JUNE RIDGWAY and REPATRIATION COMMISSION
[2009] AATA 391
•29 May 2009
Administrative Appeals Tribunal
DECISION AND REASONS FOR DECISION [2009] AATA 391
ADMINISTRATIVE APPEALS TRIBUNAL )
) No 2007/2376
VETERANS' APPEALS DIVISION ) Re JUNE RIDGWAY Applicant
And
REPATRIATION COMMISSION
Respondent
DECISION
Tribunal Miss E A Shanahan, Member Date29 May 2009
PlaceMelbourne
Decision The Tribunal affirms the decision under review.
(sgd) E A Shanahan
Member
VETERANS’ AFFAIRS – widows claim for pension – kind of death – cause of death – contribution to death by war-caused diseases – ischaemic heart disease – post traumatic stress disorder – death from metastatic carcinoma of the colon – hastening of death by ischaemic heart disease – decision affirmed
Veterans’ Entitlement Act 1986 s 8, s 13, s 120, s 120A
Statement of Principles Instrument No 3 of 1999 concerning Post Traumatic Stress Disorder
Statement of Principles Instrument No 35 of 2003 concerning Hypertension
Statement of Principles Instrument No 53 of 2003 concerning Ischaemic Heart Disease
Statement of Principles Instrument No 89 of 2007 concerning Ischaemic Heart DiseaseDoolette v Repatriation Commission (1990) 21 ALD 489
Repatriation Commission v Codd (2007) 95 ALD 619Repatriation Commission v Deledio (1998) 83 FCR 82 at 97
Repatriation Commission v Hancock (2003) FCA 711
Repatriation Commission v Law (1980) 31 ALR 140
Repatriation Commission v Norton (2008) FCA 1132
Roncevich v Repatriation Commission (2005) 218 ALR 733
Tunks v Repatriation Commission (2008) 102 ALD pg 274REASONS FOR DECISION
29 May 2009 Miss E A Shanahan, Member 1. Ronald Ridgway died on 12 November 2005 from carcinoma of the colon. The death certificate also listed the presence of ischaemic heart disease. Mr Ridgway was a veteran in receipt of the disability pension for several conditions including post traumatic stress disorder (PTSD). Mrs Ridgway made a claim for widow’s pension on 23 February 2006. Mrs Ridgway’s claim was rejected by the Repatriation Commission (the Commission) on 31 March 2006. This decision was affirmed by the Veterans’ Review Board (VRB) on 27 April 2007, on the grounds that the material did not point to a hypothesis connecting the veteran’s death with his service. Mrs Ridgway applied to the Administrative Appeals Tribunal (AAT) for a review of this decision on 6 June 2007. Mrs Ridgway was not pursuing any claim with respect to either Mr Ridgway’s carcinoma of the colon or carcinoma of the prostate.
2. Mrs Ridgway was represented by Ms J Bornstein of counsel, instructed by Williams Winter solicitors. The Commission was represented by Mr K Rudge, an advocate with the Department of Veterans’ Affairs. The Tribunal was provided with the documents lodged pursuant to s 37 of the Administrative Appeals Tribunal Act 1975 (T Documents) and the parties tendered the following documents:
For the Applicant:
·Statement of Mrs June Ridgway dated 31 May 2007 – Exhibit A1
·Report of Dr Michael Epstein dated 31 March 2008 – Exhibit A2
·Report of Associate Professor A Pitt dated 29 August 2008 – Exhibit A3
For the Respondent:
·T-Documents – Exhibit R1
·Report of Professor John Cade dated 29 February 2008 - Exhibit R2
·Report of Professor Cade dated 10 October 2008 – Exhibit R3
·Clinical Notes of Dr Slonim concerning Mr Ridgway – Exhibit R4
·Clinical Notes of Dr John Gelman concerning Mr Ridgway – Exhibit R5
·Cabrini Hospital medical records concerning Mr Ridgway – Exhibit R6
·Report of Mr. Steven Blamey, surgeon, dated 28 February 2008 – Exhibit R7
·Knox Private Hospital medical records concerning Mr Ridgway – Exhibit R8
·Clinical Notes of Dr Gideon Shaw concerning Mr Ridgway – Exhibit R9
3. Mrs Ridgway, Dr Michael Epstein, Professor Aubrey Pitt and Professor John Cade gave evidence.
ISSUES BEFORE THE TRIBUNAL
1.Was Mr Ridgway’s ischaemic heart disease war-caused?
