Harvey; Secretary, Department of Families, Housing, Community Services and Indigenous Affairs and

Case

[2009] AATA 835

29 October 2009


Administrative Appeals Tribunal

DECISION AND REASONS FOR DECISION [2009] AATA 835

ADMINISTRATIVE APPEALS TRIBUNAL      )   

)    No: 2008/5554

GENERAL ADMINISTRATIVE DIVISION        )   

ReSECRETARY, DEPARTMENT OF FAMILIES, HOUSING, COMMUNITY SERVICES AND INDIGENOUS AFFAIRS

Applicant

And    DIANNE HARVEY

Respondent

DECISION

TribunalDr J D Campbell, Member

Date29 October 2009

PlaceSydney

DecisionThe decision under review is affirmed, that is, the Respondent qualifies for carer allowance and carer payment, but on the basis that the claimant score is 30 and the total rating under the Adult Disability Assessment Tool is 49.5.

...................[sgd]...........................

Dr J D Campbell
  Member

CATCHWORDS

SOCIAL SECURITY – carer payment – carer allowance – constant care – care on a daily basis – chronic renal failure – home dialysis – basal cell carcinoma – adult disability assessment tool – decision under review is affirmed

Social Security Act 1991 ss 38C, 197, 198, 952, 954

Social Security (Administration) Act 1999 ss 80, 126

Adult Disability Assessment Determination 1999 sch 2

Bull v Attorney-General (NSW) (1913) 17 CLR 370

Re Kedwell and Secretary, Department of Social Security (1987) 13 ALD 419

Re Mrs M and Director-General of Social Security [1983] 5 ALN N365

Re Seager and Director-General of Social Security (1984) 6 ALD 55

Re Yousef and Director-General of Social Security (1981) 4 ALD 316

REASONS FOR DECISION

29 October 2009

Dr J D Campbell, Member

  1. Mrs Dianne Harvey lodged a claim for carer allowance (CA) and/or carer payment (CP) on 23 October 2007.  Mrs Harvey nominated Mr Harvey (her husband) as the person for whom she provided care services.

  2. Mrs Harvey submitted with her claim a completed claimant questionnaire dated 23 October 2007 and a Health Professional Assessment completed by Dr Phillip Trew, the treating nephrologist, on 22 September 2007.  In his report, Dr Trew nominated Mr Harvey as suffering from renal failure, hypertension and extensive skin cancers requiring regular surgery.  Dr Trew also noted that Mr Harvey had undergone a joint replacement procedure.

  3. On 16 November 2007, Mrs Harvey's claim for both CA and CP was rejected on grounds that a reply to correspondence had not been received (T41, T42), and assessed caring activities did not exceed 25 hours per week (T57 p330 (doc 21 of 26)).

  4. Following receipt by Centrelink of a letter dated 22 November 2007 (T44) from Dr Pang, a consultant dermatologist, and a clarification report from Dr Trew dated 6 December 2007 (T45), Centrelink, on 27 December 2007, following a review of the earlier decision to reject, considered that the decision should be changed, with Mrs Harvey being granted both CP and CA with date of effect from 23 October 2007 (T46, T47).

  5. On 8 February 2008, Centrelink made a further determination that the CA and CP were granted in error, as care was not being provided on a daily basis.  The decision-maker also noted that the debt that had been raised should be waived because of sole administrative error (T57, p325 (doc 8 of 26)).

  6. On 18 July 2008, an Authorised Review Officer (ARO) affirmed the decision of 8 February 2008 to cancel the granting of CP and CA to Mrs Harvey.  In reaching his decision, the ARO relied upon further responses received from Dr Trew dated 11 July 2008 (T50) relating to clarification of issues of the level of daily care required, as well as receiving policy advice from the National Office Carers Program on what questions to ask of Dr Trew.  As a consequence, the ARO had the rating under the Adult Disability Assessment Tool (ADAT) reassessed with a new treating health professional score nominated as 6.5.  The ARO concluded that as the health professional score was less than the 12 points required to qualify for CA, Mrs Harvey did not qualify for CA.  Similarly, the ARO concluded that as the health professional score was less than the 10 points required to qualify for CP, Mrs Harvey did not qualify for CP.

  7. On 16 October 2008, the Social Security Appeals Tribunal (SSAT) set aside the decision to cancel both CA and CP, and in so doing determined that Mrs Harvey provides constant care to Mr Harvey and that the relevant assessments under ADAT were a claimant score of 28.75 points and a health professional score of 19.5 points.

issues

  1. The relevant issues in this matter are:

    (a)Is Mr Harvey a disabled adult?

