Muraca and Secretary, Department of Employment and Workplace Relations
[2006] AATA 26
•16 January 2006
Administrative
Appeals
Tribunal
DECISION AND REASONS FOR DECISION [2006] AATA 26
ADMINISTRATIVE APPEALS TRIBUNAL № V2005/399 & V2005/400
GENERAL ADMINISTRATIVE DIVISION
Re: CATERINA MURACA
Applicant
And:SECRETARY, DEPARTMENT OF EMPLOYMENT AND WORKPLACE RELATIONS
Respondent
DECISION
Tribunal: Miss E.A. Shanahan, Member
Date:16 January 2006
Place:Melbourne
Decision:1. The Tribunal affirms the decision that Mrs Muraca is not entitled to a Disability Support Pension as her medical conditions have not been fully investigated, stabilized or diagnosed.
2.The Tribunal finds that Mrs Muraca is not in a marriage-like relationship and is thus entitled to a Newstart Allowance at a single rate.
3.The matter is remitted to the respondent to assess Newstart Allowance payments.
(sgd) E.A. Shanahan
Member
SOCIAL SECURITY – disability pension – insufficient medical data – new start allowance – marriage like relationship – separated but living under the same roof – exercise of the discretion under section 24 (1) (c)
Social Security Act 1991 (Cth) s 4(3) and s 94(1)(a), (b) and (c)
In the Marriage of Todd (No 2) (1976) 9 ALR 401
Staunton-Smith v Secretary Department of Social Security (1991) 32 FCR 164
Re Peck and Secretary Department of Social Security (1992) 76 SSR 1107
REASONS FOR DECISION
16 January 2006 Miss E.A. Shanahan, Member
1. Mrs Muraca worked as a Personal Carer with the Coasit Italian Assistance Agency. She injured her back, neck and left shoulder in a fall at work in May 2002 and she received Workcover payments for a total of 104 weeks. Two attempts to return to work with the Agency were made, the last being just after Easter 2004. These attempts and her position was terminated. In addition to her physical injuries, Mrs Muraca also suffers from hypertension which is well controlled with medication, ventricular ectopic beats, treated with beta blockers and appears well controlled and morbid obesity which has not been treated. Mrs Maruca suffers from anxiety and depression, depression being the major factor since the death of her first-born son from leukaemia, at the age of 19, in 1989. She has been taking small doses of anti‑depressants for many years.
2. Mrs Muraca lives with her husband in a house he built in Fawkner some seven years ago. They own the property jointly and in order to build the house a mortgage was taken out in both their names; although Mrs Muraca has never contributed financially to the repayment of the mortgage. Prior to her injury, and to a lesser degree while on Workcover payments, Mrs Muraca contributed financially to the day-to-day costs of running the home including food, insurance, utilities and petrol. Mrs Muraca’s limited ability to contribute to household expenses during the period in which she received Workcover became a source of friction between herself and her husband. When the Workcover payments ceased on 11 June 2004 she was unable to contribute financially at all. This accentuated the existing disharmony between the couple. Mrs Muraca claims that she and her husband separated just prior to June 2004, while continuing to live under the same roof. Since that time they have had their own bedroom and bathroom. They have not had any sexual relationship for several years. They do their own cooking, washing and limited cleaning and do not share any social activities.
3. Mrs Muraca lodged a claim for a Disability Support Pension (DSP) on 26 November 2004. Her claim was rejected on 13 January 2005 by a Centrelink delegate; following which Mrs Muraca lodged further medical documents on 14 January 2005. On reconsideration the decision was affirmed on the basis that Mrs Muraca did not satisfy s 94(1)(b) and (c) of the Social Security Act 1991 (the Act).
4. Mrs Muraca had claimed Newstart Allowance (NSA) when her DSP application failed. She was assessed as eligible to receive NSA, but was paid at the rate applicable to a member of a couple i.e. her husband’s income was taken into account. She currently receives $128.40 per fortnight. Mrs Muraca sought review of this decision and an authorised review officer (ARO) affirmed the decision on 21 February 2005.
5. Mrs Muraca applied for review of both of these decisions to the Social Security Appeals Tribunal (SSAT). They were heard on the same day (12 April 2005) and were affirmed by the SSAT. Mrs Muraca applied for review of the SSAT decision by this Tribunal on 10 May 2005.
