Favaloro and Comcare (Compensation) - [2024] ARTA 278

Favaloro and Comcare (Compensation) [2024] ARTA 278 (29 November 2024)
ReviewNumber: 2023/5112, 2023/8990
Division:GENERAL DIVISION
File Number(s): 2023/5112 & 2023/8990
Re:Peter James Favaloro
APPLICANT

AndComcare
RESPONDENT

DECISION
Tribunal:R Cameron, General Member
Date:29 November 2024
Place:Melbourne

Pursuant to s 105 of the Administrative Review Tribunal Act 2024 (Cth), the Tribunal affirms both of the decisions made under review dated 16 May 2023 and 20 November 2023.
................................[sgd]........................................
General Member
Catchwords – Commonwealth employee – review of entitlement to medical expenses for hypertension – extensive clinical notes provided in evidence – was the applicant’s claimed condition of ‘hypertension’ significantly contributed to by his employment – applicant’s current condition of hypertension is a persistence of a pre-existing condition and other lifestyle factors – decisions under review affirmed.
Legislation
Administrative Review Tribunal Act 2024 (Cth)
Safety, Rehabilitation and Compensation Act 1988 (Cth)
Evidence Act 1995 (Cth)
REASONS FOR DECISION
R Cameron
INTRODUCTION

There are two applications before the Tribunal for consideration.
In the first application (No. 2023/5112) the applicant seeks review of a reconsideration determination made by the respondent on 16 May 2023 which affirmed a previous determination made on 16 March 2023 (‘the first reviewable decision’). The previous determination made on 16 March 2023 declined liability for the pharmaceutical ‘Coversyl Plus’ otherwise referred to as ‘Coversyl’ purchased on 7 March 2023 pursuant to s 16 of the Safety, Rehabilitation and Compensation Act 1988 (Cth) (‘the SRC Act’).
In the second application (No. 2023/8990) the applicant seeks review of a reconsideration determination made by the respondent on 20 November 2023 which also affirmed a previous determination made on 11 May 2023 declining liability for hypertension pursuant to s 14 of the SRC Act (‘the second reviewable decision’).
A BRIEF PROCEDURAL HISTORY
The applicant lodged with the respondent a Certificate of Capacity dated 31 January 2023 completed by his general practitioner. That certificate diagnosed the applicant as experiencing, ‘[a]djustment reaction with mixed emotion features hypertension aggravated by stress.’
Further lodged with the respondent by email on 3 February 2023 were receipts for prescriptions that the applicant purchased as at 2 February 2023. Amongst these prescriptions were for a medication Coversyl.
Additionally, the applicant further lodged with the respondent the invoice or receipt for medication Coversyl Plus dated 7 March 2023.
Following receipt of the above material a Comcare Delegate made a decision on 16 March 2023 concerning the applicant’s claim to be reimbursed for amounts expended on the Coversyl or Coversyl Plus medication. (‘the 16 March 2023 decision’). The claim was denied. The grounds relied upon by the Delegate in declining the applicant’s claim for reimbursement for such medication were as follows:
(a)Coversyl Plus is an antihypertensive applied for the management of hypertension,
(b)the applicant’s compensable condition is an ‘adjustment disorder with mixed emotional features’; and
(c)Comcare had not accepted liability for any secondary conditions.
As he was entitled to do, the applicant sought reconsideration of the 16 March 2023 decision.
As noted above, a Director from Comcare’s Reconsiderations and Appeals division made the reviewable decision which confirmed the previous decision declining liability for the medication Coversyl purchased on 7 March 2023 pursuant to s 16 of the SRC Act. The reviewable decision declined liability on the grounds that such medication was not obtained in relation to the applicant’s compensable condition relying upon medical information, details of which were articulated in the decision itself, and need not be reproduced for the purposes of these reasons.