    (b)What does the term “constant care” mean?

    (c)Is Mrs Harvey alone providing the constant care for Mr Harvey?

    (d)What does the term “receives care and attention on a daily basis from the person” mean?

    (e)What was Mr Harvey’s ADAT score at the date of cancellation, and in particular, what were the relevant scores for the claimant questionnaire and the professional questionnaire at that time?

    (f)Does Mrs Harvey qualify for CP and/or CA?

evidence

  1. Mr Harvey in a written statement dated 21 May 2009, together with a number of annexures (Exhibit R4), detailed that he suffers from chronic renal failure for which he undergoes home dialysis on Mondays, Wednesdays and Fridays of every week, with such an activity having occurred for a number of years and will continue until his death – the issue of a renal transplant not being feasible because of his extensive cancerous skin condition.

  2. Mr Harvey confirmed the contents of his written statement in oral evidence and in so doing confirms the role of his wife in both his dialysis program (eight hours involvement on three days a week), ensuring that he takes his medication on a daily basis and that an appropriate dietary regime is maintained.

  3. Mr Harvey confirmed that he has been in receipt of a disability support pension (DSP) since 1 March 2005.  Further, Mr Harvey confirms that he suffers from extensive basal cell carcinoma involving head, neck, face, trunk and extremities – a condition clearly evident at the hearing and for which he receives extensive and continuing treatment, including biopsies and excisions, with occasional skin grafts, all undertaken by his dermatologist, Dr Pang.  Mr Harvey also detailed and confirmed Mrs Harvey’s role as driver, wound dresser, assistant in dressing and grooming during the acute stages, shopper and meal preparer, again during the acute recovery phase.  Mr Harvey also detailed the extensive nature of his treatment for his skin cancer by Dr Pang, which involved a program of continuing excisions on a weekly to two-weekly basis, amounting to 20 to 30 biopsies/excisions a year.

  4. Mrs Harvey, in oral telephone evidence, confirmed the material documented in her written statement dated 20 May 2009 (Exhibit R2).  I further note the annexures attached to her written statement in which she documents a diary of her activities relating to her care activities for Mr Harvey over a two week period – such being representative of what has been and will continue to be for an indefinite period.  I also note that Mrs Harvey is under the care of Dr Smith, a consultant psychiatrist, in relation to anxiety and concerns pertaining to the wellbeing of her husband.

  5. The material provided by Mrs Harvey details her role in the home dialysis program, as well as defining her role in Mr Harvey’s ongoing skin treatment program.

  6. In both his written statement dated 25 May 2009 (Exhibit R3), and during oral evidence, Dr Pang, a consultant dermatologist, detailed the nature and extent of Mr Harvey’s skin cancers, the requirement that Mr Harvey will require ongoing surgical procedures to remove the skin cancers for the rest of his life, with such surgery programmed a few weeks apart.  Dr Pang also detailed Mrs Harvey’s role in both the wound aftercare and her role in assisting Mr Harvey with his everyday personal care activities during such post-operative periods.  Dr Pang provided detailed billing records, which include 13 excisions, one skin graft and six biopsies over an eight-month period between 15 January 2008 and 16 September 2008.  That the treatment for his cancerous condition is ongoing is evidenced by Dr Pang’s financial billing accounts that indicate that Mr Harvey received attention on at least 17 occasions between 22 April 2008 and 29 April 2009, involving two specialist consultations, 6 skin biopsies, 13 excisions and 4 removals of separate skin lesions.

consideration and findings

  1. I have examined and considered the material which is before me and I have listened to the oral evidence of Mr Harvey, Mrs Harvey and Dr Pang.  I note that on casual visual observation of Mr Harvey at the hearing that his widespread skin condition has led to significant scaring and disfigurement.

  2. While I note that there was some disagreement between Mr and Mrs Harvey in their oral evidence over the issue of shopping and the undertaking of some other domestic activities, I consider that their respective accounts given in evidence are a true and best reflection of their compromised existences over many years.

  3. Further, I would observe from the material before me that there are at least three previous applications by Mrs Harvey for CP and CA since March 2005.  I observe that there is a relative consistency in the factual material, with differences evident in the claimant and health professional questionnaires in relation to the renal dialysis treatment and the aftercare of the skin excisions.

