in answering his questions and seemed able to focus on things and pick up various points being made during the hearing.
Functional Effects, Table 4.3. The appropriate rating is nil, Ms Breuer submitted, to reflect that there is no impact upon activities of daily functioning in Mr Dangerfield's life.
Occupation, Table 4.4. Ms Breuer conceded that, noting all of the expert opinions, the appropriate rating is 8 to reflect that Mr Dangerfield has an inability to work.
Domestic Situation, Table 4.5. Ms Breuer contended that the appropriate rating, noting the assessments by Dr Law, the Board and Mr Cipriani is 2 or 3. Dr Dinnen provided a higher rating of 6, but Ms Breuer contended this was too high. Ms Breuer noted that Mr and Mrs Dangerfield are still together and still have discussions over their family and their financial circumstances. Mrs Dangerfield cooks Mr Dangerfield's meal each night.
Social Interaction, Table 4.6. Ms Breuer stated that Mr Dangerfield has never been particularly social. She therefore submitted that the Tribunal should not rate him for having low social interaction when social interaction has never been part of his lifestyle. Accordingly the rating appropriate to this category is 1 or 2 points.
Leisure Activities, Table 4.7. Ms Breuer noted that Mr Dangerfield has not undertaken many leisure activities throughout his life and everything appears to be related to his alcohol consumption. Again Ms Breuer submitted that the appropriate rating is 1 or 2 points.
Current Therapy, Table 4.8. Ms Breuer contended that a rating of 5 points is appropriate to reflect that Mr Dangerfield needs care and is not in need of intensive psychiatric treatment.
Turning to lifestyle, Ms Breuer submitted that under Table 22.1, Personal Relationships, a rating of 2 or 3 points would be appropriate to reflect that Mrs Dangerfield does undertake activities for her husband and they are still living together.
Mobility, Table 22.2. Ms Breuer submitted that a rating of nil is appropriate to reflect that there is no impact upon mobility by Mr Dangerfield's conditions of generalised anxiety disorder or alcohol abuse.
Recreational and Community Activities, Table 22.3. The appropriate rating is 2, Ms Breuer submitted, to reflect that Mr Dangerfield's leisure activities never have been a major part of his life apart from those associated with alcohol.
Domestic/Employment, Table 22.4. The appropriate rating for this category is 5 points to reflect that Mr Dangerfield is no longer able to work.
The over all lifestyle rating from Chapter 2 is 2 points, Ms Breuer submitted.

Therefore with an impairment rating of 30 points (6 + 6 + 8 + 3 + 5 = 28, rounded to 30) combined with a lifestyle rating of 2 points, a Disability Pension at 50 per cent of the General rate is produced. If the Tribunal found this was the correct rating, then Mr Dangerfield would not be eligible for consideration of the Special rate of pension.
If, however, the Tribunal finds that Mr Dangerfield has accepted conditions of generalised anxiety disorder and alcohol abuse and the assessment of those conditions reaches 70 per cent of the General rate or more, then he would be eligible for consideration of payment of pension at the Special rate. In such circumstances Mr Dangerfield would meet subsection 24(1)(a) of the Act. Ms Breuer further conceded that in relation to subsection 24(1)(b) of the Act, Mr Dangerfield would also satisfy that because on the balance of probabilities, Mr Dangerfield is totally and permanently incapacitated as a result his accepted disabilities of generalised anxiety disorder and alcohol abuse alone, sufficient to render him incapable of undertaking remunerative work for more than eight hours per week. In so conceding, the Respondent is relying on the reports of Dr J Chen, Dr Schultz and Mr Cipriani.
