Nicholls and Secretary, Department of Social Services (Social services second review)

[2016] AATA 907

Nicholls and Secretary, Department of Social Services (Social services second review) [2016] AATA 907 (15 November 2016)

Division	GENERAL DIVISION
File Number	2016/2840
Re	Mr Craig Nicholls
APPLICANT
And	Secretary, Department of Social Services
RESPONDENT

DECISION

Tribunal	Mr Conrad Ermert, Member
Date	15 November 2016
Place	Melbourne

The Tribunal affirms the decision under review.

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Mr Conrad Ermert, Member

SOCIAL SECURITY - Disability Support Pension - relevant period for qualification - whether conditions were fully diagnosed, fully treated and fully stabilised - whether impairments attracted 20 or more points under the Impairment Tables - requirement for 20 impairment points not met - decision affirmed.

LEGISLATION

Social Security Act 1991

Social Security (Administration) Act 1999

Social Security (Tables for the Assessment of Work-related Impairment for Disability Support Pension) Determination 2011

REASONS FOR DECISION

Mr Conrad Ermert, Member

15 November 2016

1. On 24 September 2015 Mr Craig Nicholls, the Applicant, lodged with Centrelink a claim for Disability Support Pension (DSP).  Centrelink is the service provider for the Secretary, Department of Social Services, the Respondent.  In his claim Mr Nicholls listed his disabilities and illnesses as:  Neuro Sarcoidosis, Complex Migraine, Tremors / seizures, hypertension and Gastritis-irritable bowel. 

2. On 20 December 2015 an officer of Centrelink rejected the claim on the basis that his conditions did not attract an impairment rating of at least 20 impairment points, meaning that he did not satisfy the prerequisites for DSP under the Social Security Act 1994 (the Act).  Mr Nicholls requested a review of the decision to reject his claim.  On 9 March 2016 and Authorised Review Officer (ARO) affirmed the decision, finding that:

   ·Mr Nicholls’ neurosarcoidosis was not fully treated and stabilised,

   ·Mr Nicholls’ diabetes was not fully treated and stabilised, and

   ·Mr Nicholls did not have a continuing inability to work 15 hours per week.

3. Mr Nicholls requested a review of the ARO’s decision.  On 10 May 2016 the Social Services and Child Support Division of the Administrative Appeals Tribunal (AAT1) found that Mr Nicholls’ conditions of neurosarcoidosis and diabetes were not fully diagnosed, treated and stabilised, and as such could not be allocated impairment points.  The AAT1 affirmed the ARO decision.

4. This matter is a review of the AAT1 decision.

   HEARING

5. Mr Nicholls represented himself at the hearing and gave evidence on oath.  His father was present as a support person.  Mr Pietro Nacion, of Sparke Helmore, represented the Respondent. 

6. I have before me the documents provided by the Respondent in accordance with section 37 of the Administrative Appeals Tribunal Act 1975 (the T-Documents). 

7. For Mr Nicholls I took in as Exhibit A1 a bundle of medical reports and other documents received at the Tribunal on 29 September 2016. 

8. For the Respondent I took in for consideration the Secretary’s Statement of Facts, Issues and Contentions dated 10 October 2016.

   LEGISLATION

9. The relevant legislation is contained in the:

   ·Social Security Act 1991,

   ·Social Security (Administration) Act 1999 (the Administration Act),

   ·Social Security (Tables for the Assessment of Work-related Impairment for Disability Support Pension) Determination 2011 (the Impairment Tables), and

   ·Social Security (Active Participation for Disability Support Pension) Determination 2014 (the Program of Support Determination).

   ISSUES

10. Subsection 94(1) of the Act details the requirements for qualification for DSP as follows:

    (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…

11. The issues I must determine are whether:

    ·Mr Nicholls has physical, intellectual or psychiatric impairments; and if so

    ·The impairments attract a rating of at least 20 points under the Impairment Tables; and if so

    ·He has a continuing inability to work.