With respect to the second reviewable decision, the applicant lodged with the respondent on 27 February 2017 a claim form described as ‘Notification of a Newly Reported Condition’. The ‘new condition’ which the applicant claimed for was described as ‘hypertension aggravated by stress’. In response to question 5 of that form which asked the applicant to describe how the new injury or illness had been caused by his existing compensable condition he replied, ‘[t]his condition has always been part of my existing compensable condition and has been noted in the diagnosis on all my accepted medical certificates’.
As noted above, on 11 May 2023, the respondent denied liability for hypertension on the grounds that there was insufficient evidence to conclude that the applicant’s hypertension was related to or caused by his employment.
In making the second reviewable decision,[1] the reconsideration officer condescended to considerable detail in outlining the evidence that was before him with respect to the matter. Those details need not be reproduced for the purposes of these reasons. The fulcrum of the decision made by the reconsideration officer can, however, be distilled into several key elements that were relied on in making the determination as follows:
(a)The currently available information confirmed that the applicant was aware he had high blood pressure from at least mid-1994 at a time when he was diagnosed with ‘work-related stress’;
(b)Further the applicant’s age of 61 years at the time of him being diagnosed with hypertension at the Geelong Hospital in July 2009, his family history of heart attack and hypertension together with other matters adversely affecting his health, including being overweight, lack of exercise and long-term alcohol overuse were factors which contributed to or cause the condition claimed for;
(c)The reconsideration officer did not believe that the applicant’s general practitioner had been furnished with his full medical and family history when he concluded that there was a connection between the applicant’s compensable condition and the subsequent diagnosis at Geelong Hospital of a hypertension condition; and
(d)Therefore, in considering the risk factors in matters which may be taken into account when considering if the claimed condition of hypertension was contributed to a ‘significant degree’, on balance, they found that the applicant’s employment from between approximately November 2008 and 30 January 2009 or his compensable condition, could not be considered to a contributed to significant degree to him experiencing those symptoms of hypertension or aggravation of hypertension from that time and continuing. Accordingly, they concluded that the respondent was not liable to the applicant for the claimed condition.
[1] JTB, 173,
THE EVIDENCE BEFORE THE TRIBUNAL
There was documentary and oral evidence before the Tribunal.
The applicant gave evidence on affirmation.
As for documentary evidence a Joint Tribunal Book comprising 192 pages, arranged by the parties which contained all relevant documents including medical reports, clinical notes, other medical records, claim forms, and correspondence was tendered.
During the conduct of the hearing three additional documents were tendered. They were a Medical Certificate for Workers Compensation dated 23 October 2009 signed by Dr Hales the applicant’s then treating general practitioner, a further Certificate of Capacity dated 31 January 2023 signed by Dr Arman Ouveysi the applicant’s current treating general practitioner, together with a letter of 22 July 2010 from a delegate of the respondent addressed to the applicant.
ISSUES FOR CONSIDERATION BY THE TRIBUNAL
The respondent in its Statement of Facts, Issues and Contentions lodged on 24 September 2024, helpfully and accurately articulates the issues for determination by the Tribunal.[2]
[2] Respondent’s Statement of Facts, Issues and Contentions, [5] – [6].
They may be summarised as follows:
(a)With respect to application No. 2023/8890, whether the applicant’s ailment of ‘hypertension’ was significantly contributed to by his employment, such that liability should be accepted for such claimed condition of ‘hypertension’ pursuant to s 14 of the SRC Act as a ‘disease’ and therefore being an ‘injury’ within the meaning of sections 5A and 5B of the SRC Act; and
(b)Further, with respect to application No. 2023/5112, whether the applicant is entitled to compensation under s 16 of the SRC Act for a claimed medication being ‘Coversyl Plus’ and if so, whether it is:
(i)being obtained in relation to the accepted condition; and
(ii)reasonable treatment for the applicant to obtain in all circumstances.
A SUMMARY OF THE APPLICANT’S EVIDENCE
The applicant who was self-represented, at the commencement of the hearing, made submissions from the bar table which were adopted by him when he was in the witness box. The thrust of his submissions was to take exception to the contentions of the respondent in its Statement of Facts, Issues and Contentions in several respects. In particular, he challenged vigorously the contents of paragraph 10 of that document.
