JAMES RICHARD IBBETSON and REPATRIATION COMMISSION

Case

[2012] AATA 167

16 March 2012


[2012] AATA 167

Division VETERANS' APPEALS DIVISION

File Number

2010/3871

Re

JAMES RICHARD IBBETSON

APPLICANT

And

REPATRIATION COMMISSION

RESPONDENT

DECISION

Tribunal

G. D. Friedman, Senior Member

Date 16 March 2012
Place Melbourne

The Tribunal sets aside the decision the decision under review and substitutes a decision that Mr Ibbetson suffers from post-traumatic stress disorder which is war-caused with effect from 17 April 2009.  In all other respects the Tribunal affirms the decision under review.

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

G. D. Friedman, Senior Member

VETERANS' AFFAIRS – veterans’ entitlements – post-traumatic stress disorder – traumatic events – whether condition diagnosed and war-caused

Veterans' Entitlements Act 1986 ss 9, 120(1)

Benjamin v Repatriation Commission (2001) 70 ALD 622

Kaluza v Repatriation Commission [2010] FCA 1244

Mines v Repatriation Commission (2004) 86 ALD 62

Re Codd and Repatriation Commission [2008] AATA 1177

Repatriation Commission v Deledio (1998) 83 FCR 82

Repatriation Commission v Hill [2008] FCA 50

Repatriation Commission v Warren [2007] FCA 866

REASONS FOR DECISION

G. D. Friedman, Senior Member

  1. James Ibbetson served in the Australian Army from 22 January 1964 to 2 July 1971.  His service in Vietnam from 17 January 1968 to 6 February 1969 constitutes operational service under the Veterans' Entitlements Act 1986 (the Act).

  2. Mr Ibbetson is currently receiving a disability pension at 100 per cent of the general rate based on the acceptance by the respondent that his medical conditions of bilateral sensorineural hearing loss and ischaemic heart disease are war-caused.  On 17 July 2009 Mr Ibbetson lodged a claim for post-traumatic stress disorder (PTSD) and alcohol abuse to be accepted as war-caused relating to events that occurred during his service in Vietnam.  His claim was refused by the respondent and the decision was affirmed by the Veterans’ Review Board (VRB).  Mr Ibbetson seeks review only of the decision regarding PTSD.

ISSUES

  1. The issues before the Tribunal are whether Mr Ibbetson suffers from PTSD, and, if so, whether the condition is war-caused.

DOES MR IBBETSON SUFFER FROM PTSD?

  1. The Tribunal is required to determine to its reasonable satisfaction whether Mr Ibbetson suffers from any particular injury or disease (Benjamin v Repatriation Commission (2001) 70 ALD 622).

  2. In the Diagnostic and Statistical Manual of Mental Disorders (Fourth Ed, Text Revision) (DSM-IV) a diagnosis of PTSD requires that:

    A.        The person has been exposed to a traumatic event in which both of the following were present:

    (1)       the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or threat to the physical integrity of self or others

    (2)       the person’s response involved intense fear, helplessness, or horror…

  1. Using this definition there must be both a traumatic event, which answers the description given, and a response of the required intensity.  In Mines v Repatriation Commission (2004) 86 ALD 62 Gray J said at 74:

    If the question is posed as whether a veteran has suffered PTSD as a result of a traumatic event said to have occurred during the veteran’s operational service it must be answered by saying that the decision maker must be reasonably satisfied that the traumatic event occurred before reaching the conclusion that the veteran suffered PTSD.

  1. This reasoning was followed in Repatriation Commission v Hill [2008] FCA 50.

  2. In Repatriation Commission v Warren [2007] FCA 866 Kiefel J stated:

    [23] The question that the appeal raises is whether it is necessary that the Tribunal make its findings, as to the existence of the disease claimed, expressly and in detail, by reference to the criteria in the SoP. The applicant relies upon cases which hold that it is necessary for the decision-maker to have regard to the definition of injury or disease in the applicable SoP: see Repatriation Commission v Codd [2005] FCA 888 at [48] and Gosewinckel 59 ALD at [55]. Those cases however also make plain that it may be expected that the Tribunal will act upon medical opinion as to diagnosis. The point made by Weinberg J in Gosewinckel 59 ALD at [55], is that the Tribunal is not in a position to accept a doctor’s opinion as to the existence of a disorder without knowledge of the criteria essential to its diagnosis.