Ms Breuer submitted, however, that the Respondent does not accept, on the balance of probabilities, that Mr Dangerfield satisfies the requirements of subsection 24(1)(c) of the Act. That is, on the balance of probabilities, Mr Dangerfield is not by reason of the incapacity from alcohol abuse alone, prevented from continuing to undertake the remunerative work that he was undertaking. In this regard, Ms Breuer submitted that a very significant factor in Mr Dangerfield being unable to continue working is his age. This is also supported by Dr Chen and Mr Cipriani. Referring to Forbes v Repatriation Commission (supra), Ms Breuer submitted that that decision is authority for factors such as age being considered to impact upon whether or not a person is able to continue working. A factor such as age can therefore be taken into account when making a determination under subsection 24(1)(c) of the Act. Furthermore, Ms Breuer contended that the ameliorating provision of subsection 24(2)(b) of the Act does not assist Mr Dangerfield because there is no evidence that he attempted to seek work. Mr Dangerfield was 64 years of age on application and was about to reach retirement age. In the Respondent's submission the Special rate pension was not intended to be paid to people in such circumstances as Mr Dangerfield. Accordingly, Mr Dangerfield does not have any entitlement to payment of pension at the Special rate, Ms Breuer concluded.
Findings
The Tribunal has reached a decision in this matter, taking into account the oral and documentary evidence, the legislation and by applying the case law. Before turning to the specific issues in this matter, following Fitzmaurice v Repatriation Commission (supra), the Tribunal considers that the application for review must encompass the totality of the decision made by the Board, that is the issue of both entitlement to pension and if entitlement is established, then the assessment of the appropriate rate of pension.
The Tribunal finds it convenient to deal firstly with the issue of Mr Dangerfield's credit. The Tribunal notes some differences in the evidence as to dates, such as when and where Mr Dangerfield was when the British freighter was fired upon in the Formosa Strait or whether or not he encountered MIG fighters whilst he was serving in HMAS CONDAMINE. Also at issue are the number of action stations he experienced as compared with the number of action stations recorded in HMAS CONDAMINE's official proceedings.
It is important when considering the issue of credibility to note that Mr Dangerfield has been medically assessed as having generalised anxiety disorder and alcohol abuse. The symptoms of these conditions include memory loss and lack of concentration as well as obvious signs of anxiety. Mr Dangerfield was very clear in his evidence that he does have difficulties with his memory and the Board in its decision also noted this. There is consistency in Mr Dangerfield's recollection of the particular events which caused him stress but his detail as to when these might have occurred is, in some instances, inconsistent with the facts. The Tribunal does not consider that this inconsistency is in any way deliberate or indicative of an attempt to mislead the various decision-makers in this matter. Further, the issue of the number of action stations as recorded in the official proceedings in HMAS CONDAMINE as compared with the high number of Mr Dangerfield's recollection, could in fact reflect that some of the action stations were real and others were drills. At the time Mr Dangerfield was in HMAS CONDAMINE and locked in either the diesel generator or the engine/boiler room, he would not therefore have been in a position, at the time he was experiencing this stress, to know whether these were real action situations or drills. Again, the Tribunal does not consider this discrepancy indicative of a lack of credibility on Mr Dangerfield's part. The Tribunal notes that section 119 of the Act has some relevance in this matter. In these circumstances the Tribunal finds that Mr Dangerfield is a witness of truth.
Generalised Anxiety Disorder
The Tribunal finds that on all the objective medical evidence and Mr Dangerfield's own evidence, he suffers from the condition of generalised anxiety disorder. Having examined the diagnostic criteria contained within paragraph 4 of Statement of Principles, Instrument 48 of 1994, as amended by Instrument Number 275 of 1995, concerning Generalised Anxiety Disorder, the Tribunal considers that all of the diagnostic criteria are met. This conclusion was reached by looking at the particular symptoms and their impact upon Mr Dangerfield, as required by those diagnostic criteria.
The Tribunal considers that the date of clinical onset of generalised anxiety disorder during the time Mr Dangerfield was posted to Korea, is between February and November 1955. The Tribunal is confirmed in this view when noting the opinion of Dr Law in a report of 9 November 1998 and also Dr Dinnen's oral evidence. The specific description by Mr Dangerfield at the time of his operational service was that he felt anxious, he was sweating, feeling restless and on edge and had very poor sleeping habits. While Dr Schultz later qualifies his opinion, he also expresses the view that it is likely that the onset of the anxiety symptoms commenced when Mr Dangerfield was in Korea.
