Guy and Repatriation Commission
[2003] AATA 867
•5 September 2003
Administrative
Appeals
Tribunal
DECISION AND REASONS FOR DECISION [2003] AATA 867
ADMINISTRATIVE APPEALS TRIBUNAL )
) No Q2002/417
VETERANS' APPEALS DIVISION ) Re COLIN MacKENZIE GUY Applicant
And
REPATRIATION COMMISSION
Respondent
DECISION
Tribunal Senior Member K L Beddoe
Dr J B Morley, Member
Major-General J N Stein, MemberDate5 September 2003
PlaceBrisbane
Decision The Tribunal affirms the decisions under review.
(Sgd) KL Beddoe
Senior Member
CATCHWORDS
VETERANS’ AFFAIRS – benefits and entitlements – disability pension – alcohol abuse or dependence – psychoactive substance (alcohol) abuse – diagnosis - whether applicant experienced a stressful event or suffered from a psychiatric condition prior to the clinical onset of psychoactive substance abuse or dependence
Veterans’ Entitlements Act 1986 ss 5, 6
Re Guy and Repatriation Commission [2001] AATA 685
Guy v Repatriation Commission [2002] FCA 525REASONS FOR DECISION
5 September 2003 Senior Member K L Beddoe
Dr J B Morley, MemberMajor-General J N Stein, Member
1. The respondent decided, inter alia, to refuse the applicant’s disability pension claim in respect of alcohol dependence or alcohol abuse. The Veterans’ Review Board varied the decision to include the diagnosis of psychoactive substance (alcohol) abuse but affirmed the decision as varied, that is the claim was refused. The applicant also made a claim (which was refused) in relation to gastro-oesophageal reflux disease. The respondent concedes this matter if the applicant is successful in relation to psychoactive substance (alcohol) abuse.
2. The applicant sought review in this Tribunal. The matter was heard on 22 June 2001 by a Full Tribunal (Senior Member Muller, Dr Kennedy and Mr Way, Members) (Re Guy and Repatriation Commission [2001] AATA 685). We will describe this Tribunal as “the first Tribunal”. That Tribunal’s decision was the subject of an appeal to the Federal Court (Guy v Repatriation Commission [2002] FCA 525). The Federal Court:
(a)set aside the decision of the Tribunal;
(b)remitted the matter back to a differently constituted Tribunal; and
(c)made an order for costs, if any.
3. At the hearing the applicant conducted his own case and Miss Ford appeared for the respondent. The following documents were tendered and put into evidence before the Tribunal.
§Exhibit A Report of Dr Holm, dated 13 April 2003
§Exhibit B Statement of Mr Daley, dated 15 February 2003
§Exhibit C Statement of Mr Clancy, dated 16 September 2003
§Exhibit D Statement of Mr Howard
§Exhibit 1 Copy of Appeal Book
§Exhibit 2 Copy of Transcript, dated 22 June 2001
§Exhibit 3 Report and attachments of Commodore Mulcare, 4 September 2002
§Exhibit 4 Medical Examination Record – Australian Police
§Exhibit 5 Report of Senior Constable Miles 4183, dated 3 June 1957
§Exhibit 6 Report of Queensland Police Inspectors’ Office, dated June 1957
§Exhibit 7 Report of Queensland Police Inspectors’ Office, dated 1 August 1958
§Exhibit 8 Report by Government Medical Officer, dated 5 February 1975
§Exhibit 9 Report by G H Furseman, dated 16 March 1979
§Exhibit 10 Letter from Commissioner of Police to applicant, 3 January 1980
§Exhibit 11 Letter from Commissioner of Police to applicant, 1 December 1980
§Exhibit 12 Application for advertised position, dated 26 August 1957
§Exhibit 13 Authorised Commissioned Officer’s Report dated 12 November 1984
4. Oral evidence was given by the applicant, Mr Daley, Mr Clancy and Dr Holm.
5. In relation to the primary claim for Alcohol Dependence or Alcohol Abuse the following statements of principle were said to be relevant:
Instrument 5/1994 Psychoactive Substance Abuse or Dependence
Instrument 76/1998 Alcohol Dependence or Abuse.