    [25] The anterior, or threshold, question for the Tribunal is whether the veteran suffers from the disease as claimed. It is a distinct and separate statutory question, in the nature of a precondition to any entitlement to a pension. There is no provision of the VEA which expressly requires the Tribunal to have regard to the SoP criteria in determining this question. The requirement that the Tribunal be reasonably satisfied that the veteran suffers from the claimed disease will usually require medical opinion. A clinical diagnosis of a condition classified under DSM-IV would necessarily have regard to that Manual and the criteria provided by it.

  3. In Re Codd and Repatriation Commission [2008] AATA 1177 the Tribunal stated:

    [16] ...Separating the question of the existence, or the characterisation, of a disease (and perhaps an injury) from its aetiology is sometimes difficult. For instance, statements of principles in respect of diseases such as alcohol dependence or alcohol abuse (the statements of principles relevant to the present case), post traumatic stress disorder (as in Mines) or anxiety disorder (also in Mines) commonly include among the criteria against which a hypothesis is to be assessed reference to an event that would constitute a possible cause of the disease, eg a “stressor”. The question is whether the decision-maker should determine as part of the preliminary process, applying the balance of probabilities standard, whether the veteran experienced such an event, or whether that issue belongs in the four-step Deledio process, as part of the hypothesis tested against the relevant statement of principles...

    [17] The solution to this problem adopted by the Federal Court is not to undertake such a full inquiry as to whether the veteran suffers from the particular disease as would involve the determination of the disease’s aetiology. Rather, the solution is to determine on the balance of probabilities whether the veteran is suffering from a collection of symptoms that would amount to the disease in question, if the crucial fact relevant to its aetiology were to have existed…

  1. Mr Ibbetson told the Tribunal that after leaving school in Year 10 he began an apprenticeship with the army and qualified as a clerk with the Royal Australian Army Service Corps (RAASC).  In 1968 he was sent to Vietnam where he performed clerical duties at Vung Tau and later at the headquarters of Australian forces (AFV) in Saigon until he returned to Australia in 1969.  He worked as a clerk storeman and in July 1970 he applied successfully to the Officer Cadet School in Portsea, Victoria for training as an Officer, but in February 1971 he was discharged from the army as medically unfit after injuring his left knee.

  2. Mr Ibbetson stated that there were a number of traumatic events during his service in Vietnam that caused significant distress.  The first event occurred in Saigon, on or about 12 November 1968, when he was told that a motorcyclist had attached a satchel or briefcase containing explosives to the side of a bus he was travelling on, causing Mr Ibbetson distress when he realised the danger he had been exposed to even though there was no explosion (the satchel event).

  3. The second event occurred on the day of his arrival in Vung Tau harbour on HMAS Sydney, and while waiting for road transportation to the base his group heard gun fire nearby and he was terrified (the gun fire event).  The third event occurred on the night he arrived at the Australian base at Vung Tau and he was informed the next morning that the base had been subject to mortar fire (the mortar fire event).  The fourth event occurred when he was travelling in a jeep as a gunner protecting a convoy of vehicles between Vung Tau and Nui Dat, when he heard gun fire and was in fear for his life (the convoy event).  The fifth event occurred when he travelled by helicopter to a fire support base and heard small arms and mortar fire, and was scared (the fire base event).           

  4. In respect of the satchel event Mr Ibbetson stated that he was travelling in a crowded bus with about fifty Australian service personnel.  He was seated to the rear of the bus and noticed a disturbance.  Soon afterwards, and while still on the bus, he was told that someone had attached a satchel, connected to a coat hanger, to the side of the bus.  He said that he was informed that an Australian warrant officer who was a passenger on the bus had noticed the satchel being attached and had flicked it away.  There was discussion on the bus about whether the satchel contained explosives.  He explained that he did not observe the incident, but others on the bus had described the event in detail to him when he returned to his accommodation.  He said that he was distressed and shaking at the realisation that his life, and the lives of others on the bus, had been in danger.  He said he was a bundle of nerves and asked to be placed on the roof of his accommodation and the AFV when performing guard duty because he felt the buildings were vulnerable to attack and that this was the safest place.  He increased his alcohol consumption.    