Thus there is a hypothesis put that on operational service in Korea, Mr Dangerfield was caused to have the onset of generalised anxiety disorder. This hypothesis is not unrealistic or implausible and hence the Tribunal turned to the relevant Statement of Principles to consider whether or not a reasonable hypothesis could be raised, linking Mr Dangerfield's operational service to the condition of generalised anxiety disorder. Turning to factor 1(b) of the Generalised Anxiety Disorder Statement of Principles, which requires that Mr Dangerfield experience a stressful event not more than two years before the clinical onset of generalised anxiety disorder, the Tribunal notes that Mr Dangerfield described a number of stressful events which caused him feelings of anxiety and stress. The Tribunal considers that there are at least three stressful events, which alone could have caused Mr Dangerfield to exhibit such feelings. Firstly, when entering the Formosa Strait in mid March 1955, the HMAS CONDAMINE was called to action stations. Mr Dangerfield's position as stoker had him on duty in the engine/boiler room. He was locked in there for a period of between four and five hours. While the Tribunal acknowledges that Mr Dangerfield may have had practice drills in action stations before, this had not been on operational service and further, it is in the context of there being very real danger in the Formosa Strait. Mr Dangerfield feared being hit and knowing that if that occurred, the risk to his life or the possibility of injury was very real given the nature of the location where there were high temperatures and machines working under great pressure. Mr Dangerfield stated that he feared for his life and was anxious and stressed, he experienced a dry mouth, raised heartbeat and shortness of breath. He was at this stage 21 years old.
A further stressful event occurred on action stations and although the Tribunal is not aware whether this was an actual or drill situation, it did occur on operational service and in circumstances where the Tribunal accepts that Mr Dangerfield was locked in the diesel generator room alone. Being alone and below deck, the feelings of anxiety and panic were very real to Mr Dangerfield and it is understandable that he felt extremely anxious. Dr Dinnen's opinion in relation to this event was also useful to the Tribunal.
Another stressful event occurred again whilst on operational service when HMAS CONDAMINE was caught in a typhoon. At that time, half the crew were unable to perform their duties because of their extreme seasickness. Mr Dangerfield was also seasick but he continued to work up to ten to 12 hour shifts. Again he was afraid that the ship, if submerged as it crashed through the waves, could experience damage to the engine room which would mean at least certain severe injury or possibly drowning. During this occurrence, Mr Dangerfield feared for his life.
The Tribunal finds that factor 1(b) of the Generalised Anxiety Disorder Statement of Principles is met and therefore a reasonable hypothesis is raised within the meaning of subsection 120(3) of the Act. The Tribunal turned to consider subsection 120(1) of the Act to decide whether it could accept sufficient of the facts as are necessary to support this raised hypothesis.
The Respondent contended that there were fewer action stations than mentioned by Mr Dangerfield and that there was also no real danger at sea as history has indicated. Dr Dinnen opined that the quantity of stressful events was not particularly relevant, that it was the quality of the stress and indeed the reaction of the person experiencing the stress, which is important. The fact is, and the Tribunal has found, that there were a number of stressful events as recorded, which caused Mr Dangerfield to have feelings of stress and anxiety. The Tribunal also considers that travelling through the Formosa Strait during a period of great danger, as reported by Mr O'Keefe, is somewhat different to the context of taking the precautionary step of "putting a top on a sports car when it rains". It is clear from Mr O'Keefe's report that there was a dangerous period in the Formosa Strait from February to November 1955 because of the actions of the Nationalist Chinese forces taking an increasingly aggressive stance. With the benefit of hindsight, it is possible to say that danger to HMAS CONDAMINE never eventuated, however this does not distract the Tribunal from finding that the stress Mr Dangerfield experienced was real, the danger was real and his reaction to it was reasonable in all those circumstances. There is nothing in the material which disproves that action stations and a typhoon occurred. Whether or not the action station was real or part of a drill, given the context of being in Korean waters, even if this was over a two week period, should not discount the effect these circumstances had on Mr Dangerfield's well being. Further, although the Tribunal has not used the events of the possible attack by a MIG fighter or the firing on the British freighter as a stressful event, it is clear that MIG fighters were in the area and that HMAS CONDAMINE recorded Chinese voices on the voice channels. It is also clear that British freighters were fired upon and indeed even hit during the period Mr Dangerfield was in Korean waters. Such knowledge could have been communicated to the ship.
Nothing in Mr O'Keefe's report therefore disproves that the events which Mr Dangerfield reported as stressful events occurred and that his reaction to these was as stated.