2.Did Mr Ridgway’s ischaemic heart disease contribute to his death thereby raising a reasonable hypothesis linking his death to his war service?
BACKGROUND TO THE APPLICATION
4. Mr Ridgway served with the Australian Army (the Army) from 18 December 1941 until 29 November 1945, during which time he was posted to New Guinea for just over two years. In New Guinea he served as an ambulance driver and a hospital orderly. After the war Mr Ridgway worked initially as a driver, then a builder with his brother until 1954, when he bought a hardware store. He continued in the hardware store until the age of 60 (1977), when he retired.
5. Mrs Ridgway had known her husband prior to his enlistment and described him as then being happy-go-lucky. After his service he was anxious, withdrawn, suffered nightmares and regularly became irritable. Despite this he managed the hardware business efficiently and was active in his church. But he rarely socialised other than at his regular church attendances and his participation in Anzac Day functions every year. He avoided discussing his experiences during the war. Toward the end of his working life he displayed difficulty dealing with clients and suppliers to his hardware store.
6. Following their retirement, Mr and Mrs Ridgway cared for some years for the children of their daughter, who had died in 1992. Mr and Mrs Ridgway were avid gardeners. Mr Ridgway continued to garden until he became physically unwell.
7. In 1997 Mr Ridgway successfully claimed a disability pension based predominately on the diagnosis of PTSD made by Dr Pomorin in July 1997. Dr Pomorin recorded a 20 year history of an anxiety disorder, which had been treated by Mr Ridgway’s general practitioner and a psychiatrist. Mr Ridgway also suffered from supraventricular tachycardia for many years. In 1993 he was diagnosed with hypertension and in 1999 with carcinoma of the prostate. The carcinoma of the prostate was quiescent until 2002 when bony metastases were detected. Neither the hypertension nor the carcinoma of the prostate was considered to be war-caused in 1999. In 2001 he was diagnosed with coronary artery disease and ischaemia were diagnosed and surgery was recommended. Mr Ridgway declined surgery and was thereafter treated conservatively by his cardiologist, Dr Gelman.
8. In April 2003 Mr Ridgway suffered a pathological fracture of the neck of his right femur due to secondary metastatic carcinoma (Ex R8). In July 2005 Mr Ridgway was investigated for bowel symptoms, predominantly severe constipation, and was eventually found to have carcinoma of the colon with the diagnosis being based on raised serum enzymes (Ex R6). Staging procedures in the form of CT scanning revealed malignant deposits in both lungs and the liver. Despite chemotherapy, Mr Ridgway became increasingly frail and wheelchair bound. He was admitted to the Cabrini Palliative Care Unit in Prahran for palliative care on 25 October 2005 and on admission was described as being moderately cachetic. He died on 12 November 2005. Mr Ridgway’s anti-hypertensive and cardiac medication had been stopped prior to 3 October 2003 and his dose of Plavix reduced. He did report one episode of angina after the cessation of these drugs but this was relieved by nitrolingual spray (Ex R5).
9. Mrs Ridgway lodged a claim for widow’s pension on 23 February 2006, based on the hypothesis that Mr Ridgway’s death from carcinoma of the colon had been contributed to by his ischaemic heart disease, thereby hastening his death. There was no dispute that Mr Ridgway had ischaemic heart disease, hypertension, carcinoma of the colon and carcinoma of the prostate. The factor relied upon to link Mr Ridgway’s ischaemic heart disease to his war service was the presence of hypertension; which in turn was linked to his service by the presence of an anxiety disorder dating from the time of service. The Commission argued that PTSD was not an anxiety disorder. The VRB had confirmed the decision of the primary delegate: that Mr Ridgway’s death had not been contributed to by ischaemic heart disease and that his carcinoma of the colon did not meet the requirements of the Statement of Principles (SoP) concerning carcinoma of the colon (Instrument N° 1 of 2004).