He steadfastly submitted that the contention of the respondent, that the report of Dr Hales dated 3 May 2023, which stated that he had no history of hypertension prior to 2009 was incorrect and indeed not the case. In support of this submission, the applicant gave evidence that he did not require any hypertension or blood pressure medication prior to the year 2009. By way of corroboration of this evidence, he submitted that he had been a blood donor prior to 2009. As a blood donor he would not be permitted to give blood if his blood pressure was too high, which presumably, was measured at the time of, or shortly prior to, making a blood donation.
Another limb to the applicant’s submission concerned the evidence that appeared in certain material before the Tribunal concerning his past medical history and family history. He acknowledged that his father had a quadruple heart bypass problem, several members of his family had kidney problems and many members of his family experienced high cholesterol levels. The applicant stated he has had none of those conditions. The only medication he had taken was blood pressure medication since the incident that led to his previously compensable condition being accepted occurred in early 2009.
It was reiterated by the applicant, with strong reference to the report of Dr Hales of 3 May 2023, who he emphasised had been his treating general practitioner for many years, including when the compensable condition first arose, for which a claim was made in 2009, that the stress he was under caused by his workplace at the time was what caused his increased blood pressure. Particular emphasis was placed on the comments made by Dr Hales in the report of 3 May 2023 which stated, amongst other things, ‘[h]e has no evidence of hypertension prior to 2009’.
Reference should also be made to a submission, or perhaps more accurately and email, in brief form made by the applicant on 15 July 2024.
In the submission, the applicant had by then received a copy of the report prepared by and respondent’s advice to Associate Professor Gutman. The applicant sought to challenge the findings in that report with the history itemised by Dr Hales which recorded no history of hypertension prior to the incident in 2009. In the submission, the applicant stated that he did see Dr Hales on 5 October 2006, where a blood pressure reading was recorded of 170/90. On that occasion, Dr Hales did not prescribe any medication and the applicant submitted it was not needed. In essence, this submission contended that by reason of these fact that he did not suffer from the hypertension for which he now claims.
Finally, the applicant placed reliance on the fact that he had been paid in the past by the respondent and it had now stopped.
It is appropriate to mention several aspects of the evidence given by the applicant during cross-examination. He was carefully and searchingly cross examined. There was particular emphasis placed upon the entries recorded in clinical notes made by several of the applicant’s treating general practitioners over many years.
At the commencement of cross-examination, the applicant was taken to the observation contained in Dr Hales’ report of 3 May 2023, referred to above, which stated that there was no evidence of hypertension prior to 2009. It was specifically put to the applicant that it was incorrect. His initial response to the question was to state that he had never taken medication prior to 2009 and later when pressed, conceded somewhat reluctantly that Dr Hales should have said there was no evidence that he required medication prior to that date.
As for the clinical notes, the first clinical note that the applicant was taken to in cross-examination was one recording a visit made by the applicant to Dr Williams on 19 April 2005. Dr Williams was a general practitioner who also practised from the same surgery as Dr Hales.
The applicant’s evidence concerning his attendance on Dr Williams on 19 April 2005 was at considerable variance to the evidence he gave with respect to his attendance on other general practitioners from time to time that he was taken to. His consistent evidence was that he had no recollection of ever seeing Dr Williams. When several of the specific entries recorded in Dr Williams’ clinical note of that day were accurately put to him his consistent response was that he could not recall.
Dr Williams made an entry in his clinical notes which recorded ‘high BP + lots of cardiac risk factors incl. dad’s big AMI at 61 y.o’.[3] The applicant could not recall this. However, he readily conceded that his father had a big heart attack at the age of 61. It seems unlikely that Dr Williams, even though he had treated the applicant’s father from time to time, would have included this reference in his clinical notes unless the applicant had referred to the fact during the consultation.
[3] JTB, 117.