  4. Nevertheless, I am satisfied and so find that:

  • Mr Harvey does suffer from chronic renal failure;

  • That Mr Harvey is dialysed three days a week (Monday, Wednesday, Friday);

  • That such dialysis occurs at home, with Mrs Harvey present for the eight hours that it takes to prepare, undertake and clean up;

  • That for at least five to five and a half hours of that dialysis period, Mr Harvey is restricted to a set of fixed circumstances that prevents other than limited static activity;

  • That the condition of chronic renal failure is permanent as Mr Harvey is unable to undergo renal transplantation because of his cancerous skin condition, such dialysis continuing until his death;

  • That because of his renal failure, Mr Harvey is restricted in terms of his fluid intake, has to be careful with his diet and must maintain strict adherence to his medication program;

  • That Mr Harvey does suffer from an extensive basal cell carcinoma of his skin over all aspects of his body;

  • That the skin condition requires continuous care by a dermatologist involving skin lesion biopsy, skin lesion excision with an occasional skin graft;

  • That such a skin care treatment program is likely to continue on an indefinite basis, with Mr Harvey undergoing a skin biopsy, excision, lesion removal or skin graft on a fortnightly basis;

  • That during the post-excision and/or lesion removal period, Mr Harvey requires assistance with wound dressing, showering, dressing and food preparation, as well as being unable to drive during the post-surgery recovery period;

  • That when Mr Harvey is not undergoing renal dialysis and is not in a post-surgery recovery period (length of time variable between two days and a week), Mr Harvey is generally able to care for himself, undertake shopping activities and drive a car, as well as socialise.

  1. Similarly, I conclude that Mrs Harvey undertakes the following activities in support of her husband:

  • On three days a week for eight hours a day she assists in the preparation of equipment for the renal dialysis; assists in the insertion of the cannula; assists during the dialysis period and monitors the wellbeing of Mr Harvey during that period and finally assists in the clean up of the equipment at the conclusion of the dialysis;

  • That on every day she prepares appropriate meals for Mr Harvey and herself, consistent with Mr Harvey’s dietary requirements;

  • That each day she monitors and ensures that Mr Harvey takes his required medication, including analgesic medications during post excision episodes;

  • That in relation to Mr Harvey’s ongoing skin cancer treatment program Mrs Harvey acts as driver, wound cleanser and dresser, and assistant to Mr Harvey in terms of dressing, shaving and food preparation, as well as performing the normal household tasks that Mr Harvey is unable to do or assist with their undertaking.

  1. In addressing the issue of Mrs Harvey’s claim for CP and CA, I note the following:

  • Section 38C of the Social Security Act 1991 (“the Act”) provides for the Secretary to determine “a test for assessing the disability, emotional state, behaviour and special care needs of a person aged 16 or more” and provide a method of rating the person on the basis of the results of tests, the latter providing a scale that provides for a range of scores that indicate the different levels of physical, intellectual or psychiatric disability of persons.  Such a determination is known as the Adult Disability Assessment Tool (ADAT).

  • The Adult Disability Assessment Determination 1999 defines the ADAT which requires the completion of two questionnaires, namely:

    §    claimant questionnaire to be completed by a person wishing to claim CA or CP.

    §    professional questionnaire to be completed only by a treating health professional.

  • In relation to the health professional questionnaire, the Secretary must be satisfied that such is an accurate reflection of the “disability, emotional state, behaviour and special care needs” of the person concerned.

  • In the circumstances where the Secretary is not so satisfied, the Secretary must ask for a replacement professional questionnaire to be completed by another treating health professional.

  • A rating scale methodology for each questionnaire is provided for within Schedule 2.

  1. I would also note the following instructions:

  • In relation to the claimant questionnaire, the advice provided is:

    For each question, the claimant must tick only the response code that best describes how well the person in care usually manages.  Help means any physical assistance, guidance or supervision.  Without help means that the person initiates and completes activities without assistance or supervision.

  • In relation to the professional questionnaire the advice provided is:

    This is an assessment of personal activities of daily living ...

    ... a record of what a person does, not a record of what a person could do.

    The main aim is to establish degree of independence from any help ...

    The need for supervision renders the person not independent.

    A person’s performance should be established using the best available evidence.  Asking the person, friends, relatives or both, and nurses will be the usual source, but direct observation and common sense are also important.  ...

  1. I observe that sections 197 and 952 of the Act provide for definitions of terms used within qualification for CP and CA provisions in sections 198 and 954 of the Act respectively. Common to both sections is the definition of a disabled adult:

    disabled adult means a person aged 16 or more who:

    (a)has a physical, intellectual or psychiatric disability; and

    (b)is likely to suffer from that disability permanently or for an extended period.