In such circumstances the Tribunal is not satisfied beyond reasonable doubt, for the purposes of subsection 120(1) of the Act, that there is no sufficient ground for determining that Mr Dangerfield's condition of generalised anxiety disorder was war-caused. Accordingly, the Tribunal finds that Mr Dangerfield is entitled to Disability Pension pursuant to section 13 of the Act and that Pension should be paid for incapacity arising from generalised anxiety disorder from and including 24 January 1998. Thus the Board's decision in relation to Mr Dangerfield's entitlement for generalised anxiety disorder is affirmed.
Alcohol Abuse
There is no dispute and the Tribunal finds that Mr Dangerfield suffers from psychoactive substance abuse in the form of alcohol abuse. The Tribunal has considered the diagnostic criteria contained within paragraph 4 of Instrument Number 5 of 1994 concerning Psychoactive Substance Abuse or Dependence and considers that on all of the medical evidence and Mr Dangerfield's own evidence that these criteria are met.
The evidence is that Mr Dangerfield did not consume alcohol before service apart from rare family occasions. He drank very little initially on service because he was under the legal drinking age. He was 21 years of age when serving in HMAS CONDAMINE. Here there was a daily beer ration of one 26 fluid ounce bottle of beer. He would trade with other men to obtain another bottle of beer. The beer bottles were issued with the top off but Mr Dangerfield and other men had their own bottle tops. The Tribunal accepts Mr Dangerfield's evidence that he felt uptight and he drank to relax. In Hong Kong he drank alone and to excess. On return to Australia whilst still in the Navy, but ashore, his alcohol consumption increased to ten to 12 schooners of beer per day and after service reached levels of up to 20 schooners of beer per day.
Dr Dinnen opined that Mr Dangerfield drank to self medicate. Further, Dr Dinnen opined that the onset of generalised anxiety disorder came first with the abusive consumption of alcohol occurring later, as Mr Dangerfield attempted to self medicate. Mr Dangerfield continued to drink despite knowing that it was harmful to his health, his safety and to his employment. The Tribunal considers there is present a hypothesis which is not fanciful or beyond scientific possibility linking Mr Dangerfield's abusive consumption of alcohol with service.
The Tribunal turned to the Statement of Principles, Instrument Number 5 of 1994, to ascertain whether or not a reasonable hypothesis could be raised linking Mr Dangerfield's abusive alcohol behaviour to his operational service. The relevant factor, the Tribunal finds, is factor 1(b), which requires the presence of a psychiatric condition prior to the clinical onset of psychoactive substance abuse. The Tribunal has already accepted that Mr Dangerfield had a psychiatric condition, generalised anxiety disorder, which had its onset during operational service in Korea in 1955. It was after the onset of generalised anxiety disorder that Mr Dangerfield turned to abusive consumption of alcohol to self medicate. Accordingly the Tribunal finds that factor 1(b) of the Statement of Principles is met and therefore a reasonable hypothesis is raised in terms of subsection 120(3) of the Act.
The Tribunal then considered whether or not, pursuant to subsection 120(1) of the Act, there were sufficient facts to prove this raised hypothesis. The Tribunal accepts that Mr Dangerfield drank very little alcohol before service. When Mr Dangerfield was on service in HMAS CONDAMINE in Korea, he was anxious, having experienced a number of stressful events; beer was available as a ration and it was to alcohol that he turned to ease his feelings of anxiety. As Mr Dangerfield stated, beer helped relax him and made him feel better. Upon return to Australia, but while still in the Navy, Mr Dangerfield increased his alcohol consumption. Again, the Tribunal accepts that this increase in consumption was part of the established abuse of alcohol pattern established because of Mr Dangerfield's anxiety condition. The Tribunal does not consider that there is sufficient evidence to suggest that Mr Dangerfield increased his drinking or indeed started his drinking habit because of genetic, social or environmental factors. Further, there is no evidence to support the proposition that Mr Dangerfield would have had an abusive alcohol condition regardless of whether he had served in Korea. The Tribunal in noting Dr Schultz's reports, considers that Dr Schultz misinterpreted Mr O'Keefe's historical report; however, allowing for this, Dr Schultz's initial opinion that the inception of anxiety and alcohol abuse occurred during or as a result of operational service in Korea is maintained in the Tribunal's view.