  5. Mr Ibbetson said that he has suffered nightmares from that day as a result of the incident, and described ongoing anxiety, restlessness, irritability, and a particular nightmare that involves a bright light and an explosion.  Some nightmares are worse than others.  He also said that he avoids ANZAC Day marches, Returned Services League events and gatherings of Vietnam veterans because these bring back memories of incidents that he prefers to suppress.  He stated that his symptoms of irritability, anger and his short temper have affected his employment, his social life and family relationships.  He explained that he did not discuss these matters with his general practitioner before the referral to Dr N Pomorin, consultant psychiatrist, in 2009 because he did not want to do so.  

  6. Under cross-examination Mr Ibbetson agreed that he told the VRB that some satchel bombs consisted of explosives contained in canvas bags, but maintained that he was told that this particular bomb consisted of a leather briefcase.  He said that he had made his own enquiries about the satchel event and has seen the actual briefcase, together with a photograph showing the Australian warrant officer and Vietnamese officials with the bus, which is held in the collections the Australian War Memorial in Canberra.  Mr Ibbetson also agreed that he had made previous claims for a disability pension for psychological conditions involving stressful events but had not listed the satchel event.  He explained that he had suppressed this particular event for many years until after the suicide in 1987 of a friend who served with him in Vietnam.

  7. Mr Ibbetson agreed further that he told the VRB that after being informed of the details of the satchel event he felt relief that the device did not explode and was frightened at the realisation of what might have happened, although he stated to the VRB that it did not give him…the same sense of immediate fear as someone taking a potshot at you or holding a gun at your head.  He agreed that he was asked by the VRB whether he has waking recollections of the satchel event and whether it was something that he thinks about during his waking time at all and he answered: Not really, I suppose.  He also said to the VRB that he could not remember if he ever had waking recollections of the event.  Mr Ibbetson explained that these answers have been taken out of context, and that at the VRB hearing he was stressed by the conduct of the proceedings and by being confronted with three members of the VRB who were asking questions about various matters not in any particular order.  He emphasised that he did not think about the event every day, but the memories have had a significant and lasting effect on him.           

  8. The Tribunal had before it reports from psychiatrists who have examined Mr Ibbetson.  On 25 August 2009 Dr Pomorin referred to the development of symptoms of characteristic re-experiencing, arousal and avoidance following exposure to emotionally traumatic war-time events, and he diagnosed chronic PTSD.  In respect of the satchel event, Dr Pomorin noted that if the satchel had not been detached from the bus, the vehicle would have exploded, resulting in death and/or injury.  He took a history that Mr Ibbetson could not sleep for ages after the event and had considered the incident to be the worst of the claimed traumatic events.  Dr Pomorin also stated that the suicide of a former army colleague in 1987 contributed to Mr Ibbetson’s PTSD.  He told the Tribunal that before this event Mr Ibbetson had coped with the distress caused by the stressors from his service in Vietnam by keeping a lid on them, but the stressors were unmasked by the 1987 incident, and Mr Ibbetson then re-experienced them.

  9. In a report dated 7 March 2011 Dr L Walton, consultant psychiatrist, stated that there may be a delay between involvement in a traumatic event and the realisation of such involvement, somewhat later, which seems to be the situation surrounding the satchel event, as Mr Ibbetson described feeling intense fear following the event.  Dr Walton noted that, contrary to Mr Ibbetson’s evidence to the VRB, Mr Ibbetson described to him the re-experiencing of phenomena in the form of nightmares and troublesome memories.  He took a history of long-term insomnia, irritability and a hyperstartle response and observable distress.

  10. Dr Walton noted persisting psychiatric symptoms including anxiety, irritability, depressed mood, nightmares and an avoidance and intolerance of others, but was not convinced that Mr Ibbetson exhibited significant avoidance behaviour apart from not travelling by bus; there seems no traumatic memory loss; Mr Ibbetson remains socially engaged; there is no emotional numbing or a sense of a foreshortened future.  Therefore Dr Walton believed it was unlikely that Mr Ibbetson satisfies the criteria for PTSD under the Statement of Principles (SoP) where three or more examples of the avoidance of stimuli are required.  However he concluded that from the pragmatic and somewhat looser perspective of clinical diagnosis, as opposed to the strict adherence to SoPs, PTSD would be the preferred diagnosis.  

  11. In a further report dated 17 May 2011 Dr Pomorin said that since the initial consultation with him Mr Ibbetson has attended fourteen times for treatment.  He stated that, unlike Dr Walton, he obtained a history of a sense of foreshortened future which Mr Ibbetson felt was linked to a previous history of suicide ideation.  Dr Pomorin also stated that Mr Ibbetson was not socially engaged and led a reclusive lifestyle as well as avoiding discussion and activities that reminded him of war-time experiences.  Dr Pomorin maintained his diagnosis of PTSD.