The blood pressure reading recorded by Dr Williams in the clinical note of 165/105 was put to the applicant. His robust response was, ‘I don’t accept it is accurate’. The Tribunal cannot accept this evidence from the applicant. It does not seem probable that Dr Williams would have either inaccurately recorded the blood pressure reading in the clinical notes, or in some other way reconstructed or invented it. More likely than not the entry in the clinical notes was made by Dr Williams at the time he took the applicant’s blood pressure reading. As was observed in discussion between the Tribunal and counsel for the respondent, clinical notes have the attributes of a business record within the meaning of the uniform Evidence Acts,[4] and by reason of same are prima facie proof of their contents. Also, the Tribunal finds it difficult to accept the applicant’s evidence that was given so robustly that the blood pressure reading was inaccurate, when he otherwise consistently maintained that he could not recall ever seeing Dr Williams.
[4] 1995 (Cth).
Importantly, for this application Dr Williams has in a section of the clinical notes headed ‘Actions:’ recorded that a drug known as ‘Ramipril 5mg 1 daily’ was prescribed.[5] He also recorded that the medication should be reviewed in one month’s time. Ramipril is a drug prescribed for high blood pressure. When this was put to the applicant in cross examination, he repeatedly stated that he did not recall the medication, he had no recollection of whether he took it or not, he had no recollection of getting the medication prescribed and he had no recollection of being advised to see Dr Williams for the purposes of reviewing the medication prescribed one month later.
[5] JTB,117
A clinical note of the applicant attending Dr Hales on 5 October 2006 was also put to the applicant in cross examination. The applicant acknowledged that he would agree that if Dr Hales had written the clinical note it would be accurate. The blood pressure reading recorded on that attendance was 170/90. The applicant stated that if Dr Hales had recorded it, he believed it. It was then specifically put to him that if he accepted the entries in Dr Hales clinical note of 5 October 2006 why did he not accept the entries in the clinical note previously prepared by Dr Williams following the attendance in April 2005. Once again, his response was that he did not recall seeing Dr Williams. The clinical note of Dr Hales of 5 October 2006 did refer to the applicant being prescribed Ramipril and noted that he had ceased taking them.
A clinical note of a consultation between the applicant and another general practitioner at the same clinic as Dr Williams and Dr Hales, namely Dr Schapp of 24 April 2007 was briefly referred to in cross-examination. Reluctantly, the applicant conceded that the clinical note was accurate. It recorded that the applicant needed to lose weight, which he conceded was probably correct at the time.
A clinical note recording an attendance by the applicant on Dr Hales on 30 January 2009 recorded that the applicant had lost some weight. This was the first occasion on which the applicant had consulted Dr Hales with respect to the condition for which he made a compensation claim. It was also the day he ceased work. The blood pressure reading on that day was 160/100. The applicant stated that if Dr Hales had examined him and recorded that, he would not deny its accuracy.
The applicant was then taken to the contents of a Confidential Psychological Report dated 2 February 2010 prepared by Ms D’Arcy-Tehan a psychologist, following a written request from the respondent.[6] The applicant stated that he first saw her after he had been referred by Dr Hales. Appended to that report were ‘Case Notes’ of several sessions that she had with the applicant.[7] The notes of the session of 11 February 2009 recorded several things. They were that the applicant reported a pain in his chest which his doctor had described as ‘okay’, all the tests undertaken by the applicant’s doctor were ‘ok’”, ‘Except high BP which has had for years’. A later entry recorded on that same date consists of the applicant informing her that he ‘[e]njoys drinking red wine and describes it as “his only pleasure”. Wants to do wine makers class’.
[6] JTB, 51.
[7] Ibid, 60.
When probed on these entries made by Ms D’Arcy-Tehan in her case notes, particularly with respect to having had high blood pressure for years his response was:
I don’t believe that I said that. I might have said I have had high blood pressure and I would certainly say yes, my blood pressure is high, but I wouldn’t have said I had it for years. I say that part of the record is not accurate.