ISSUES BEFORE THE TRIBUNAL
6. The issues for review are –
(i)Does Mrs Muraca qualify for a DSP?
(ii)Are Mrs Muraca and her husband in a marriage-like relationship or are they separated and living under the same roof? This issue, if decided in her favour, would enable Mrs Muraca to receive the single rate of NSA.
7. Both matters were considered by the Tribunal on the same day and evidence was given by Mrs Muraca, her daughter, Theresa Panozzo, Dr J. Scarlett and Dr T. Paulson. Mrs Muraca represented herself with the assistance of her daughter; and Mr S. Meehan appeared on behalf of the respondent. The Tribunal had before it the documents (the T‑documents relating to V2005/399 and V2005/400) pursuant to s 37 of the Administrative Appeals Tribunal Act 1975. The applicant tendered a report from Dr Scarlett dated 22 June 2005 (Exhibit A1). The respondent tendered a report from Dr Paulson dated 18 July 2005 (Exhibit R1).
EVIDENCE
8. Mrs Muraca confirmed that she suffered from right-sided neck pain, mid thoracic back pain and pain and limited movement in her left shoulder. In addition, she had worsening depression which had commenced after the death of her son in 1989. Mrs Muraca’s other medical conditions remained stable and she was taking beta blockers for her ventricular ectopic arrhythmia; Voltaren, Naprosyn and Panamax for her neck, back and shoulder pain; Zantac to counteract the effects of the non-steroidal anti-inflammatories on her gastrointestinal tract; anti‑hypertensive's for her high blood pressure and Tryptanol and Ducene for her depression.
9. Mrs Muraca confirmed that she had attempted further investigation of her neck pain in the form of CT scanning and an MRI scan; but despite sedation she had developed severe claustrophobia and both procedures had to be abandoned. The Tribunal obtained information that Mrs Muraca develops pain in both legs after walking for 10 minutes, rests for 10 minutes and continues for a further 10 minutes. She stated she has had these symptoms for many years but they had not been investigated. A recent chest X-ray had been performed and showed her heart to be enlarged. Dr Scarlett had arranged for her to have an echo‑cardiogram but this had not yet been performed. Overall, she felt her condition, including her depression, was deteriorating. She continued to live in the marital home as her plan to live with her daughter had not yet eventuated, as there had been a delay in the building of her daughter’s home.
10. In cross-examination, Mr Meehan concentrated on the relationship between Mrs Muraca and her husband. Mrs Muraca said she and her husband owned their home in Fawkner. As the mortgaged property was in joint names, they were required to have a bank account in both names. Despite this, she had never made any mortgage payments since her husband built the house in 1995 (the Tribunal notes the date is 1997 according to the T‑documents). Mrs Muraca confirmed that her husband owns a shop in Lygon Street, Brunswick in partnership with his brother and that this property is not mortgaged. Her husband does not have any superannuation; but she has a small amount and her husband is named as the beneficiary. Mr Gino Muraca, the applicant’s husband, owns their 1991 Mitsubishi motor car, which she will drive occasionally. Mrs Muraca said that she had considered divorce but had not discussed this with her husband, although she had discussed it with her sisters and her children. She had however told her husband of her plans to live with her daughter once her daughter’s house was built. While she had not discussed with her husband what would happen to their marital home, she believed that it would have to be sold and the proceeds split.
11. Mrs Muraca said she and her husband no longer visited family members or friends together. At Easter she went to her daughter’s home and her husband went to his brother’s home in Box Hill. She spent last Christmas with her daughter’s mother-in-law and her husband did not accompany them. Mrs Muraca confirmed that she and her husband eat at different times, perform their own household chores and sleep in separate rooms. This situation had been the norm since she ceased obtaining Workcover payments and was unable to contribute to household expenses.
12. The Tribunal asked Mrs Muraca who did the household cleaning and she replied that her daughter did all of it. The Tribunal also asked if the fact that she was a Roman Catholic might influence her decision to pursue a divorce. Mrs Muraca said she occasionally goes to church and her husband never goes. Mrs Muraca used to go to church several times a week until the death of her son, after which her faith floundered. Mrs Muraca told the Tribunal that her husband has not worked since 1995 when he underwent surgery for a tumour in the right axilla which resulted in a brachial plexus injury. Since that time he has received monthly payments from his private disability insurance. In addition, he receives rent from the property in Lygon Street, Brunswick.