6. We make the following findings of fact.
7. The applicant was born on 9 May 1933 and joined the Royal Australian Navy on 9 November 1950. He had operational service on HMAS Shoalhaven in Korean waters from 17 July 1954 to 17 March 1955 and from 21 September 1956 to 12 October 1956 in the Far East Strategic Reserve on HMAS Melbourne.
8. He was discharged from the Navy on 8 May 1957 serving a total of six years and six months.
9. Extracts from service records, at folios 34-39 of Exhibit 1, show that the applicant suffered an injury in a fight in 1952 while on shore leave from Shoalhaven, and other minor incidences of illness including gastroenteritis while serving on HMAS Vengeance.
10. From 1957 to 1988, the applicant was employed by the Queensland Police Service and rose to the rank of Inspector, before taking early retirement at age 55. During his service he was awarded the Police Good Conduct Medal. He said he did not drink during working hours.
11. The applicant made a statement in these proceedings which was marked as Exhibit 3 by the first Tribunal and is now part of Exhibit 1 before this Tribunal (at pages 137-140). The statement refers to a number of instances said to be stressors which we summarise as follows:
(a)a potentially serious accident occurred while cleaning the ship’s boilers in Hong Kong during operational service – the applicant was at risk of being electrocuted but was able to escape from inside the boiler before the power supply was cut and no physical injury occurred to the applicant or other crew members;
(b)while in Japanese waters and in a closed up station in the after steering department, the applicant and an AB seaman were ordered to after steer the ship because steering from the bridge had failed – the circumstances were claustrophobic – the time of the incident is unknown and the orders were carried out without incident;
(c)as a member of armed boarding parties but did not witness exceptional incidents;
(d)searching for bodies and debris after a typhoon but only on basis that the ship locate the bodies and debris;
(e)rescue of a disabled tanker off Arnhem Land – in his oral evidence before the first Tribunal;
(f)the death in Colombo of another stoker, it is said, because of salt deficiency in his body; and
(g)during training exercises off Hervey Bay an aircraft was lost on take off and neither the crew nor craft was recovered – the applicant was working as a Leading Stoker and received orders “full astern” which was exceptional but carried out in the circumstances of the order itself rather than reasons for the bridge giving the order.
12. There is another statement by the applicant at pages 126-129 of Exhibit 1 regarding the Shoalhaven going to action stations while in Korea. Before the first Tribunal the applicant explained the statement was exaggerated and Shoalhaven had gone to action stations on one occasion upon approach of hostile aircraft which the applicant did not see or hear.
13. The applicant says, and we accept, that he engaged in heavy consumption of alcohol during his naval service to such an extent that he was the subject of discipline proceedings arising out of excessive alcohol consumption.
14. While in the Navy the applicant received the Good Conduct Badge and retained it to the end of his service.
15. Service with the Queensland Police Service was varied and included an extended period as a sergeant attached to Police Headquarters.
16. Since retiring from the Police Force the applicant has played bowls and works as a welfare officer for the Naval Association in a voluntary capacity.
17. Exhibit 4 is a Medical Examination Record on entry to the Police Service. It shows the applicant as being in good health in 1957 and fit for service as a Constable. Exhibit 5 establishes that the Police regarded the applicant as a suitable person for admission to the Police Force and Exhibit 6 is a copy of the applicant’s appointment approval by the Commissioner of Police. Exhibit 7, dated 1 August 1958, reports conduct as good, work satisfactory and that he had been sworn in as a constable.
18. Exhibit 8 is a copy of a report by a Government Medical Officer, dated 5 February 1975, reporting the applicant had no physical or mental illness and was considered fit for promotion.
19. Exhibit 9 is a copy of a report, dated 10 March 1979, reporting favourably on Sergeant (2nd class) Guy in his duties as a Police prosecutor.
20. Exhibit 10 is a copy of a letter, dated 3 January 1980, signed personally by the then Commissioner of Police noting that the applicant had recently taken sick leave for the first time since 10 May 1968 – a period of over 11 years.
21. Exhibit 11 is a copy of a letter dated 1 December 1980, also signed by the then Commissioner of Police, notifying the applicant that he had been awarded the Police Long Service and Good Conduct Medal by the Governor of Queensland.