The Tribunal finds this evidence on the part of the applicant somewhat difficult to accept. It seems unlikely than an experienced psychologist such as Ms D’Arcy-Tehan would have inaccurately recorded such an observation or would be so mistaken in the sense suggested by the applicant. This conclusion is fortified by the fact that the applicant did concede that he had mentioned on multiple occasions that he drank alcohol regularly. Indeed, he said he had consumed alcohol in significant quantities for approximately 50 years. Usually, a bottle of wine per night. This evidence was later qualified by him stating that he does not get drunk or have a hangover. He further conceded that it is fair to say that over the years doctors have told him that it would be advisable to cut back his alcohol consumption. He did admit that he told Ms D’Arcy-Tehan that he enjoyed drinking red wine. As he put it to the Tribunal, ‘you have to enjoy something in life’.
The contents of a clinical note made by his current treating general practitioner Dr Ouveysi on 23 July 2019 was acknowledged by the applicant to be accurate. That clinical note contained an entry that the applicant, ‘drinks a bottle of wine a day no desire or intention to quit’.[8]
[8] JTB, 106.

In another clinical note made by Dr Ouveysi on 6 August 2020, he recorded that the applicant drank a bottle of wine with dinner and that they discussed a reduction. The applicant in response to a question conceded in terms of his weight, that it had been consistently high over many years prior to the occurrence of the compensable psychiatric injury in 2009.
A clinical note made by Dr Ouveysi at a consultation on 8 February 2021 was also put to the applicant. He did not dispute its contents. He conceded that his blood pressure had been increasing around that time and that his cardiovascular risk which was elevated was discussed. The applicant, as was evident from the clinical note, stated that he was referred to a cardiologist. His weight was recorded at 145 kg. He contended he had never been that heavy. When pressed in cross examination however he conceded that if the doctor had recorded such things, he would not deny it.
In a clinical note made by Dr Ouveysi at a consultation on 31 January 2023, which the applicant did not deny was accurate, it has been recorded that the applicant experienced difficulty losing weight and had seen a dietician. It was also recorded that the applicant had a past history of obesity, hypertension and possibly the risk of type 2 diabetes.
Another matter that emerged in cross examination of the applicant should be referred to in these reasons. He was shown a Claim for Rehabilitation and Compensation made on the respondent on 8 August 1994 which he admitted he signed. The applicant in handwriting completed a response to question 23 of that claim form which requested that he describe in detail, amongst other things, the injuries or illness that he had suffered. The last line of that document recorded, ‘rise in blood pressure – headaches’. He conceded when questioned about that response in the claim form that it accurately depicted the symptoms he was experiencing at that time. Specifically, he conceded that he was experiencing high blood pressure then which was caused by work-related stress. He stated further that it was going back to a bad part of his life.
THE MEDICAL EVIDENCE
No doctors gave evidence at the hearing of the application. Reliance was placed by both parties on primarily the reports of Dr Hales and Associate Professor Gutman. Some other medical reports were in evidence, parts of which will be briefly referred to. The Tribunal was not specifically taken to the contents of the other medical reports, although they were in evidence.
Dr Hales
His report of 3 May 2023 has already been referred to. Some further reference to its contents is warranted. The contents of his report are referred to in their entirety and have been read and considered by the Tribunal. In that report Dr Hales stated that the applicant was diagnosed with hypertension on 22 July 2009 when he presented with certain symptoms. The applicant’s hypertension was diagnosed at a time when he was said by Dr Hales to be suffering significant work stress. The first presentation with respect to work-related stress occurred on 30 January 2009. He stated, as noted earlier, there was no evidence of hypertension prior to 2009. His current and past medical history was referred to. The family history recorded heart disease, hypertension, and bladder cancer. He stated that his report included a complete medical history.
Dr Gutman
Associate Professor Gutman, a consultant cardiologist conducted a face-to-face assessment of the applicant in his rooms on 5 March 2024. He prepared two reports that were in evidence before the Tribunal. The first report was dated 8 March 2024. A supplementary report was prepared dated 14 May 2024.