10. Prior to the hearing before this Tribunal the parties obtained expert opinion; Dr Epstein and Associate Professor Pitt for Mrs Ridgway and Professor Cade for the Commission. All three experts gave evidence before the Tribunal.
11. Dr Epstein confirmed the diagnosis of PTSD based on the psychosocial stressors experienced by Mr Ridgway in World War II. In his opinion, Mr Ridgway’s symptomotology also met the diagnostic criteria of the SoP for generalised anxiety disorder (GAD). Dr Epstein noted that while PTSD was classified in the Diagnostic and Statistical Manual of Psychiatric Disorders IV - Text Revised (DSM IV-TR) as an anxiety disorder, a classification with which he had agreed, the SoP for hypertension related to an anxiety disorder only and excluded other Axis 1 disorders such as PTSD.
12. Professor Pitt said that Mr Ridgway’s hypertension and ischaemic heart disease were proven. The hypertension was well controlled. The coronary artery disease, based on angiography findings, was severe, affecting all three major arteries to a level which ischaemia would be present, there being at least 85 per cent stenosis in each vessel. Coronary artery bypass grafting was indicated in 2001 but Mr Ridgway had refused surgery. Professor Pitt opined that the cause of death was widespread metastatic carcinoma but a contribution from ischaemic heart disease was likely but not probable, that is a likelihood of more than 50%. Additionally, he thought it was possible that a further deleterious effect on coronary artery blood flow had occurred following the cessation of Mr Ridgway’s medication with Plavix seven days before his death. Although he was not completely certain, Professor Pitt felt that seven days was the interval required for clotting to return to normal after the cessation of Plavix.
13. Professor Cade acknowledged Mr Ridgway’s proven ischaemic heart disease, hypertension, carcinoma of the prostate and carcinoma of the colon with wide spread metastases. However, he was of the opinion that his death was due solely to metastatic carcinoma, with no contribution from ischaemic heart disease in terms of hastening what he felt was an inevitable death. Professor Cade was asked to comment on the withdrawal of Plavix medication after the dose on 5 November 2005 and any relation this may have had to Mr Ridgway’s death on 12 November 2005. He agreed that this was a possible factor, although in his opinion it took at least seven days for platelet replenishment to occur after Plavix cessation. On consultation with the family a Not for Resuscitation order had been made. Professor Cade noted that all oral medication had been withdrawn on 10 November 2005; and from 7 November until 11 November increasing doses of morphine, midazolam, Serenace and ketamine had been continuously infused subcutaneously. These narcotics, anti-anxiety drugs and sedatives had provided what he considered to be appropriate palliative care.
14. Given the uncertainty regarding the time when the effect of Plavix would have been fully reversed, the Tribunal undertook to check the pharmacological activity of this drug and the manufacturer’s recommendations and product information.
DOCUMENTARY EVIDENCE
15. The documentary evidence most relevant to the issue before the Tribunal is the Cabrini Prahran Hospital Medical Record from 25 October 2005 to the time of Mr Ridgway’s death on 12 November 2005. Mr Ridgway had been admitted to hospital for terminal care. During these 18 days nursing staff had made eight-hourly entries in the clinical record, describing Mr Ridgway’s condition and progress. Entries were made by the treating oncologist and the palliative care physician at regular intervals.
16. On admission to hospital Dr Kenner, the palliative care physician, described Mr Ridgway as being moderately cachetic, frail and unable to sit up unaided. Mr Ridgway’s major symptoms at the time were back pain, lethargy and nocturnal confusion. All symptomotology and clinical signs were attributed to Mr Ridgway’s underlying metastatic carcinoma. It was noted that he suffered from ischaemic heart disease. This was assessed as stable and controlled with a GTN patch. It was recorded on 26 October that there was no history of chest pain. Throughout the period the nursing staff documented Mr Ridgway’s pain, which involved the back in the lower lumbar spinal area and both legs consistent with his known metastatic deposits of carcinoma in the lumbar spine; and one episode of right anterior chest wall pain, again at the site of the CT demonstrated secondary deposit in the lung. Mr Ridgway’s general condition deteriorated with the passage of time and his liver function tests became increasingly abnormal. Additional CT scans showed an increase in the number and size of deposits in the liver and lung. He was given narcotic analgesia on a regular basis and antibiotic therapy was stopped. Mr Ridgway suffered nose bleeds on 29 October, 4 November, 6 November and 10 November 2005. The persistent bleeding on 6 November necessitated the cessation of his regular Plavix dosage. He was also given vitamin k.