    EVIDENCE

12. In his evidence Mr Nicholls said that his application for DSP was rejected in December 2015.  In January he started to see a number of medical specialists including, amongst others, rheumatologists and ophthalmologists.

13. Mr Nicholls described his condition as being sarcoidosis of the brain, known as neurosarcoidosis.  He said it is an autoimmune disease that affects the central nervous system and is symptomatic in the brain, eyes and joints.

14. Mr Nicholls listed his other conditions as: Type II Diabetes, Hypertension, and Stroke. He was adamant that he did have a stroke in November/December 2014 which affected his left side.  He said he was in the process of obtaining a copy of the discharge certificate from Maroondah Hospital which authenticates his stroke. 

15. Mr Nicholls described the effects of his neurosarcoidosis as follows:

    ·Eyesight – he cannot drive very much and he is under investigation by an ophthalmologist;

    ·Severe migraine;

    ·Rheumatoid arthritis which affects his back, for which he receives injections; his hips, ankles, feet and toes; he has no sensation in his feet;

    ·Vertigo;

    ·Short term memory loss – he needs a medical application on his telephone to keep track of his appointments;

    ·Fatigue – “at the drop of a hat” he will need to sleep; he sleeps for about six hours during daytimes. 

16. Mr Nicholls said he takes a lot of medications.  He wakes three to five times during the night, in agony from stiffness in his joints.  Mr Nicholls said he had a minimal ability to crouch down, he can sit for a half to one hour and he needs crutches to walk.  Inside the house he uses only a walking stick. 

17. Responding to questions from Mr Nacion, Mr Nicholls said his joint pains flared up in July 2015.  Doctors at Box Hill Hospital referred him to a rheumatologist however the waiting list was too long.  Instead he sought private treatment from Dr Pun in January 2016.  Dr Pun commenced treatment with prednisolone and other drugs.  Mr Nicholls said the prednisolone had made a slight difference to his condition but each day is different.  Mr Nicholls saw Dr Pun again on 26 February 2016.  Dr Pun reduced the dosage of prednisolone to 20mg per day and commenced Mr Nicholls on methotrexate and folic acid. 

18. Mr Nicholls said he had been seeing a neurologist, Dr Lee, since August/September 2015.  Dr Lee referred Mr Nicholls for a second opinion to Dr Shuey, a neuro-ophthalmologist.  He has seen Dr Shuey twice, in July and August 2016. 

19. Mr Nicholls said that initially his diabetes was treated by his General Practitioner (GP).  He was first referred to Dr Wen, an endocrinologist, in May 2016.  Mr Nicholls said this was because of his treatment with prednisolone, which affects his blood sugar levels.

20. When asked if his condition had deteriorated since September 2015, Mr Nicholls said that his eyesight, mobility, swelling of the hands and wrists, memory, speech, fatigue, headaches, tremors and night time seizures had all deteriorated.

21. Asked about his ocular sarcoidosis Mr Nicholls said he had always had neurosarcoidosis.  It started in his eyes with ocular sarcoidosis which is in remission.  Mr Nacion referred to the Box Hill Hospital Discharge Summary of 19 June 2015which reported “final impression unlikely neurosarcoidosis given minimal improvement on steroids”.  Mr Nicholls said he disagreed with this opinion and went to see Dr Lee in August 2015.  Mr Nicholls said that Dr Lee later referred him to Dr Pun and was then sent to Dr Shuey, who is a sarcoidosis specialist. 

22. Referring to the same Discharge Summary, Mr Nacion noted the CONCLUSION in the section relating to a CT Brain and CT Angiograph of the Neck and Brain which reported “No significant abnormality is seen to account for the symptomatology”.  Mr Nicholls said that was the reason he had an MRI scan.  The MRI was arranged by Dr Atalla, an ophthalmologist, because Mr Nicholls’ eyesight had deteriorated. 