22. In 1982 the applicant applied for the position of Senior Sergeant City Station (watch-house) (Exhibit 12) and received a favourable report as to his conduct of his duties at the City Watch-house in 1984 (Exhibit 13). The applicant was subsequently promoted to Inspector and as already noted retired mid 1988.
23. We accept that the applicant retired voluntarily because of his gastro-oesophageal reflux problem and because he was an advocate for age 55 retirement from the Police Force.
24. We accept that the applicant had a motor vehicle insurance policy cancelled in 1959 because of his accident record but we are unable to come to any conclusion as to what may have been the underlying cause of the accidents. It may well be that the applicant adopted a practice of driving his vehicle while under the influence of alcohol and he escaped sanctions because of his position as a police officer but we would be speculating as to the underlying cause for the insurance company’s action.
25. Witnesses Daley and Clancy corroborated and explained the incident relating to approaching hostile aircraft. We are satisfied that Shoalhaven was approached by planes that were probably enemy aircraft (MIGs) and went to action stations because of possibility of attack. No attack occurred and we note that hostilities in the Korean War had ceased the previous year.
The Medical Evidence
26. The Tribunal heard oral evidence by telephone from Dr Ivan Holm, who also provided a report (Exhibit A).
27. Also available to the Tribunal, from the previous Tribunal hearing ([2001] AATA 685, file numbers Q2000/134 and 135), were reports, and transcripts of oral evidence (Exhibit 2), as follows:
§report from Drs Helen Mahoney and Meredith MacLeod of Queensland Medical Laboratories of 2 February 1998 on the histology of the applicant’s oesophageal biopsies (Exhibit 1, folio 75);
§two reports from Dr Carols Ho, general practitioner, of 10 March 1998 on the applicant’s gastro-oesophageal reflux disease (Exhibit 1, folios 72-74), and of 23 February 1999 on his pathological substance abuse (Exhibit 1, folios 88-90);
§three reports from Dr Angus Brotodihardjo, gastroenterologist, on the applicant’s gastro-oesophageal reflux disease, of 18 August 1997 (Exhibit 1, folio 76), 2 February 1998 (Exhibit 1, folio 77), and 3 March 1998 (Exhibit 1, folios 67-68);
§two reports from Dr Ashim Majumdar, psychiatrist, of 23 September 1998 (Exhibit 1, folio 78), and 26 August 1999 (Exhibit 1, folios 117-119), on the applicant’s heavy drinking;
§oral evidence (Exhibit 2, pp 6-15) from Dr Janis Carter, psychiatrist, and her report of 6 March 2001 (Exhibit 1, folios 130-136); and
§oral evidence (Exhibit 2, pp 34-47) from Dr William Kingswell, psychiatrist, and his report of 14 May 2001 (Exhibit 1, folios 141-147).
28. The hearing of this appeal has presented the Tribunal with two medical diagnostic questions:
(a)Does the applicant suffer from psychoactive substance abuse or dependence?
(b)Did the applicant experience a stressful event or suffer from a psychiatric condition prior to the clinical onset of psychoactive substance abuse or dependence within the meaning of Statement of Principles No 5 of 1994?
29. The Tribunal has considered the first question, of whether the applicant suffers from psychoactive substance (that is alcohol) abuse or dependence, as follows.
30. The reports of Drs Mahoney and MacLeod, Dr Ho (10 March 1998), and Dr Brotodihardjo, state that the applicant has had gastro-oesophageal reflux, with Barrett’s oesophagitis, and with an associated oesophageal stricture. Of these reports, covering the period 18 August 1997 to 3 March 1998, only that from gastroenterologist Dr Brotodihardjo of 3 March 1998 (Exhibit 1 folio 67) referred to the applicant’s alcohol consumption, in the terms that he “only drank alcohol socially, but this may have been a contributing factor to his symptoms of reflux disease”. When the applicant’s then claim for gastro-oesophageal reflux disease was refused on 13 March 1998 by the Commission, the delegate’s reasons specifically stated: “there is no history of psychoactive substance abuse or dependence involving alcohol…” (Exhibit 1, folio 25).
