MacKenzie and Repatriation Commission (Veterans' entitlements)

This matter concerned an appeal by the applicant, the widow of a deceased veteran, against a decision of the Veterans’ Review Board. The applicant sought a widow's pension, claiming her husband's death from a malignant neoplasm of the prostate was caused by his operational service. The core dispute revolved around whether the veteran's disease was war-caused, specifically whether his alcohol consumption, linked to his war experiences, was a material factor in developing the fatal cancer.

The court was required to determine two primary legal issues: the validity of the applicant's hypothesis that the veteran's death was war-caused, and the correct date for establishing the "clinical onset" of the malignant neoplasm of the prostate for the purposes of the relevant Statement of Principles. The court considered the meaning of "clinical onset" as previously discussed in *Lees v Repatriation Commission* [2002] FCAFC 398, noting it refers to the point at which a condition can be clinically identified, rather than when the underlying pathological process began.

The court reasoned that the significant rise in PSA testing in August 1998 marked the appropriate date for the clinical onset of the cancer, meaning the relevant 20-year period commenced in August 1978. Within the initial 10-year period from August 1978 to August 1988, the veteran consumed alcohol at levels likely exceeding the threshold stipulated in the Statement of Principles. The court concluded that the veteran's excessive drinking stemmed from his wartime experiences, and that this drinking was a material factor in the development of prostate cancer, which in turn caused his death. Consequently, the court found the hypothesis to be made out.

The Veterans’ Review Board's determination of 21 November 2014 was set aside and substituted with a decision that the veteran's death was war-caused and the applicant was entitled to a widow's pension. The decision's date of effect was set as 7 November 2013, in accordance with s 20(1) of the *Veterans’ Entitlement Act 1986*.