17. The records fully document the cessation of all oral medication on 9 November 2005, apart from mouthwashes and the continuous subcutaneous infusion of narcotics and sedatives in increasing doses thereafter.
18. Throughout Mr Ridgway’s hospital stay his vital signs were recorded on a daily basis until 10 November 2005, at which time he was semi-comatose. Throughout his pulse was regular and of normal rate and blood pressure, despite the cessation of anti-hypertensive therapy was normal. The oxygen (oxygen saturation) levels in the blood while inhaling room air were only slightly diminished from normal levels.
RELEVANT LEGISLATION
19. Section 13 of the Veterans’ Entitlement Act 1986 (the Act) states that the Commonwealth is liable to pay compensation to the dependent of the veteran whose death was war-caused. Section 8 outlines the circumstances in which such a death is said to be war-caused.
20. Section 120 of the Act provides the standard of proof to be applied in determining whether a veteran’s death is war-caused:
(1)Where a claim under Part II for a pension in respect of the incapacity from injury or disease of a veteran, or of the death of a veteran, relates to the operational service rendered by the veteran, the Commission shall determine that the injury was a war-caused injury, that the disease was a war-caused disease or that the death of the veteran was war-caused, as the case may be, unless it is satisfied, beyond reasonable doubt, that there is no sufficient ground for making that determination.
Note:This subsection is affected by section 120A.
…
(3)In applying subsection (1) or (2) in respect of the incapacity of a person from injury or disease, or in respect of the death of a person, related to service rendered by the person, the Commission shall be satisfied, beyond reasonable doubt, that there is no sufficient ground for determining:
(a)that the injury was a war-caused injury or a defence-caused injury;
(b)that the disease was a war-caused disease or a defence-caused disease; or
(c)that the death was war-caused or defence-caused;
as the case may be, if the Commission, after consideration of the whole of the material before it, is of the opinion that the material before it does not raise a reasonable hypothesis connecting the injury, disease or death with the circumstances of the particular service rendered by the person.
Note:This subsection is affected by section 120A.
21. As Mrs Ridgway’s claim for widow’s pension was lodged after 1 June 1994, s 120A is attracted. Section 120A states that the reasonableness of a hypothesis is to be assessed by reference to the SoP. The Repatriation Medical Authority, in accordance with s 196B of the Act, has promulgated SoPs concerning hypertension, ischaemic heart disease and PTSD.
22. Section 120(4) states:
(4)Except in making a determination to which subsection (1) or (2) applies, the Commission shall, in making any determination or decision in respect of a matter arising under this Act or the regulations, including the assessment or re-assessment of the rate of a pension granted under Part II or Part IV, decide the matter to its reasonable satisfaction.
Note:This subsection is affected by section 120B.
This section applies in determining the kind of death.
23. The Tribunal is required to follow the steps laid by the Full Court of the Federal Court in Repatriation Commission v Deledio (1998) 83 FCR (Deledio) in determining whether the hypothesis is reasonable and that it is satisfied beyond reasonable doubt that the veteran’s death was war-caused. The steps in Deledio, wherein the Federal Court has interpreted s 120 following the introduction of Statements of Principles, are:
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 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.
SUBMISSIONS
24. Mrs Ridgway relied on Professor Pitt’s opinion that a reasonable hypothesis could be postulated pursuant to which Mr Ridgway’s ischaemic heart disease hastened his death. She also relied upon the death certificate, in that the recorded cause of death was colon cancer of five months duration; and in part two of the certificate, headed Other conditions contributing to but not causing death, ischaemic heart disease was listed.