31. The first reference to the applicant drinking heavily appeared six months later, in Dr Majumdar’s first report, of 23 September 1998 (Exhibit 1, folio 78), following which the applicant lodged his claim for psychoactive substance abuse/dependence on 4 February 1999. In Dr Majumdar’s second report of 26 August 1999 (Exhibit 1, folios 117-119), he refers to the applicant’s continuing use of alcohol “despite the knowledge of having a recurrent social occupational problem that has been caused by the use of alcohol” (folio 119), mentioning his several motor-vehicle (usually single vehicle) accidents, and the cancellation of his motor-vehicle insurance policy (folio 118). He diagnosed psychoactive substance (alcohol) abuse. He did not advert to substance dependence; nor did he offer any observation comparing the applicant’s previous and his more recent alcohol consumption.
32. In her report of more than 18 months later, Dr Carter stated that the applicant’s “generalised anxiety disorder and psychoactive substance abuse and dependence developed together, and progressed together during his operational service” (Exhibit 1, folio 134); and she went on: “he developed a maladaptive pattern of alcohol use, which led to clinically significant impairment and distress”, citing his increased tolerance, withdrawal symptoms when not drinking, unsuccessful attempts to control his drinking, much time spent in alcohol-related activities, the giving up of important social, occupational and recreational activities for alcohol, and his continued drinking despite it causing recurring physical and psychological problems (folio 135). Dr Carter made no specific comparison between the applicant’s previous and recent drinking habits, but recorded: “Even now, he escalates up on his drinking, and although he says he drinks only six stubbies a day, his wife indicated that that is a very conservative estimate” (folio 135). Dr Carter referred to “fairly recent blood tests” having been performed by the applicant’s general practitioner, which were normal, but provided no further details (folio 135).
33. In his report, Dr Kingswell found:
“Mr Guy is a 68 year old man who gives a history of 50 years of habitual alcohol use to the extent of causing some ill health (oesophagitis), conflict with his wife, and impaired work performance noticeable to his (police) supervisor at Mackay. He would over this period satisfy the definition of Alcohol Abuse (DSM-IV: 305.00). He would not however satisfy the criteria for Alcohol Dependence (DSM-IV: 303.90). On this point I would dispute the report of Dr Carter. The criteria for substance dependence as set out in DSM-IV require that three or more features are present.”
34. He then goes on to examine these criteria in the applicant as follows:
“Undoubtedly Mr Guy developed tolerance to alcohol. The amount that he drank, by his account, was stable over a very long period. Mr Guy has not had the desire or made any efforts to reduce his alcohol intake. Despite his habitual use of alcohol he maintained his social and occupational health. I expect Mr Guy had some knowledge of the impact alcohol was likely to have on his health. Mr Guy has not described a withdrawal syndrome. By his account days go by during which he does not drink. He tolerates these days without significant withdrawal symptoms.” (Exhibit 1, folio 146)
35. Dr Kingswell did not remark directly on the applicant’s recent alcohol intake in comparison to past years, but noted Dr Ho’s observations on his alcohol use (Exhibit 1, folios 88-90), that he was in no apparent distress, that he drank for enjoyment, that he had not required medical attention for drunkenness, and that he interacted well with his family. He also had found that the applicant’s full blood count was normal, and his liver function tests showed no changes suggestive of alcohol abuse, although alcohol was detected in his urine at 1300 hours on the day that it was tested (Exhibit 2, page 39 lines 13-18).
36. In Dr Holm’s report he observed that during the applicant’s period of operational service, “he clearly developed a pattern of heavy alcohol abuse and dependence that became a severe problem” (Exhibit A, page 2). In his Diagnostic Assessment he opined that, whereas the applicant developed chronic anxiety symptoms during his naval service, over many years “his primary psychiatric disability has been one of chronic Alcohol Abuse” (page 2). He concluded (page 3):
“I think it is reasonably likely that his long standing pattern of alcohol abuse has been to some extent secondary to his anxiety though not entirely. Over recent years Mr Guy has lead [sic] a somewhat restricted life with little by way of stress and both his anxiety and alcohol dependence and abuse have been less of a problem than they were in the past.”