MRS PANOZZO
13. Mrs Panozzo had lived at home until her marriage seven years ago. She now resides 10 minutes by car from her parental home. She visits her mother every second day and speaks to her several times a day by telephone. She said she had noticed a distinct change in the relationship between her parents, although they attempted to hide it. They only spoke to each other when it was necessary to do so. Her parents no longer visited her and her husband and four year old child together, nor did they attend family gatherings together. Mrs Panozzo cleans her parents’ home as her mother is unable to perform these tasks. While owning a block of land, the Panozzos have had to delay the building of their house for unrelated reasons and do not expect the building to be completed until 2006. It is Mrs Panozzo’s plan to incorporate a self-contained area in the house for her mother and while she does not expect her mother to contribute to the cost of building, she would expect a contribution toward living costs.
14. The Tribunal asked how often Mrs Muraca visited her daughter, given that Mrs Panozzo went to her mother’s home every second day. Mrs Panozzo said her mother visited her once per week.
DR J. SCARLETT (BY TELEPHONE)
15. Dr Scarlett’s report dated 22 June 2005 (Exhibit A1) providing a diagnosis of chronic soft tissue injury of the left shoulder and a disc lesion of the cervical spine. He had outlined Mrs Muraca’s referral to a neurosurgeon, Mr D. Jensen, who was of the opinion that she had an intervertebral disc lesion at C6/C7; but this could not be substantiated as Mrs Muraca was not able to tolerate a CT scan or an MRI scan due to her claustrophobia. Dr Scarlett classified both lesions as permanent. In addition, he found she suffered from depression and anxiety of 20 years duration. He had assessed Mrs Muraca’s impairment under the relevant tables as 15 points for the left shoulder, 10 points for the cervical spine lesion and 10 points for the depression and anxiety. Dr Scarlett was of the opinion that Mrs Muraca was unable to perform any type of employment for a minimum of two years nor was she fit to undertake any educational or vocational training.
16. Dr Scarlett had been asked by Mrs Muraca to give evidence by telephone. However, on the day of the hearing, Dr Scarlett was extremely busy and his evidence was of short duration. The Tribunal asked him whether there were any X‑rays of the shoulder or neck in his possession and whether Mrs Muraca had seen a psychologist or psychiatrist regarding her depression and anxiety. The Tribunal also asked for the results of the examination of the left shoulder and neck and in particular the range of movements at these two sites. Dr Scarlett said that he had never examined the patient’s neck or left shoulder in such detail and did not have any idea of the range of movement. He was able, after a short search, to locate X‑rays done, or the reports of X‑rays done, in November 2002, involving the shoulder and neck; and an ultrasound of the shoulder, all of which were reported as normal. In answer to Mr Meehan’s question regarding whether Mrs Muraca’s anxiety and depression had been stable over the past 12 months, Dr Scarlett replied that it was but he had only seen her this year as she had previously attended a female general practitioner who had since left the practice.
DR T. PAULSON
17. Dr Paulson examined Mrs Muraca at the request of the respondent and had provided a report dated 18 July 2005. Dr Paulson had noted the injury in May 2002 and the continuing neck, left shoulder and back pain. She also noted that a cervical myelogram performed on 29 September 2004 had been normal. In addition, a plain X‑ray of the thoracic spine had been reported as normal. On examination, Dr Paulson had reported a 25 per cent loss of the range of movement of the neck and 50 per cent loss of range of thoracolumbar spinal movement; much of which was due to Mrs Muraca’s morbid obesity and large abdominal girth. Dr Paulson assessed Mrs Muraca’s hypertension as diagnosed, treated and well controlled and causing no impairment. Similarly, the ventricular ectopic beats were controlled with beta blockers and did not affect Mrs Muraca’s function. For these two conditions she allotted zero impairment points. Mrs Muraca’s anxiety and depression had been present for many years, but had never been assessed by a psychiatrist or psychologist except for one psychologist’s opinion for Workcover purposes. Mrs Muraca told Dr Paulson that her depression had become more severe in recent months. As it had not been fully investigated or stabilized, the impairment point assessment was not attracted. Likewise Mrs Muraca’s morbid obesity had not been treated and did not attract an impairment rating. Dr Paulson concluded that Mrs Muraca was currently unfit for full time work pending the outcome of further investigation and treatment of her neck, shoulder and back pain. However, once these conditions had been fully investigated, treated and stabilized she would be fit for part-time work and possibly full time work. A suitable type of work was light semi‑sedentary work with limited bending, lifting and sustained sitting.