25. In Repatriation Commission v Codd (2007) 95 ALD 619 Gordon J at paragraph 39:
[39] On the proper construction of the VE Act, consistent with its evident statutory purpose and existing authority, the “kind of death met by the [veteran]” that is to be considered is the question of medical causation or the kind of death, being a medical cause of death, including the contributing or underlying medical cause of death.
Mrs Ridgway relied on Gordon J’s interpretation of the kind of death.
26. With respect to the extent of contribution, Mrs Ridgway relied upon the decision of the Federal Court in Repatriation Commission v Law (1980) 31 ALR 140, Doolette v Repatriation Commission (1990) 21 ALD 489 and the High Court in Roncevich v Repatriation Commission (2005) 218 ALR 733.
27. Ms Bornstein contended that the Tribunal must assess the kind of death to its reasonable satisfaction, that is, a standard of proof on the balance of probabilities (Repatriation Commission v Hancock (2003) FCA 711). If the Tribunal was satisfied as to contribution, it must then consider the claim in terms of the four steps of Deledio. The hypothesis relied on by Mrs Ridgway was complex. Ms Bornstein argued that Mr Ridgway’s anxiety state present at the time of his service, later diagnosed as an anxiety disorder and treated by his general practitioner and a psychiatrist, and in 1997 diagnosed by Dr Pomorin as late onset PTSD, were both forms of an anxiety disorder as required by the SoP concerning hypertension (Instrument N° 35 of 2003). Mrs Ridgway relied on Factor 5(n) of this SoP which states:
(n)suffering from a clinically significant anxiety disorder for the six months immediately before the clinical onset of hypertension;
28. The diagnosed hypertension in turn satisfied Factor 6(a) of the SoP concerning ischaemic heart disease (Instrument N° 89 of 2007).
THE RESPONDENT
29. Mr Rudge contended that the cause of death was carcinoma of the colon and that there was no evidence of any contribution from ischaemic heart disease. Professor Pitt had in his evidence concluded that on the balance of probabilities ischaemic heart disease did not contribute by hastening Mr Ridgway’s death. Professor Cade had excluded any contribution by the cessation of the drug Plavix to coronary artery thrombosis.
30. Mr Rudge contended that should the Tribunal find there was a contribution and proceed to test the reasonableness of any hypothesis in accordance with the steps of Deledio, the sub-hypothesis relating the development of hypertension to an anxiety disorder did not meet Factor 5(n) of the SoP concerning hypertension, in that any anxiety disorder Mr Ridgway suffered was not clinically significant as defined by the SoP. Mr Ridgway had not required treatment on a monthly basis by his general practitioner or a psychiatrist. Similarly, the SoP regarding PTSD (Instrument N° 5 of 2008), if it was to be considered as an anxiety disorder, requires that the condition must be clinically significant as outlined in Factor F, causing:
clinically significant distress or impairment in social, occupation or other important areas of functioning.
Mr Rudge submitted that the evidence before the Tribunal indicated that Mr Ridgway had had a happy family life, was successful in his small business and dealt with problems such as his daughter’s death, Mrs Ridgway’s cancer of the breast and the need for them to care for their grandchildren very efficiently. There was no evidence of impaired social functioning; Mr Ridgway had been a member of the Returned and Services League which he attended, had attended at Anzac Day marches and functions on an annual basis and had regularly attended his church.
TRIBUNAL’S DELIBERATIONS
31. The Commission does not dispute that Mr Ridgway suffered from PTSD, hypertension, ischaemic heart disease, carcinoma of the prostrate and carcinoma of the colon.
32. The medical cause of death was carcinoma of the colon with widespread metastasis. The death certificate also records ischaemic heart disease as a significant illness contributing to but no causing death. The latter entry is justified, given Mr Ridgway’s well documented high grade coronary artery stenosis as described by his treating cardiologist. Professors Pitt and Cade agree that Mr Ridgway’s ischaemic heart disease was clinically significant.
33. In considering the kind of death of the veteran the Tribunal is required to ask itself the question of whether war-caused disease contributed in any way to the death.