Prior to conducting the face-to-face assessment of the applicant, Dr Gutman was provided with a comprehensive letter of instruction dated 27 February 2024 together with a vast array of documentation concerning the applicant. The documentation accompanying the letter of instruction to Dr Gutman included medical records and clinical notes that had been summoned from the local doctor, Barwon Health and Surf Coast Medical GP Clinic. The records summoned from Surf Coast Medical included a substantial number of clinical notes of consultations conducted by general practitioners at that clinic with the applicant, several of which have been referred to earlier in these reasons, and some of which were put to the applicant in cross examination. Most of those clinical notes were made by a GP who had treated the applicant for many years, being Dr Hales.
The letter of instruction to Dr Gutman of 27 February 2024 in a section headed ‘Medical Condition’, requested that he furnish to the respondent’s lawyers his opinion with respect to a series of matters. These matters included his opinion as to the specific diagnosis of the condition which the applicant had, his opinion as to when the applicant was first impaired by clinically identifiable symptoms of the condition, relevant history, including pre-existing or underlying conditions suffered by the applicant, including any predisposition to stressors and his opinion as to whether the applicant’s current condition was an aggravation, acceleration, or recurrence of a pre-existing or underlying condition.
The contents of Dr Gutman’s report of 8 March 2024 are referred to in their entirety and have been considered by the Tribunal. It is appropriate for the purposes of these reasons to repeat several matters referred to in his report.
He stated that the specific diagnosis of the applicant is hypertension with such condition being first recorded on 19 April 2005. Additionally, he stated that there were no symptoms attributable to the applicant’s hypertension and he observed no differential diagnosis of hypertension. He reported, consistently with the clinical notes referred to previously, that the condition was first recorded on 19 April 2005 (during the consultation with Dr Williams as referred to above) when his blood pressure was 165/105 mmHg and then confirmed again on 5 October 2006. Associate Professor Gutman further recorded that there were no symptoms attributable to the applicant’s hypertension.
Associate Professor Gutman expressed the opinion that the applicant is not clinically impaired by hypertension.
In response to a specific question, whether the applicant’s current condition was an aggravation, acceleration, or occurrence of a pre-existing or underlying condition, Associate Professor Gutman stated that it was not. He considered that the applicant’s current condition is a persistence of a pre-existing condition of hypertension.
Another question in a letter of instruction furnished to Associate Professor Gutman requested his opinion about what the main factors were, including his former employment and non-work-related, which had contributed to his claimed condition. In response Associate Professor Gutman stated that the main factors contributing to the claimed condition that can be identified as relating to his hypertension are obesity and excessive alcohol intake. He further stated that the applicant’s former employment is not a current factor contributing to his hypertension. He observed that the applicant has not worked since 2009 and was retired on medical grounds in 2010. Once again, he repeated that obesity and excessive alcohol intake are significant contributing factors to his hypertension. It was also observed by him, as was verified by much of the evidence before the Tribunal, including that from the applicant, that excessive alcohol intake has been noted for 50 years and the applicant appeared to have been overweight or obese for many years. This observation was also borne out from several clinical notes that were in evidence before the Tribunal and concessions or admissions made by the applicant when he was in the witness box during cross-examination.
Associate Professor Gutman was also specifically requested to advise whether the factors identified by him as contributing to the applicant’s claimed condition, in response to the previous question still contribute to such condition. In response he stated such factors (obesity and excessive alcohol intake) still contribute to the applicant’s current condition of hypertension. Further, he commented that obesity and excessive alcohol intake are known aetiological agents causing hypertension.
Brief mention should be made of the supplementary report prepared by Associate Professor Gutman following a further request from the respondent’s lawyers in a letter of 9 May 2024. The further request from the respondent’s lawyers was sent to Associate Professor Gutman after the applicant had been furnished with a copy of his first report of 8 March 2024. The applicant took exception with some of the references made by him in that report concerning the applicant’s history, in particular that he was considered to be a smoker by Dr Williams. The further letter from the applicant’s solicitors informed Associate Professor Gutman that he said he had never smoked. By way of response, Associate Professor Gutman quite properly referred to the fact that he stated in his first report that the applicant never smoked. He clarified that what he did say was that the clinical notes provided included a reference to the applicant stopping smoking in 2005. Associate Professor Gutman noted that he was referring to the clinical notes provided not the applicant’s statement. Having considered the information contained in the further letter from the respondent’s lawyers he did not wish to change his report and only provided the clarification referred to above.[9]
[9] JTB, 190.