Accordingly, the Tribunal is not satisfied beyond reasonable doubt, for the purposes of subsection 120(1) of the Act, that there is no sufficient ground for determining that Mr Dangerfield's condition of alcohol abuse was war-caused. In such circumstances, the Tribunal finds that Mr Dangerfield is entitled to be paid a Disability Pension, pursuant to section 13 of the Act, for the condition of alcohol abuse. Again this part of the decision by the Tribunal is in agreement with the Board's decision so far as entitlement to pension for alcohol abuse is concerned. Pension is payable for this condition from and including 24 January 1998.
The Tribunal now turns to the issue of assessment of the two conditions, generalised anxiety disorder and alcohol abuse. The Tribunal has undertaken an assessment of Mr Dangerfield's accepted conditions using the Tables contained within Chapter Four of the Guide. The Tribunal notes that there are a wide variety of opinions as to the appropriate assessment for Mr Dangerfield's conditions and in making its own assessment it has taken these into account in addition to Mr Dangerfield's evidence.
Table 4.1, Subjective Distress. Mr Dangerfield describes feelings of anxiety, sweating, poor sleep, flashbacks and lack of concentration. The Tribunal notes that Mr Dangerfield's alcohol consumption helps to mask some of the symptoms but also notes that he has decreased his alcohol consumption in recent times. The Tribunal considers that the appropriate rating is 10 points to reflect Mr Dangerfield has frequent symptoms causing moderate distress. The description accompanying a rating of 15 points is, in the Tribunal's view of all of the evidence, not an accurate description of Mr Dangerfield's condition.
Table 4.2, Manifest Distress. The Tribunal considers that the appropriate rating is 10 points to reflect distress, which is apparent to casual observers. The distress was not observed to be constant and the Tribunal also noted Mr Dangerfield's evidence that he had not consumed alcohol that day.
Table 4.3, Functional Effects. Mr Dangerfield is able to function in day to day situations and undertake activities of daily living. The Tribunal considers that the appropriate rating is 1 point to reflect minor difficulties.
Table 4.4, Occupation. The Tribunal accepts that Mr Dangerfield's alcohol abuse and generalised anxiety disorder mean that he cannot work and accepts that a rating of 8 points is appropriate.
Table 4.5, Domestic Situation. Mr and Mrs Dangerfield still live together but their relationship is very poor. They do discuss issues in common such as their daughter, their grand-daughter and payment of bills; Mrs Dangerfield continues to cook Mr Dangerfield's evening meal. Mr and Mrs Dangerfield have made a decision to stay together, as it is better for them financially and also to provide a support for their daughter and grand-daughter. The Tribunal considers that the appropriate rating is 5 points.

Table 4.6, Social Interaction. Mr Dangerfield's evidence is that he has always been a loner and that he drinks alone although he does meet up with between ten or 20 drinking friends at the local club. He does not arrange to meet them and speaks only with whoever is there. The Tribunal considers that the appropriate rating is 5 points to reflect reduced social interaction.
Table 4.7, Leisure Activities. Mr Dangerfield has given up his mechanical repair of bikes, he is unable to read because he cannot remember the preceding pages but he does go to the club. The Tribunal considers any current leisure activity revolves around Mr Dangerfield's need for alcohol. The Tribunal considers that the appropriate rating is 5 points to reflect a loss of interest in most leisure activities.
Table 4.8, Current Therapy. The Tribunal considers the appropriate rating is 3 points to reflect that Mr Dangerfield needs to have psychiatric care and medication in the form of self medicating with alcohol. He has not seen Dr Law recently but is considering contacting Dr Law again.
Applying the processes of Chapter Four of the Guide, the rating considered appropriate by the Tribunal for generalised anxiety disorder and alcohol abuse is:
15 + 10 + 8 + 5 + 5 = 43 points rounded to 45.
In relation to a lifestyle rating, the Tribunal considers that the appropriate rating is 3 points taken from the shaded area of Scale 23.1. There is nothing to suggest to the Tribunal that the rating should be any higher. Thus an impairment rating of 45 points with a lifestyle rating of 3 points produces a Disability Pension at 80 per cent of the General rate with effect from 24 January 1998.