37. In summary, whereas Dr Carter has concluded that the applicant suffers alcohol dependence as well as abuse, Dr Kingswell has diagnosed only alcohol abuse; Dr Majumdar has made no reference to the applicant being dependent on alcohol. Dr Holm found that the applicant’s alcohol abuse has been “his primary psychiatric disability”, and that, in recent years, it, and his alcohol dependence, have lessened; and this observation is consistent with Dr Brotodihardjo’s record of the applicant’s apparently more moderate recent drinking habits (Exhibit 1, folio 67), and Dr Kingwell’s satisfactory findings on the applicant’s liver function tests and full blood count.
38. Accordingly, on this first question, from the not previously available medical evidence that has been presented to this hearing, the Tribunal finds that the applicant suffers alcohol abuse, and that this probably is less severe than in the past. On weighing the respective opinions of the psychiatrists the Tribunal is satisfied, from Dr Kingwell’s specific observations of the DSM-IV criteria in the applicant, as cited above, that the applicant does not presently suffer alcohol dependence.
39. On the second question, in neither of his reports did Dr Majumdar address the possibilities of the applicant experiencing stressful events during his naval service, nor his consequent possible development of a psychiatric condition such as a generalised anxiety disorder.
40. However, in her report (Exhibit 1, folios 130-136), Dr Carter has identified the following stressful events:
(a)the HMAS Shoalhaven’s “state of preparedness” en route to Japan, while traversing the Formosa Strait (6 to 7 August 1954, refer Exhibit 3, attachment 4, paragraph 6);
(b)the HMAS Shoalhaven’s “action stations” incident when patrolling the Korean West Coast waters (12 September 1954, refer Exhibit 3, attachment 5, page 1);
(c)his “near electrocution” incident when cleaning boilers on HMAS Shoalhaven during its periodical refit in Hong Kong (21 to 26 November 1954, refer Exhibit 3, attachment 7, paragraph 8);
(d)the main steering failure incident;
(e)armed boarding party experiences;
(f)typhoon experiences (refer Exhibit 3, attachment 4, paragraph 5; attachment 7, paragraph 7; attachment 8, paragraph 9; and perhaps attachment 10, paragraph 16);
(g)towing rescue of a disabled vessel by HMAS Shoalhaven (18 to 21 March 1954, refer Exhibit 3, attachment 11, paragraphs 6-9);
(h)death of stoker Tim Lys from salt deficiency on HMAS Melbourne in Colombo on or about 10 April 1956 (Exhibit 1, folio 139); and
(i)crash of a Sea Venom aircraft, causing the deaths of both aircrew members, during the applicant’s HMAS Melbourne service, in late August 1956, off Hervey Bay (Exhibit 1, folio 140).
41. It appears that the first six of these occurred during the applicant’s period of operational service from 17 July 1954 to 16 March 1955 (his other operational service period was 21 September to 12 October 1956). During her oral evidence to the previous hearing, Dr Carter stated that the “near electrocution” (the third) incident was probably the most stressful to the applicant (Exhibit 2, page 8); and that this stress was augmented in 1964, during his Police service, when he attended a fatal electrocution, and subsequently realised that he also could have been electrocuted had he touched the deceased man’s body (Exhibit 1, folio 134). The applicant, when providing his evidence, and in his submissions, to this hearing, also has emphasised the stressful effect on him of the second (“action stations”) incident, on Sunday, 12 September 1954. Dr Carter found that he had had symptoms of a general anxiety disorder “from an early time” (Exhibit 2, page 14 lines 9-10), and diagnosed that these experiences caused … symptoms of generalised anxiety disorder (which) have stayed with him throughout his life after operational service” (Exhibit 1, folios 134 and 136).