  2. In the light of my earlier findings that Mr Harvey suffers from chronic renal failure and extensive basal cell carcinoma of the skin, and that both conditions are permanent, I am satisfied that Mr Harvey meets the requirements of being a disabled adult.

  3. I note that section 198 of the Act provides the criteria which must be satisfied for Mrs Harvey to qualify for CP. These include the following:

  • Mrs Harvey must provide “constant care” for Mr Harvey.

  • Mr Harvey must be a disabled adult who has been assessed and rated under the ADAT and given a score under that tool of at least 25, with such a score being calculated on the basis of a total professional questionnaire score of at least 10.

  1. Further, I observe that section 197 of the Act defines care, insofar as CP is concerned, as including attention and supervision.

  2. In addressing the term “constant care”, I note the definition of the word “constant” detailed from the following sources:

Concise Oxford Dictionary – unmoved, resolute, unchanging, unremittent as to attention, chatter.

New Oxford Dictionary – occurring continually over a period of time; remaining the same over a period of time.

Guide to Social Security Law – “a carer is said to provide constant care if they personally provide care on a daily basis for ‘a significant period’ during each day.  The care may be active, supervisory or monitoring ...” (Part 1.1 C310)

Re Mrs M and Director-General of Social Security [1983] 5 ALN N365:

… ‘constant care and attention’ encompasses care and attention which is continually recurring.  Nevertheless, ‘constant’ denotes more regularity or periodicity than ‘spasmodic’ ...

Re Seager and Director-General of Social Security (1984) 6 ALD 556:

We are thus of the opinion that s 105J [Social Security Act 1947] looks to “care and attention” that is either continuous or continually recurring, but not to “care and attention” that is merely intermittent or spasmodic.  If the care and attention that is provided is regular and frequent, is provided on an on-going basis, day to day, over a period of months, then such attention can be described as “constant” though there are periods of inattention within each 24-hour cycle.  [at 566]

… The legislation provides “constant care and attention” simpliciter, not “constant care and attention every day”…  [at 564]

Re Yousef and Director-General of Social Security (1981) 4 ALD 316 at para 22:

We consider that the meaning we should adopt for the word “constant” for present purposes is that if the need for care and attention is continually recurring the statutory requirement is satisfied ...  In this case the care and attention that is needed recurs frequently as far as an actual onset of asthma is concerned, and as far as that goes has been continually recurrent.  But the care and attention needed here goes beyond that.  Watchfulness for an onset of asthma continues “without pause or letup”.

Re Kedwell and Secretary, Department of Social Security (1987) 13 ALD 419 at 420:

The degree of care and attention requires for the purposes of a carer’s pension was higher than that required for the purposes of handicapped child’s allowance and should be taken as referring to the provision of significant assistance every day rather than to the provision of assistance on a continually recurring basis.

  1. I am mindful that all of the cases cited in the previous paragraph refer to understanding and meanings given to the phrase “constant care and attention” in the context of particular legislation existent at the time.  My task is to give a meaning to the phrase “constant care” within the context of the Social Security Act 1991. I observe that s 38C provides for the Secretary to devise a test for assessing the disability, emotional state, behaviour and special care needs of a person and provide a method for rating the person, being a score established according to a scale that provides for a range of scores that indicate the level of physical, intellectual or psychiatric disability of a person. Further, I observe that the Adult Disability Assessment Determination 1999 provides for the construction of such a test, namely the ADAT, with the instructions for completion of the two questionnaires nominated.

  2. I note that the term “care” has been defined to include attention and supervision. I note the dictionary definitions of constant as unmoved, resolute, unchanging, unremittent as to attention, occurring continually over a period of time, remaining the same over a period of time. I would conclude that the phrase “constant care” refers to care needs which are unchanging, unremittent, occurring continually and remaining the same over a period of time. I have already concluded that the assessment of the care needs, including the level of care needs, are and remain a function of the ADAT. I would further conclude that, as a consequence of the functions nominated in the Act and referred to above, phrases that “constant care” requires the provision of care on a daily basis “for ‘a significant period’ during each day”, a carer would be expected to provide at least the equivalent of a normal working day, could only be relevant if the phrase “constant care” was to be interpreted as constant care on a daily basis – a meaning that the statute could have conveyed by including the words “on a daily basis” and clearly one that was not adopted.

  1. In defining “constant care” as I have, I am mindful that such a definition points to the provision of care that is occurring continually or remains the same over a period of time, with the latter encompassing circumstances of continuous reoccural.  In relation to the phrase “period of time”, the time period must reflect the opportunity to assess adequately the need for the provision of constant care, and the likelihood for it to be required on a continuing and permanent basis.