  12. In a further report received by the respondent on 18 January 2012 Dr Walton stated that the only diagnosis to be considered is that of PTSD, and that his current position was that the clinical criteria were fulfilled, with the cause of PTSD being the satchel event.

  13. In a report dated 20 July 2011 on behalf of Writeway Research Services Pty Ltd Mr W Barsley noted that, in relation to the satchel event, the Services Member of the VRB stated at the hearing of the VRB on 28 July 2010:

    …Firstly, let me say, there is no dispute that the bomb incident occurred, it is written history and it involved Australian soldiers.  There is a photograph that is on the 137 report, [a document prepared for the VRB] so that is not in dispute…

  14. Mr Barsley stated that despite extensive research of official records, including the diary of the Commander of the headquarters of the AFV and the military police incident reports for Saigon in the relevant period, no evidence of the event could be found.  Mr Barsley concluded that this was not surprising because there had been no explosion or casualties, no damage to the bus and there was no other enemy activity involved.

  15. Under cross-examination Mr Barsley stated that his research indicated that Mr Ibbetson was not rostered for duty on 12 November 1968, so he would not have been on the bus.  Mr Barsley agreed that the Australian War Memorial has in its collection a briefcase believed to be the briefcase in question.  He also acknowledged that a photograph held by the War Memorial purporting to show the warrant officer with the briefcase has a description:

    SOUTH VIETNAM, 1968-11-12.  WARRANT OFFICER CLASS 2 DON ANDREWS OF POINT LONSDALE, VIC. (CENTRE) EXAMINES A SATCHEL BOMB WHICH WAS HOOKED TO THE SIDE OF A BUS IN SAIGON ALONGSIDE THE SEAT HE OCCUPIED.  THE WARRANT OFFICER QUICKLY FLICKED IT OFF THE WIRE MESH AND PROBABLY SAVED A NUMBER OF LIVES AS THE BUS HAD FIFTY TROOPS ON IT AT THE TIME.  WITH HIM ARE VIETNAMESE POLICE DRIVER MR TU (LEFT) AND SPECIAL INVESTIGATION POLICE OFFICER, POLICEMAN ON.   

  1. Mr Barsley said that a film held by the War Memorial: Bomb attempt on Australian troops DPR/TV/961 made on 12 November 1968 has a description:

    A Viet Cong attempt to explode a satchel charge against a bus-full of Australian troops in Saigon at the end of last week was foiled… 

  1. He said that the descriptions accompanying the photograph and the film suggest that the satchel event occurred about a week before 12 November 1968.  Further research by Mr Barsley reveals that on 7 November 1968 WO2 Andrews was rostered for duty, suggesting that the satchel event occurred on that day.

  2. In a statement dated stated 30 November 2009 Mr P Curran, welfare/pensions officer of the RAASC Vietnam Association, said that he was present on the bus on 12 November 1968 and remembers the event vividly.  He explained that he saw the motorcycle approach the vehicle with a satchel but was unaware until later that the intention was to attach an explosive device to the bus.  He said that he was told about the details of the incident on arrival at the accommodation, and his reaction was of horror, sleep deprivation and self-medication with alcohol.  Mr Curran said that his war-caused PTSD was triggered by the event.  He also stated that Mr Ibbetson was posted to headquarters AFV at the time and would have travelled on the particular bus.   

  3. Under cross-examination Mr Curran stated that there were no other reported satchel bomb incidents in November 1968, and was adamant that the satchel event occurred on 12 November 1968.

  4. In a statement dated stated 30 November 2009, Mr R Lowe stated that he was present on the bus on 12 November 1968 and saw the motorcycle approach, although he did not witness the actual attaching of the satchel.  Mr Lowe stated that he was told about the incident when the bus reached its destination, and the realisation of the consequences if the warrant officer had not removed the satchel was the main cause of his PTSD.  He said that Mr Ibbetson was a member of headquarters AFV at the time and would have travelled on the particular bus.   