42. Dr Kingswell noted the applicant’s several stressful experiences during his service, such as the “action stations” incident, travelling through the Formasa Strait, his near-electrocution when cleaning boilers, his boarding party experiences, and being caught in a typhoon. He found that, although the applicant’s “operational service exposed him to stressful circumstances”, they “were not significantly different to that experienced by many of the seaman” (Exhibit 1, folio 147). He disagreed with Dr Carter’s diagnosis of generalised anxiety disorder commencing during his operational service, or that the applicant’s symptoms had continued throughout his life since his operational service, indicating that Dr Carter had not documented these symptoms, nor had they been described by any other observer. He did not believe that the applicant had “suffered from a psychiatric disorder prior to the onset of his alcohol abuse” (Exhibit 1, folio 147). Both in his report (folio 147), and in his oral evidence, he stated that the applicant’s condition of anxiety would only be a disorder if “his anxiety was inappropriate to the situation” (Exhibit 2, page 36 lines 1-12), and if it caused “social and occupational dysfunction” (line 17). He adhered to this view, without qualification, under cross-examination, remarking that, during the applicant’s naval service, “he made exemplary progress with the possible exception of drinking too much” (page 44 lines 19-22). On re-examination, he agreed with Mr Smith, the departmental advocate, that the applicant was not significantly distressed or impaired in social occupation or other important areas of functioning in the period in the Navy after he came back from Korea (page 47 lines 2-5).
43. In his report Dr Holm has stated:
“It is clear that Mr Guy describes experiencing a number of periods that he found severely stressful and during which he experienced severe anxiety. Broadly these incidents could be interpreted as fulfilling the criteria for experiencing ‘severe psycho social stressors during operational service’.” (Exhibit A, page 2)
44. He opined that the applicant’s present symptoms accorded with a diagnosis of a mild generalised anxiety disorder, and that he had had anxiety symptoms “more or less continuously” since his naval service (Exhibit A, page 3). However, during his oral evidence at this hearing, after Miss Ford, counsel for the Commission, outlined to him the applicant’s Police career, he changed this view. He agreed with her that the applicant’s functioning during his Police career was inconsistent with him suffering an anxiety disorder. He also agreed that the applicant’s answer to the questions in the Personal Relationships section of his Lifestyle Questionnaire, in which the only box which he ticked was ”you are sometimes tense and a little anxious but still get on well with most people most of the time” (Exhibit 1, page 55) was also not consistent with an anxiety disorder.
45. The Tribunal finds that these views are supported by the contents of Exhibits 4, 6, 8, 10 and 11; for example, the Tribunal notes that Exhibit 4 records that, at his medical examination for entrance into the Police Force of 21 August 1957, the applicant’s general demeanour under examination was “calm”, showing no evidence of “psychic disturbance”; and Exhibit 8 records that, on 5 February 1975, the Government Medical Officer found that he had “no physical or mental illness”.
Consideration
46. We accept that Dr Carter’s report, in particular, raises an hypothesis connecting the applicant’s operational service with his consumption of alcohol (Exhibit 2). The hypothesis relies in particular upon the action stations incident and the cleaning of boilers at Hong Kong incident. There is reference to an incident while the applicant was in the Police force and to other stressful events but Dr Carter has adopted a meaning for operational service which does not accord with the defined meaning in section 6C of the Veterans’ Entitlements Act 1986 (“the Act”).
47. Sub-section 6C(1) of the Act relevantly provides that a member of the Defence Force who has rendered continuous full time service in an operational area as a member of a unit of the Defence Force allotted for duty in the operational area is taken to have been rendering operational service in the operational area while the member was so rendering continuous full time service.
48. Sub-section 5B(1) of the Act provides that an operational area means an area described in Schedule 2 which includes the area of Korea, including the waters contiguous to the coast of Korea for a distance of 185 km seaward from the coast for the period 27 June 1950 to 19 April 1956. That period includes the period to 17 March 1955 only, but includes the period while Shoalhaven was in Hong Kong from 21 November to 19 December.
49. Section 6E of the Act provides that a member of the Defence Force who was assigned for service in the demilitarised zone between North Korea and South Korea after 18 April 1956 is taken to have been rendering operational service while he was so rendering continuous full time service in that zone. We are satisfied that the applicant had such operational service on HMAS Melbourne from 21 September 1956 to 12 October 1956.
50. The Tribunal finds that the applicant’s periods of operational service did not involve any combat experiences, and that the periods of operational service occurred after the Korean war armistice had been signed, and hostilities had ceased. The Tribunal agrees with the submission of Miss Ford, Counsel for the Commission, that the applicant’s claimed stressful events do not fall within the relevant definition of the relevant Statement of Principles.