18. Dr Paulson was informed at the start of her evidence that ultrasounds and X‑ray examinations had been performed in 2002 with respect to Mrs Muraca’s shoulder and neck and that these were normal. Dr Paulson regarded this as adequate investigation and provided an impairment rating of 5 points for the neck and 5 points for the left shoulder and arm. She regarded Mrs Muraca’s symptoms as musculoskeletal in origin and of mild to moderate degree which would render her fit for light part-time work. Dr Paulson said Mrs Muraca’s medication of Tryptanol and Valium for her depression was in extremely small doses and that further specialist opinion and treatment could improve these conditions.
DOCUMENTARY EVIDENCE BEFORE THE TRIBUNAL
19. Dr N. Utthanaphol had treated Mrs Muraca, at Dr Scarlett’s general practice, for some years. She provided two reports dated 26 November 2004 (T6) and 7 May 2005 (T9) and a medical certificate of 14 January 2005 (T10). There was a further treating doctor’s report dated 13 January 2005 (T13). In her first report, Dr Utthanaphol stated she had treated Mrs Muraca from 9 April 2002 and had diagnosed musculoskeletal back and left shoulder pain, hypertension and ventricular or ectopic beats. Dr Utthanaphol regarded Mrs Muraca’s arm, shoulder and back pain as being permanent and preventing her from working for the next 24 months. On 7 January 2005, Dr Utthanaphol reported that Mrs Muraca was having increased difficulties with her husband due to financial issues and there was a general lack of support from her husband. Dr Utthanaphol provided a certificate dated 14 January 2005 confirming her original diagnosis and that Mrs Muraca’s prognosis was uncertain and that at the time of the certification she could not work more than 8 hours per week at light duties. The various diagnoses were confirmed on 13 January 2005.
20. Mrs Muraca was assessed by Dr P. Tutton and Dr N Rose of Health Services Australia on 6 December 2004, at the respondent’s request. Dr Tutton assessed Mrs Muraca’s back pain as temporary; the neck pain as permanent and attracting an impairment rate of 5 points, the shoulder pain as permanent but attracting an impairment rate of zero and the hypertension and ectopic heart beats as being permanent, well treated and controlled, with an impairment rating of zero for both conditions. Mrs Muraca’s morbid obesity was regarded as being temporary and untreated and therefore attracted no impairment points. Dr Rose, having assessed Mrs Muraca on 6 December 2004, declared her fit for at least part-time work, advised weight loss and vocational rehabilitation and recommended a further assessment in six months time. Dr Rose recommended that Mrs Muraca was fit for work as a sales assistant or office worker.
21. With respect to Mrs Muraca’s claim to be separated from, but living under the same roof as her husband, the Tribunal was provided with copies of Mrs Muraca and her husband’s income tax returns of 2002, real estate details, an RACV loan statement, bank statements, Telstra accounts, Medicare card, driver’s licence and assessments by Centrelink of their living arrangements as outlined by Mrs Muraca and her husband. These documents indicate that Mr and Mrs Muraca are joint owners of their home, they have a joint bank account related to the mortgage on this property, Mr Muraca derives an income from a private disability insurance policy and rental of a business property he owns with his brother, they both have separate bank accounts other than than the one related to their mortgage, the property in Lygon Street, Brunswick is owned by Mr Muraca and his brother, the Telstra accounts are directed to Mrs Muraca, the rate notices for the property in Lygon Street, Brunswick East are directed to Mr Muraca and his brother and the mortgage payments are directed to Mr Muraca.
THE SOCIAL SECURITY APPEALS TRIBUNAL DECISIONS
22. On 1 April 2005, the SSAT affirmed both decisions. In the case of the application for a DSP, this Tribunal found that the applicant did not attract any impairment points for either her hypertension or ventricular ectopic beats as these conditions were not causing any functional impairment. The other conditions had not been fully investigated, diagnosed and stabilised. With respect to the application (V2005/400) relating to whether or not Mrs Muraca was a member of a couple in a marriage-like relationship, the SSAT again affirmed the decision of the primary decision-maker but stated that the issues in this case “are finely balanced”.