34. In Law the Full Court of the Federal Court said (at 151):
It seems clear that the expression “attributable to” in each case involves an element of causation. The cause need not be the sole or dominant cause: it is sufficient to show “attributability” if the cause is one of a number of causes provided it is a contributing cause.
and in Roncevich the majority of the High Court held (at 734):
… A causal link alone or a causal connexion is capable of satisfying a test of attributability without any qualifications conveyed by such terms as sole, dominant, direct or proximate …
35. In Doolette O’Loughlin J held (at 490):
If death is hastened because of the accelerated progress of a disease and that acceleration was itself caused by a war-related condition, death would be attributable to service.
36. The standard of proof in identifying the kind of death is provided for in s 120(4) of the Act, as pointed out by Selway J in Hancock.
37. Thus, if the Tribunal is satisfied on the balance of probabilities that there is a contribution to the veteran’s death by a war-caused disease a hypothesis is raised. The Tribunal is not so satisfied.
38. There is no evidence in the material before the Tribunal of any episode of cardiac ischaemia occurring during Mr Ridgway’s final hospital admission from 25 October 2005 until his death on 12 November 2005. The documentation of his course and progress in hospital is detailed and of a very high standard. His pulse and blood pressure recorded daily were stable throughout, although detailed recordings ceased on 10 November 2005 following the withdrawal of all oral medication and the substitution of increasing doses of narcotics and sedatives given by continuous subcutaneous infusion.
39. During the hearing the Tribunal had undertaken to check the pharmacological activity of Plavix (see paragraph 14) as doubt had been raised regarding the time taken to reverse this drug’s effect on reducing platelet activity to a degree that coronary artery thrombosis may have occurred as a terminal event. The possibility that the withdrawal of Plavix medication after 5 November 2005 had resulted in a thrombotic tendency was first raised during the hearing. Plavix had been prescribed to reduce Mr Ridgway’s risk of coronary artery thrombosis. The drug acts to prevent platelet clumping, thereby preventing the initiating step in clot/thrombus formation. Where surgery is contemplated Plavix is stopped at least seven days before the surgery to allow a new generation of platelets to be produced by the bone marrow. Overshoot in the production of platelets has been described (Professor Cade’s evidence) and carcinoma alone is known to increase coagulability. As Mr Ridgway died seven days after Plavix was ceased, this raised a further potential mechanism whereby his ischaemic heart disease could have contributed to death by acute coronary artery thrombosis.
40. According to the authoritative MIMS Annual 2003 (as up-dated by E-MIMS since 2003), Plavix blocks platelet adenosine diphosphate preventing platelets from clumping. The action is irreversible and platelet function is only restored by a new generation of platelets produced by bone marrow. This takes at least seven days. Plavix is metabolised, that is broken down, to an inactive state, solely by the liver. The use of this drug is contraindicated where liver function is impaired. In late September 2005 Mr Ridgway’s Plavix dose was reduced to one tablet every second day because of extensive bruising. The drug was ceased on 6 November 2005 after a dose administered on 5 November 2005 because of the difficult to control nosebleed. At that time Mr Ridgway’s liver function tests were moderately, severely abnormal due to metastatic carcinoma involving the liver. Despite the cessation of Plavix the epistaxis recurred on 10 November 2005. This recurrence strongly suggests that the anticoagulant effect of Plavix had not been reversed and the drug’s activity in the setting of impaired liver function had persisted. There is no evidence to support or point to a contribution by the cessation of Plavix to an ischaemic myocardial episode.
41. Having examined all the material before it, the Tribunal is satisfied that a hypothesis linking the veteran’s death to any war-caused disease is not raised and the claim fails at Step 1 of Deledio. The requirements of S120(3) are not met.
42. Therefore, the Tribunal affirms the decision under review.
I certify that the forty-two (42) preceding paragraphs are a true copy of the reasons for the decision herein of
Miss E A Shanahan(sgd): Leah Berardi
ClerkDates of Hearing 2 December 2008, 26 March 2009
Date of Decision 29 May 2009
Counsel for the Applicant Ms Judith Bornstein
Solicitor for the Applicant Ms Ursula Noyé, Williams Winter Solicitors
Counsel for the Respondent Mr Ken Rudge
Solicitor for the Respondent Ms Jean McCulloch, Veterans' Affairs
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