Other doctors and healthcare professionals
There was a comparatively brief letter from Dr Talman a psychiatrist addressed to Dr Hales on 24 November 2009. Dr Talman diagnosed the applicant as suffering from a stress-related conversion disorder. He provided a differential diagnosis of alcohol withdrawal seizures. Nothing further was referred to in that report concerning the applicant’s consumption of alcohol. However, the reference to alcohol withdrawal seizures would indicate that the applicant at that time had a significant and probably long-term alcohol consumption problem.
A report dated 20 May 2009 from Dr Cotton, a Clinical and Organisational Psychologist, was in evidence. In a section on ‘Alcohol and Substance Use’ it was recorded that, ‘[h]e typically consumes one bottle of wine each night’. He recorded that the applicant was then exhibiting symptoms that were consistent with a diagnosis of adjustment disorder with mixed anxious and depressed mood. He did not make any reference to the applicant suffering from hypertension.
Dr Trifiletti an Occupational Physician prepared a report concerning the applicant dated 18 February 2010. In that report she made several references to the applicant’s level of alcohol consumption. She observed it was a relevant factor in terms of the management of his psychiatric condition as it is a central nervous system depressant. Further, she stated that the applicant’s excessive alcohol consumption, which had been present and exceeded the NHMRC (National Health and Medical Research Council) recommendations for increased risk of short-term and long-term health problems, had been present for at least the past 30 years. In this context she considered his prognosis is guarded. The Tribunal should observe, that overall, these references by Dr Trifiletti were largely consistent with the evidence that the applicant gave during his cross-examination concerning his level of alcohol consumption.
CONSIDERATION
Was the applicant’s claimed condition of ‘hypertension’ significantly contributed to by his employment?
Having considered all the evidence before it, the Tribunal is not satisfied that the applicant’s claimed condition of ‘hypertension’ was significantly contributed to by reason of his employment previously with the Commonwealth.
It primarily reaches this conclusion that the applicant’s claim condition of hypertension was not significantly contributed to by his employment because it prefers the contents of the two reports prepared by Associate Professor Gutman rather than the report of Dr Hales.
For reasons that the Tribunal does not know, Dr Hales did not refer to the applicant’s patient history, which presumably must have been available to him when he prepared his report to the respondent of 3 May 2023. Some detail of the applicant’s history concerning a condition of hypertension has been canvassed earlier in these reasons by reference to the several clinical notes that were in evidence, the contents of which were put to him in cross-examination. The Tribunal has concluded that certainly by 2005 when the applicant consulted Dr Williams and was prescribed blood pressure medication he was suffering from the condition of hypertension. Further, more probably than not, he had suffered from hypertension for some years beforehand. This is borne out by reference to the condition of a rise in blood pressure referred to in the claim form that he signed on 8 August 1994. Unfortunately, because Dr Hales has not referred to that history prior to 2009 and he did not give evidence, the Tribunal does not know whether his opinion would change or might otherwise be different had he taken that history between 2005 and 2009 into account. This history was of course furnished to Associate Professor Gutman prior to him conducting the face-to-face assessment of the applicant as he did on 5 March 2024.
Associate Professor Gutman is a highly qualified and experienced Consultant Cardiologist. As such a highly qualified and experienced medical professional, whose store of knowledge and experience clearly include the diagnosis and treatment of conditions such as hypertension, there does not seem a rational reason to reject the opinions he expresses in his reports.