  5. In assessing the satchel event, the Tribunal takes into account that Mr Ibbetson’s description of the event and its impact, given to medical practitioners, the VRB and the Department of Veterans’ Affairs has been reasonably consistent.  Although some details of the events described by Mr Ibbetson were shown to be inaccurate, the Tribunal is satisfied that he made a genuine effort to recollect incidents that occurred more than forty years ago.  Clearly he found the Tribunal’s proceedings stressful and the Tribunal accepts his evidence that he also felt stressed during the VRB proceedings, particularly during the VRB hearing when his advocate asked for a short adjournment which was refused by the Presiding Member and Mr Ibbetson was asked many questions on a variety of topics for a considerable time.  Accordingly the Tribunal places little importance on any inconsistency between his evidence to the VRB concerning the level of fear or distress he felt in the aftermath of the satchel event, and his evidence to the Tribunal or to medical practitioners.

  1. The Tribunal finds that Mr Ibbetson was a passenger on a bus in Saigon on or about 7 November 1968 when a satchel or briefcase containing explosives was placed on the side of the vehicle by a person on a motorcycle, and that an Australian warrant officer detached the satchel and there was no explosion.  The Tribunal finds further that, although Mr Ibbetson was not aware of the details of the satchel or its contents at the time, he suffered distress and anxiety when he was made aware of the circumstances while on the bus, and particularly when he reached his destination and was informed of the details of the incident and its potentially life-threatening consequences.  Therefore the Tribunal finds that Mr Ibbetson …experienced, witnessed or was confronted with an event or event that involved actual or threatened death or serious injury, or threat to the physical integrity of self or others as provided for in the definition of PTSD in DSM-IV.     

  2. The Tribunal accepts Mr Ibbetson’s evidence to the Tribunal and to medical practitioners that his reaction to the satchel event involved shaking, followed by nightmares and lasting symptoms as described by him.  This is consistent with the medical evidence, including the opinion by Dr Pomorin that Mr Ibbetson exhibits three or more examples of the avoidance of stimuli and meets the definition of PTSD.  The evidence is also consistent with Dr Walton’s pragmatic somewhat looser perspective of clinical diagnosis of PTSD, and his opinion that the satchel event was an example of PTSD with a delayed reaction.  For these reasons the Tribunal concludes that Mr Ibbetson’s response to the satchel event involved intense fear, helplessness or horror as provided for in the definition of PTSD in DSM-IV.  Therefore the satchel event constitutes a traumatic event to which Mr Ibbetson has been exposed and the Tribunal finds that he suffers from PTSD.

  3. In view of its findings the Tribunal does not need to consider whether the other claimed stressors constitute traumatic events for the purposes of diagnosis.

IS PTSD WAR-CAUSED?

  1. Section 9 of the Act provides that where an injury or disease results from an occurrence that happened while a veteran was rendering operational service or where it arose out of, or was attributable to that service, the injury or disease will be taken as being war-caused. Causation questions such as these, where Mr Ibbetson has rendered operational service, are addressed by applying the standard of proof in s 120(1) of the Act. That requires decision-makers to determine that an injury or disease is war-caused unless satisfied beyond reasonable doubt that there is no sufficient ground for making that determination.

  2. In the circumstances of this case, where Mr Ibbetson has rendered operational service, the issue of whether the diagnosed condition was caused by operational service is to be decided by reference to the four-step process identified by the Federal Court in Repatriation Commission v Deledio (1998) 83 FCR 82 at 97-98:

    1.        The Tribunal must consider all the material which is before it and determine whether that material points to a hypothesis connecting the injury, disease or death with the circumstances of the particular service rendered by the person.  No question of fact finding arises at this stage.  If no such hypothesis arises, the application must fail.

    2.        If the material does raise such a hypothesis, the Tribunal must then ascertain whether there is in force an SoP [Statement of Principles] determined by the Authority under s 196B(2) or (11).  If no such SoP is in force, the hypothesis will be taken not to be reasonable and, in consequence, the application must fail.

    3.        If an SoP is in force, the Tribunal must then form the opinion whether the hypothesis raised is a reasonable one.  It will do so if the hypothesis fits, that is to say, is consistent with the "template" to be found in the SoP.  The hypothesis raised before it must thus contain one or more of the factors which the Authority has determined to be the minimum which must exist, and be related to the person's service (as required by ss 196B(2)(d) and (e)).  If the hypothesis does contain these factors, it could neither be said to be contrary to proved or known scientific facts, nor otherwise fanciful.  If the hypothesis fails to fit within the template, it will be deemed not to be "reasonable" and the claim will fail.