51. In the terms of Instrument 76 of 1998 the factors that must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting alcohol abuse with the circumstances of the applicant’s operational service include:
(a)suffering from a psychiatric disorder at the time of the clinical onset of alcohol abuse; or
(b)experiencing a severe stressor within the two years immediately before the clinical onset of alcohol abuse; or
(c)suffering a psychiatric disorder at the time of the clinical worsening of alcohol abuse; or
(d)experiencing a severe stressor within the two years immediately before the clinical worsening of alcohol dependence or alcohol abuse.
52. We are not satisfied on the evidence that the applicant has suffered from a psychiatric disorder so that (a) and (c) above simply do not apply.
53. As to whether the applicant experienced a severe stressor we are satisfied that the only event experienced by the applicant during operational service that might evoke intense fear, helplessness or horror in a person, was the incident in Hong Kong where there was a perceived threat that he might be electrocuted. Such a perception was certainly open on the facts as related to us and it is apparent, on the evidence, that the applicant and others perceived at the time that there was a risk of serious injury or death. Whether the event in the boiler was such that it could be said that it might evoke intense fear, helplessness or horror is however not apparent to us. Clearly there was what might be described as an anxious moment while the applicant removed himself from the boiler and the electricity was disconnected, but there was no incident which, in our view, could be described as an event that might evoke intense fear, helplessness or horror. The applicant reacted as any reasonable person would react, by removing himself from the danger.
54. We are not satisfied that the applicant experienced a severe stressor, as defined, during his operational service.
55. The same considerations apply in relation to Instrument No 5 of 1994, being the instrument in force when the respondent made its decision in relation to gastro-oesophageal reflux disease. The wording of the earlier instrument is different to a significant degree. Being satisfied that the applicant does not have a psychiatric condition we need to consider whether the applicant experienced a stressful event. Stressful event is defined as an incident in which there were external stimuli (such as combat) that would result in psychological stress, and where there were subjective symptoms of increased stress.
56. There were two events that might be described as stressful events:
(a)The boiler cleaning incident in Hong Kong; and
(b)The Shoalhaven closing down for action stations while in Korean waters.
As to the first incident we have already described it as an anxious moment and we do not accept that it could result in psychological stress. As to the second there was no combat and the incident was really no different to other occasions when the ship might be closed up when there was no external stimuli that would result in psychological stress. Being overflown by aircraft suspected of being MIG fighters which were flying at a height that made it apparent they were not attacking is not external stimuli in terms of the definition of stressful event. We are satisfied there was no stressful event as defined.
57. Bearing this in mind, the Tribunal has found Dr Kingswell’s opinion to be persuasive, and supported by the oral evidence of Dr Holm. The Tribunal concludes that the applicant did not suffer any significantly stressful events (ie any more than normally experienced by seamen), nor did he have a psychiatric condition, prior to the clinical onset of psychoactive substance abuse or dependence.
58. Furthermore, the Tribunal has noted that the applicant continued to drink, often heavily, during his 30 years Police career after leaving the Navy; for example, he was recorded by Dr Kingswell to say that, soon after joining the Police force “he found that alcohol use was part of the culture of the job… he drank most days but not all’ (Exhibit 1, folio 143); and in giving his oral evidence to the previous hearing, the applicant acknowledged that throughout his 30 years service in the Queensland Police, he had problems with alcohol abuse: “Yes I did drink too much the whole time” (Exhibit 2, page 25 lines 3-4).
59. In the view of the Tribunal, these many years of heavy drinking as a matter of choice following the applicant’s completion of his naval service negates any extent to which his alcohol abuse may be attributed to his operational service.
60. Accordingly the Tribunal finds that the applicant’s alcohol abuse is not connected to a stressful event, or the development of a psychiatric condition, during the circumstances of the applicant’s service prior to the clinical onset of his alcohol abuse.
61. For these reasons the decisions under review will be affirmed.
I certify that the 61 preceding paragraphs are a true copy of the reasons for the decision herein of Senior Member K L Beddoe, Dr J B Morley and Major-General J N Stein, Members
Signed: ...................................................................................
Associate
Date of Hearing 11 June 2003
Date of Decision 5 September 2003The Applicant appeared in person
Counsel for the Respondent Miss E Ford
Solicitor for the Respondent Australian Government Solicitor
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