Melville and Military Rehabilitation and Compensation Commission (Compensation)

This matter concerned an application to review a decision of the Military Rehabilitation and Compensation Commission (the Commission) regarding liability for a pilonidal sinus condition under the *Military Rehabilitation and Compensation Act 2004* (Cth). The applicant, who served in the Australian Army, claimed several conditions, including pilonidal sinus and its aggravation, adjustment disorder, depression, dry eye syndrome, elbow epicondylitis, and sleep apnoea. The Commission had accepted liability for right medial epicondylitis but rejected liability for the other claimed conditions, including the pilonidal sinus. The applicant sought review specifically of the rejection of liability for the pilonidal sinus and its aggravation.

The primary legal issue before the court was whether the applicant's pilonidal sinus, or its aggravation, was connected with the circumstances of his relevant service, to be determined on the balance of probabilities. This required consideration of the factors outlined in the relevant Statement of Principles concerning pilonidal sinus, specifically sections 9(2)(a) and (b), 9(5)(a) and (b) (relating to driving, seated passenger duties, and being overweight or obese), and section 9(7) (inability to obtain appropriate clinical management).

The court considered the evidence presented, including the applicant's oral testimony and medical records. While it was not in contention that the applicant suffered a recurrence of pilonidal sinus during his service, the court found that none of the factors specified in the Statement of Principles were met. Specifically, regarding section 9(7), the court determined that while there had been a series of medical appointments and referrals between January and April 2014, this constituted a difficulty or delay rather than an "inability" to obtain appropriate clinical management. Consequently, the court concluded that, on the balance of probabilities, the applicant's pilonidal sinus was not connected with the circumstances of his service.

Accordingly, the court affirmed the Commission's decisions to reject liability under section 23 of the Act for pilonidal sinus and the aggravation of the underlying pathology of pilonidal sinus.