When Pension is assessed at 70 per cent or higher, then consideration must be given pursuant to section 24 of the Act as to whether or not an earnings-related rate of pension is appropriate. In this instance, as Mr Dangerfield is not working, section 24 of the Act concerning Special rate is appropriate. Some guidance has been provided to the Tribunal in its consideration of Mr Dangerfield's entitlement to Special rate by Forbes v Repatriation Commission (supra).
The Tribunal is satisfied that pursuant to subsection 24(1)(a), Mr Dangerfield meets this requirement as he has a General rate of pension of at least 70 per cent.
Turning to subsection 24(1)(b) of the Act, the Tribunal is also satisfied and the Respondent concedes based on all the evidence, that Mr Dangerfield is on the balance of probabilities, totally and permanently incapacitated for work, as a result of his accepted disabilities of generalised anxiety disorder and alcohol abuse alone, and these conditions in themselves are sufficient to render him incapable of undertaking remunerative work for more than eight hours per week.
The Tribunal considered subsection 24(1)(c) of the Act. The Tribunal accepts that as a result of having to cease work, Mr Dangerfield experienced a loss of remuneration, which has continued. The Tribunal considers, however, that there are a number of factors which impact upon Mr Dangerfield's ability to continue to undertake the remunerative work which he was previously undertaking. In this regard, the Tribunal notes that Mr Dangerfield's age is significant in preventing him from continuing remunerative work. At the time of cessation of work, Mr Dangerfield was aged 64 and nearing retirement age. The Tribunal also notes from Dr Chen that there are other medical conditions present, particularly osteo-arthritis of the knees, which would prevent Mr Dangerfield continuing his work. The Tribunal has gained some support from its conclusions by reference to Banovich v Repatriation Commission (1986) 69 ALR 395 and Cavell v Repatriation Commission (1998) 9 AAR 539.
The Tribunal further considered subsection 24(2)(b) of the Act, which if satisfied, can ameliorate the impact of subsection 24(1)(c). Unfortunately, there is no evidence before the Tribunal that Mr Dangerfield genuinely sought remunerative work since ceasing work in 1996. In fact, the Tribunal notes Dr Dinnen's report of 3 August 2000, in which Dr Dinnen expressed the view that because Mr Dangerfield was financially secure, he lacked any motivation or real interest in returning to work (Exhibit A1). Hence the ameliorating provisions provided for in subsection 24(2)(b) are not satisfied.
Thus, while the Tribunal finds that Mr Dangerfield satisfies subsections 24(1)(a) and (b) of the Act, it finds that the evidence does not allow subsection 24(1)(c) or subsection 24(2)(b) of the Act to be satisfied. In such circumstances, Mr Dangerfield is not qualified for payment of pension at the Special rate.
In all the circumstances, the Tribunal finds that Mr Dangerfield is entitled to a Disability Pension pursuant to section 13 of the Act for the conditions of generalised anxiety disorder and alcohol abuse. Disability Pension should be paid at 80 per cent of the General rate from and including 24 January 1998.
Accordingly, for all the reasons set out above and pursuant to section 43 of the Administrative Appeals Tribunal Act 1975, the Tribunal determines that:
1.        The Veterans' Review Board decision of 3 September 1999, as it relates to the conditions of generalised anxiety disorder and alcohol abuse, is affirmed.
2.        The part of the Veterans' Review Board decision of 3 September 1999, as it relates to the assessment of Disability Pension, is set aside and in substitution therefor the Tribunal assesses Mr Dangerfield's Disability Pension at 80 per cent of the General rate from and including 24 January 1998.
I certify that the 171 preceding paragraphs are a true copy of the reasons for the decision herein of Ms SM Bullock, Senior Member
Signed:         ............................[sgnd]..................................................
  Sharonne Brainenberg, Associate
Date of Hearing  31 October 2000
Date of Decision  22 December 2000
Counsel for the Applicant        Mr Mark Vincent
Solicitor for the Applicant         R L Whyburn and Associates
Advocate for the Respondent Ms Susie Breuer, Advocate, Department of Veterans' Affairs.