RELEVANT LEGISLATION
23. With respect to the application by Mrs Muraca for a DSP, the relevant legislation is contained in s 94(1)(a), (b) and (c) of the Act as follows:
94(1)A person is qualified for disability support pension if:
(a)the person has a physical, intellectual or psychiatric impairment; and
(b)the person's impairment is of 20 points or more under the Impairment Tables; and
(c)one of the following applies:
(i)the person has a continuing inability to work;
(ii)the Health Secretary has informed the Secretary that the person is participating in the supported wage system administered by the Health Department, stating the period for which the person is to participate in the system; ...
24. The criteria for forming an opinion about the relationship as to whether the applicant is a member of a couple or separated but living under the same roof is addressed by s 4(3) of the Act which provides:
4(3)In forming an opinion about the relationship between 2 people for the purposes of paragraph (2)(a) or subparagraph (2)(b)(iii), the Secretary is to have regard to all the circumstances of the relationship including, in particular, the following matters:
(a)the financial aspects of the relationship, including:
(i)any joint ownership of real estate or other major assets and any joint liabilities; and
(ii)any significant pooling of financial resources especially in relation to major financial commitments; and
(iii)any legal obligations owed by one person in respect of the other person; and
(iv)the basis of any sharing of day-to-day household expenses;
(b)the nature of the household, including:
(i)any joint responsibility for providing care or support of children; and
(ii the living arrangements of the people; and
(iii)the basis on which responsibility for housework is distributed;
(c)the social aspects of the relationship, including:
(i)whether the people hold themselves out as married to each other; and
(ii)the assessment of friends and regular associates of the people about the nature of their relationship; and
(iii)the basis on which the people make plans for, or engage in, joint social activities;
(d)any sexual relationship between the people;
(e)the nature of the people's commitment to each other, including:
(i)the length of the relationship; and
(ii)the nature of any companionship and emotional support that the people provide to each other; and
(iii)whether the people consider that the relationship is likely to continue indefinitely; and
(iv)whether the people see their relationship as a marriage-like relationship.
SUBMISSIONS
25. The applicant did not make any submissions to the Tribunal, but relied on evidence given.
26. Mr Meehan submitted that the Mrs Muraca did not qualify for a DSP as she had only 10 impairment points allotted for her various conditions. While both Dr Paulson and Mrs Muraca believed that her present state had deteriorated, there was no evidence that this had been thoroughly investigated or stabilized and that there was the potential for an improvement with a change in treatment. In addition, Mr Meehan argued that even if s 94(1)(b) of the Act had been satisfied, there still remains a potential for Mrs Muraca to perform some work in accordance with s 94(1)(c) of the Act.
27. Mr Meehan submitted that the evidence before the Tribunal was, with respect to Mrs Muraca being separated from her husband and living under the same roof, the same as that presented to the SSAT; as was the evidence of her daughter. Thus, on the balance of probabilities, the Tribunal should find that they were living in a marriage-like relationship. Mr Meehan acknowledged that the Tribunal could exercise a discretion to find that in certain circumstances there was not a marriage‑like relationship.
TRIBUNAL’S DELIBERATIONS
28. On the evidence before the Tribunal it is obvious that Mrs Muraca satisfies s 94(1)(a) of the Act in that she has a physical and psychiatric impairment. Section 94(1)(b) of the Act requires that Mrs Muraca’s medical conditions attract an impairment rating of at least 20 points under the Tables For The Assessment Of Work-Related Impairment For Disability Support Pension in Schedule 1B of the Act. On the evidence before the Tribunal, her shoulder and neck conditions have been assessed at 10 impairment points. However, there has been no assessment regarding her psychiatric status or her back pain and as no diagnosis has been made or appropriate treatment given, an assessment cannot be performed. The Tribunal does note that there are several new symptoms which have not been investigated at this stage. The Tribunal is satisfied that Mrs Muraca does not meet the requirement of s 94(1)(b) and (c) of the Act at this time.