  2. In addressing the issue of “constant care” within the context of this matter, I acknowledge that Mr Harvey has two permanent conditions, and that each disability requires the provision of care, albeit different, on an ongoing and permanent basis.  The provision of care by Mrs Harvey in relation to Mr Harvey’s chronic renal failure has been described earlier in this decision, with the provision of such care being ongoing and remaining the same for the indefinite future.  Similarly, the provision of care by Mrs Harvey for Mr Harvey’s skin carcinoma condition has been described.  Clearly, while the range of services provided by Mrs Harvey for Mr Harvey in relation to the latter condition remains continuously ongoing, there is variability as to when a particular provision of care is provided, with such variability arising as a consequence of the condition and the doctor’s treatment of the condition.

  3. I am satisfied, and so find on the balance of probabilities, that Mrs Harvey is providing constant care in relation to Mr Harvey’s two permanent conditions, namely, chronic renal failure and basal cell carcinoma of the skin, with my analysis pointing to the requirement for Mrs Harvey to provide care on a continuous, ongoing basis.

  4. Before proceeding further, I am mindful that on 8 February 2008 Centrelink made a determination that Mrs Harvey had been incorrectly granted CP and CA on 27 December 2007, with both payments being cancelled as from the date of lodgement, namely, 23 October 2007. Such a review was conducted pursuant to s 126 of the Social Security (Administration) Act 1999, which permits the Secretary, pursuant to s 80 of the same act to make the determination that he did.  Despite the fact that the issues in this matter involve a cancellation determination, I observe that this does not alter the material which I am permitted to consider, as the date of cancellation involved material lodged with the claim on 23 October 2007.

  5. I note that Mrs Harvey completed the claimant questionnaire on 23 October 2007, such a questionnaire being a formal requirement for the ADAT.  Question 24 provides the following instructions in relation to completing the questions contained therein:

    [T]ick the box that best describes how well the person in your care usually manages.

    ·The person’s abilities include what he/she can do when using his/her aids, appliances or special equipment items.

    ·Where the person’s disability or condition is episodic or is only apparent at certain times, the question should be answered for when the person is not experiencing an episode or flare-up of the disability/condition.

    ·Help means any physical assistance, guidance or supervision.  Help also includes prompting the person to undertake daily activities, e.g. you may need to prompt the person you care for to take medication, eat or dress themselves etc.

  6. I note that the Secretary in this matter contends that the claimant questionnaire completed by Mrs Harvey does not best describe how well Mr Harvey usually manages.  I understand that the completion of the claimant questionnaire may pose some difficulty with Mr Harvey suffering from two chronic and permanent conditions, each of which presents a need for care, albeit of a different nature, and in the case of the chronic renal failure the use of special equipment items (dialysis machine) on a routine and regular basis three days a week.  In short, it can be said that while Mr Harvey’s chronic renal disease is not episodic or subject to flare-up, the treatment of such is of such a nature as has been outlined.  The care that is provided by Mrs Harvey is reflective of the treatment process, and is further complicated by the care necessary for Mr Harvey’s treatment of his chronic skin condition.

  7. Further, even if I were to perceive that there were some ambiguities in the instructions nominated, I am mindful that the Act is beneficial legislation designed to assist the needy and the disadvantaged. I am reminded of what Isaacs J stated in Bull v Attorney-General (NSW) (1913) 17 CLR 370 at 384:

    ... [T]his is a remedial Act, and therefore, if any ambiguity existed, like all such Acts should be construed beneficially ... This means, of course, not that the true signification of the provision should be strained or exceeded, but that it should be construed so as to give the fullest relief which the fair meaning of its language will allow …

  8. While the claimant may have, and indeed has, had some difficulty in completing the claimant questionnaire, as evidenced by her earlier completion of other claimant questionnaires associated with lodgement of earlier claims, I consider that Mrs Harvey has completed the claimant questionnaire on 23 October 2007 in a manner which best reflects how well Mr Harvey usually manages in accordance with the stated instructions.

  9. In such circumstances, I note and so find that the appropriate score for the claimant questionnaire is 30.  Such scoring is mandated by Schedule 2 of the ADAT, once one is satisfied that the responses are an adequate reflection of the disability – special care needs of Mr Harvey.