    4.        The Tribunal must then proceed to consider under s 120(1) whether it is satisfied beyond reasonable doubt that the death was not war-caused, or in the case of a claim for incapacity, that the incapacity did not arise from a war-caused injury.  If not so satisfied, the claim must succeed.  If the Tribunal is so satisfied, the claim must fail.  It is only at this stage of the process that the tribunal will be required to find facts from the material before it.  In so doing, no question of onus of proof or the application of any presumption will be involved.

  1. In relation to the first step from Deledio, after considering evidence from Mr Ibbetson and the psychiatrists about his PTSD and the satchel event, the Tribunal determines that the material points to a hypothesis connecting the condition with the circumstances of the particular service rendered by Mr Ibbetson.  Therefore he satisfies the first step.

  2. In respect of the second step from Deledio, there is a SoP in force, being SoP Nº 5 of 2008 concerning PTSD.  Therefore Mr Ibbetson satisfies the second step.

  3. In relation to the third step from Deledio the Tribunal has considered all the material, including the evidence from Mr Ibbetson and the psychiatrists about the satchel event, and forms the opinion that the hypothesis raised is a reasonable one.  Therefore Mr Ibbetson satisfies the third step.

  4. In relation to the fourth step from Deledio, the Tribunal must decide whether it is satisfied beyond reasonable doubt that there is no sufficient ground for determining that Mr Ibbetson’s PTSD was due to his operational service within the meaning of the Act.  It is at this stage that the Tribunal is called upon to make findings of fact.  Mr Ibbetson’s claim will succeed unless one or more of the facts necessary to support the hypothesis is disproved or the truth of a fact inconsistent with the hypothesis is proved.

  5. Factor 6 in Instrument Nº 5 of 2008 provides:

    (a)experiencing a category 1A stressor before the clinical onset of posttraumatic stress disorder;

  1. In paragraph 9 of the SoP:

    "a category 1A stressor" means one or more of the following severe traumatic events:

    (a)       experiencing a life-threatening event;

    (b)being subject to a serious physical attack or assault including rape and sexual molestation; or

    (c)being threatened with a weapon, being held captive, being kidnapped, or being tortured;

  1. There is no definition of the term clinical onset in the SoPs or in the Act.  In Kaluza v Repatriation Commission [2010] FCA 1244 Jacobson J stated at [92] and [93]:

    The meaning of the expression “clinical onset” was considered by the Full Court in Lees. The effect of what their Honours (Heerey, Moore and Kiefel JJ) said at [13] was that there is aclinical onsetof a disease, either:

    when a person becomes aware of some features or symptoms which enable a doctor to say that the disease was present at that time; or

    when a finding is made on investigation which is indicative to a doctor that the disease is present.

    The definition therefore emphasises the need for a determination of theclinical onsetby medical evidence. It is for the doctor to say when theclinical onsetoccurred by the presence of features or symptoms. But the clinical onset is not necessarily when the patient first sees a doctor for medical treatment.

  2. Dr Pomorin acknowledged that Mr Ibbetson first attended for assessment of his psychological issues in 2009 but had suppressed his symptoms of PTSD that arose in Vietnam until 1987.  Dr Walton concluded that Mr Ibbetson’s PTSD emerged within hours of the satchel event.  After considering the medical evidence the Tribunal finds that clinical onset of PTSD occurred shortly after the satchel event in November 1968.

  3. For reasons given in relation to whether Mr Ibbetson suffers from PTSD, the Tribunal accepts his evidence, supported by the medical evidence, that the satchel event was a life-threatening event that constitutes a category 1A stressor that was experienced by Mr Ibbetson before the clinical onset of PTSD.  Consequently Mr Ibbetson satisfies factor 6(a) of SoP Nº 5 of 2008 and satisfies the fourth step from Deledio, and his condition of PTSD is war-caused.

DECISION

  1. The Tribunal sets aside the decision the decision under review and substitutes a decision that Mr Ibbetson suffers from post-traumatic stress disorder which is war-caused with effect from 17 April 2009.  In all other respects the Tribunal affirms the decision under review.

I certify that the preceding 45 (forty-five) paragraphs are a true copy of the reasons for the decision of G. D. Friedman, Senior Member.

................................[sgd Michael Heffernan]....................................

Associate

Dated  16 March 2012  

Dates of hearing 23 and 24 January 2012, 13 March 2012
Counsel for the Applicant Mr G Chancellor
Solicitors for the Applicant Williams Winter
Counsel for the Respondent Mr G Purcell
Solicitors for the Respondent Department of Veterans' Affairs
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