29. Mrs Muraca’s second application (V2005/400) related to her NSA, which was being paid at the rate of a person being a member of a couple; whereas she submitted that she was separated but living under the same roof as her husband. In reaching an opinion about the relationship, the Tribunal must take s 4(3) of the Act into consideration. Section 4(3)(a) requires the Tribunal to consider the financial aspects of the relationship. The evidence indicates that Mrs Muraca and her husband have joint ownership of a property in Fawkner and that the mortgage is in both names. The bank account relating to this mortgage, with the National Bank of Australia, is in joint names. But the evidence before the Tribunal is that Mrs Muraca has never contributed to the mortgage payments. In addition, she stated that because of the mortgage requirements dating back to 1995 or 1997 she was required to declare herself a joint mortgagee. Section 4(3)(a)(ii) requires the Tribunal to look at any significant pooling of financial resources especially in relation to major financial commitments. As previously stated, Mrs Muraca has never made any contribution to the mortgage repayments and her financial commitments have related only to her half share of household expenses, which she has not been able to meet since her Workcover payments terminated. There is no evidence before the Tribunal of any legal obligations upon one person in respect of the other person (s 4(3)(a)(iii)); and while household expenses have been shared in the past, she is no longer able to contribute because of her impecunious state (s 4(3)(a)(iv)).
30. Section 4(3)(b) requires the Tribunal to examine the nature of the household. There appears to be no joint responsibility for providing care or support of children as all the children are now adults (s 4(3)(b)(i)). On the evidence of Mrs Muraca and her daughter, the living arrangements of Mrs Muraca and her husband are quite separate, they have separate bedrooms and bathrooms and do not eat together. They do their own shopping and the daughter does the cleaning. Husband and wife wash their own clothes (s 4(3)(b)(ii) and (iii)).
31. With regard to the social aspects of the relationship, it appears on the evidence that Mrs Muraca and her husband have no common interests or friends and spend the various Christian celebrations quite separately, Mrs Muraca going to her daughter’s home and Mr Muraca going to his brother’s home. On the evidence of Mrs Muraca and her daughter, close friends and family regard them as being separated (s 4(3)(c)(i), (ii) and (iii)). Mrs Muraca’s evidence is that there has been no sexual relationship between her and her husband for many years (s 4(3)(d)).
32. On the evidence before it the Tribunal cannot see that there is any commitment by Mr and Mrs Muraca to their marriage. They appear to live quite separately and do not provide any companionship or emotional support and Mrs Muraca has, despite her Roman Catholicism, given serious consideration to divorce. When her daughter completes the building of her house, she will relocate to live with her daughter. Mrs Muraca’s evidence is that when she has somewhere else to live she will pursue a property settlement so that she can provide some payment to her daughter for her upkeep and her cost of living in general. Certainly, Mrs Muraca does not see her relationship as a marriage-like one. Mr Muraca’s opinion of the relationship was not communicated to the Tribunal. On the evidence they appear to have no companionship or support from the relationship (s 4(3)(e)).
33. The Tribunal determines that there is no marriage-like relationship existing between Mrs Muraca and her husband. In light of this decision it is not necessary to consider s 24 of the Act, which provides that a person may be treated as not being a member of a couple under “special reasons”. Were such consideration necessary, the Tribunal would have considered Mrs Muraca’s stated intention to leave her home to reside with her daughter as of early 2005 and this intention being defeated by financial problems her daughter was experiencing which will not allow her new home to be built until the year 2006. Mrs Muraca’s daughter has indicated that it is her intention that a separate area of the home will be devoted to her mother’s use and while self-contained will be part of the family home. It is clear that Mrs Muraca could not afford separate accommodation on $128.40 per fortnight.
34. For the reasons given above, the Tribunal affirms the decision in relation to Mrs Muraca’s application for her DSP (V2005/399) and sets aside the decision in relation to the payment of a NSA at a married as opposed to single rate. For the calculation of her NSA Mrs Muraca should be assessed at the single rate.
I certify that the thirty-four [34] preceding paragraphs are a true copy of the reasons for the decision herein of :
Miss E. A. Shanahan, Member
(sgd) Catherine Lake
Clerk
Date of Hearing: 21 October 2005
Date of Decision: 16 January 2006
Advocate for the applicant: Nil
Advocate for the respondent: Mr S. Meehan, Legal Services Branch, Centrelink
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