Further, in expressing the opinion he did, he had the benefit of an array of documentation. Much of that documentation, being treating general practitioners’ clinical notes were put to the applicant in cross examination. The Tribunal has concluded that the contents of those clinical notes are accurate and reliable. Therefore, in expressing the opinions that he did in his reports, Associate Professor Gutman was properly instructed with an appropriate evidentiary or factual foundation for reaching the conclusions that he did. These clinical notes were not referred to by Dr Hales, even though as noted earlier, he must have had access to those clinical notes maintained by his practice which included those made by Dr Williams in 2005. It is puzzling indeed that he did not refer to these notes in preparing his report in expressing the opinions contained in them as he did. It is another reason why the Tribunal prefers the opinions expressed by Associate Professor Gutman.
Another reason why the Tribunal prefers the opinion expressed by Associate Professor Gutman rather than that of Dr Hales, relates to another aspect of the applicant’s patient history. It will be recalled that Associate Professor Gutman stated that the main factors that can be identified relating to the applicant’s hypertension are obesity and excessive alcohol intake. Particularly, in several of the clinical notes that were carefully scrutinised during the applicant’s cross examination the applicant’s weight problems, if not obesity, were manifestly apparent.
Dr Hales in his report did not consider the question of obesity and excessive alcohol content and the contribution they may have made to the applicant’s claimed condition of hypertension. This is another reason why the Tribunal prefers the report of Associate Professor Gutman. Had that history been considered by Dr Hales it is possible that his opinion concerning the causes of the applicant’s condition of hypertension may have been different. We simply do not know.
It is quite evident from the material before the Tribunal, including the concessions made by the applicant in cross examination, not to mention the observations made by the other doctors and healthcare professionals referred to above, mainly Dr Talman, Dr Cotton and Dr Trifiletti, that the applicant has consumed significant amounts of alcohol over many years. Certainly, the evidence contained in the reports of Dr Talman and Dr Trifiletti bear witness to the excess alcohol intake that the applicant has indulged in for a significant portion of his adult life. Certainly, the report of Dr Trifiletti, an experienced Occupational Physician, with its reference to the applicant’s excessive alcohol consumption being in excess of the NHMRC recommendations for increased risk of short-term and long-term health problems and having been present for at least the past 30 years, is to a considerable extent corroborative of the opinions expressed by Associate Professor Gutman as such consumption being a main factor contributing towards his claimed condition of hypertension.
Therefore, the Tribunal accepts the opinion of Associate Professor Gutman that the applicant’s current condition of hypertension is a persistence of a pre-existing condition. It also accepts his opinion that the main factors that can be identified relating to his hypertension are obesity and excessive alcohol intake. Therefore, it also accepts his opinion that the applicant’s former employment is not a current factor in contributing to his hypertension. More probably than not, such condition has existed for a considerable time prior to the onset of the claimed condition in 2009.
CONCLUSION
Having concluded that the applicant’s ailment of hypertension was not significantly contributed to by his employment, therefore with respect to application No 2023/8990 (concerning the second reviewable decision) there is no liability on the part of the respondent pursuant to s 14 of the SRC Act. Therefore, the second reviewable decision will be affirmed.
With respect to application No 2023/5112 (concerning the first reviewable decision), by reason of the fact that the Tribunal has concluded that the applicant’s ailment of hypertension was not significantly contributed to by his employment and therefore, there is no liability on the part of the respondent under s 14 of the SRC Act, for similar reasons the applicant is not entitled to compensation under s 16 of that Act. Therefore, the first reviewable decision will be affirmed.

69. I certify that the preceding 68 (sixty-eight) paragraphs are a true copy of the reasons for the decision herein of General Member R. Cameron

.......................[SGD]..........................
Associate
Dated: 29 November 2024

Date of hearing: 17 October 2024

Applicant’s representative: Self-represented

Solicitor for the Respondent: Moray & Agnew

Counsel for the Respondent Ms Felicity Blair

Date of hearing:	17 October 2024
Applicant’s representative:	Self-represented
Solicitor for the Respondent:	Moray & Agnew
Counsel for the Respondent	Ms Felicity Blair