  10. On 6 December 2007 Dr Trew provided clarification of his answers to questions 7 and 8 in the health professional questionnaire completed on 22 September 2007 in the following terms:

    1.  Q7. Mobility …

    While on dialysis is immobilised to a chair/incliner for duration of treatment 5 hours second daily.

    2.  Q8. Dressing …

    Mr Harvey has multiple skin cancers.

  11. In further clarification on 11 July 2008 Dr Trew advised that:

  • Mr Harvey’s joint replacement does not impact on his ability to function independently.

  • That Mr Harvey does need some help with toilet use during period on dialysis.

  • That Mr Harvey is immobile on the days on which he is undergoing dialysis but is independent on days when he is not undergoing dialysis.

  • Issues of assistance with and frequency of daily dressings and/or bathing is a matter for referral to his skin surgeon.

  1. I note that Dr Pang had provided clarification in correspondence dated 22 November 2007 that Mrs Harvey needs to twice daily dress a wound, washing first with salty water and then applying Betadine.  Such occurs in situations where Mr Harvey is unable to do it himself by virtue of the site of the wound.

  2. I note that the main areas of contention relate to the completion of questions 4, 7 and 8 of the professional questionnaire.  The main contention by the Secretary is that the care needs recorded in the health professional questionnaire are not an accurate reflection of when he is not on dialysis.

  3. I consider the argument contended by the Secretary is inconsistent with the main aim of the professional questionnaire to establish the independence from any help, and focuses on what Mr Harvey could do rather than a record of what he does.  It would appear to me that Dr Trew’s completion of the professional questionnaire in the way he has, together with his further clarifications and those from Dr Pang, focus on the care needs arising from both chronic and permanent conditions.  I would further comment that the thrice weekly dialysis program dictates a specific care program to be undertaken by Mrs Harvey, which cannot be ignored.  Similarly, after seeing Mr Harvey in person, and having had Dr Pang explain the severity of Mr Harvey’s skin condition and the complexity of the ongoing treatment program, I consider that the professional questionnaire, as completed and clarified, is an accurate reflection of Mr Harvey’s disability, emotional state, behaviour and special care needs arising from his two chronic conditions.

  4. If I were not so satisfied, my only recourse would be to ask for a replacement health professional questionnaire to be completed.  As indicated, I find such a course of action unnecessary and, further, if such were to be done, I would be concerned that such issues which have been before me would still remain to be determined.

  5. In accordance with the ADAT scales, I find Mr Harvey’s total professional score is 19.5 and a final ADAT score of 49.5 (adding both scores together).

  6. As a consequence of my findings, that Mrs Harvey is the only person providing constant care for Mr Harvey, that the score under the assessment tool is 49.5, with such a score calculated on the basis of a total professional score of 19.5, I conclude that Mrs Harvey qualifies for CP.

  7. Section 954 provides the criteria for qualification for payment of CA. There is no argument that Mr Harvey is an Australian resident, and the care receiver is a family member. I have already made findings that Mr Harvey has been assessed and rated under the ADAT with a score 49.5, calculated on the basis of a professional questionnaire score of 19.5.

  8. The final issue is whether Mr Harvey receives care and attention on a daily basis from a person who is an Australian resident.  I have previously outlined the care and attention given by Mrs Harvey, an Australian resident, to Mr Harvey.  I am satisfied that some elements of care, whether it be supervision, monitoring or actual physical activity, are given by Mrs Harvey to Mr Harvey on a daily basis.  In so stating, while I am mindful that the physical care activities are somewhat predicated by the scheduling of treatment programs for Mr Harvey’s two chronic conditions, the monitoring and supervisory activities to do with diet and food preparation, fluid intake and medications are clearly ongoing and occurring on a daily basis.

  9. With such findings, I conclude that Mrs Harvey satisfies the qualifications for CA at the time her claim was lodged on 23 October 2007.

  10. In the light of my findings, while affirming the decision under review, I vary the claimant score to 30 and in so doing vary the total rating under the ADAT to 49.5.  I would note that the date of effect is 23 October 2007, but that payment has already been made and not reclaimed between 23 October 2007 and 8 February 2008. 

I certify that the 49 preceding paragraphs are a true copy of the reasons for the decision herein of Dr J D Campbell, Member

Signed:         ...............[sgd].................................................................
  Associate

Date of Hearing  1 September 2009 
Date of Decision  29 October 2009
Representative of the Applicant                Ms J Maclean, Centrelink Legal Services and        Procurement Branch 
Counsel for the Respondent          Mr T Brennan
Solicitor for the Respondent          Ms M Lubowski, Welfare Rights Centre