23. Asked about his rheumatoid arthritis Mr Nicholls said it was first diagnosed by Dr Pun in January 2016.  Mr Nicholls agreed that Dr Pun, in his report of 5 August 2016 (in Exhibit A1 bundle) reported a diagnosis of “Severe generalised pain from possible auto-immune arthritis – Uncertain – as diagnosis is still being established as yet”.  Mr Nicholls said that is why he was referred to Dr Shuey.

24. Mr Nicholls accepted the contents of the following reports (in Exhibit A1 bundle):

    ·Dr Tate dated 8 August 2016;

    ·Dr Atalla dated 9 August 2016; and

    ·Dr Shuey dated 31 August 2016.

25. Asked whether he had participated in a Program of Support (POS) in the period 24 September 2012 to 24 September 2015 Mr Nicholls said that he had never been asked.  He was gainfully employed full-time.  He said he had never been unemployed until he became a carer for his wife, and then became ill himself.

    TRIBUNAL CONSIDERATIONS

    Relevant Period

26. Schedule 2, subsection 4(1) of the Administration Act requires Mr Nicholls’ qualification for DSP to be determined from the date of his claim to a date 13 weeks thereafter. In this case the relevant period is 24 September 2015, the date of the claim, to 24 December 2015, that being a period of 13 weeks.

    Impairments

27. The Respondent concedes that Mr Nicholls satisfies subsection 94(1)(a) of the Act in that he suffers from the following conditions:

    ·Stroke,

    ·Diabetes,

    ·Sarcoidosis/neurosarcoidosis,

    ·Chronic migraines,

    ·Cardiac condition, and

    ·Other conditions:

    oGeneralised sepsis and gastroenteritis,

    oIrritable bowel syndrome,

    oChronic back pain,

    oAuto-immune disease, and

    oElevated lumbar pressure.

28. There is medical evidence to support these conditions.  I accept the concession and find accordingly.

    Application of Impairment Tables

29. In order to satisfy section 94(1)(b) of the Act, Mr Nicholls must have impairments that can be allocated an impairment point rating of at least 20 points. The Impairment Tables provide the criteria by which impairment points are allocated to impairments.

30. Subsection 6(3)(a) of the Impairment Tables states that an impairment rating can only be assigned to an impairment if the impairment is permanent.  Subsection 6(4) provides that a condition is permanent if the condition:

    (a)has been fully diagnosed by an appropriately qualified medical practitioner, and

    (b)has been fully treated, and

    (c)has been fully stabilised.

31. I will consider each condition in turn. I will first consider whether the impairment is permanent and then, if it is permanent, what the correct allocation of impairment points is for that condition.

    Stroke

32. In considering the diagnosis I note the following reports:

    ·Royal Melbourne Hospital (RMH) Discharge Summary of 4 March 2015 which recorded: “?TIA at Maroondah 11/14 but supposedly normal brain imaging”;

    ·Eastern Health Final Discharge Summary of 19 June 2015  which recorded: “No significant abnormality is seen to account for the symptomatology”;

    ·Dr Lee dated 21 April 2016 which records: “ He has … and possible stroke in left occipital lobe”; and

    ·Dr Tate dated 8 August 2016 which includes as a diagnosed condition “Past Stroke”.

33. However, in his evidence and his submissions, Mr Nicholls was adamant that he had suffered a stroke and that the report from Maroondah Hospital was still being acquired.  Mr Nacion accepted that it was possible for the stroke to have been fully diagnosed.

34. I note the support for the possibility of a stroke in the reports of the Royal Melbourne Hospital (RMH) and Dr Lee.  I also accept the evidence of Mr Nicholls, which was clear and detailed in regard to the hospital’s investigations and the existence and contents of a report.  I accept that at the relevant period the condition was fully diagnosed. 

35. The absence of material relating to the further treatment relating to the stroke or its further investigation suggests that any post-discharge treatment has been completed and the condition stabilised.  However, even assuming this to be the case, there is no corroborated evidence of any functional impairment arising from the stroke.  I assign a rating of zero to this condition.

    Diabetes

36. In considering the condition I note the following reports:

    ·RMH Discharge Summary of 4 March 2015 which records as a comorbidity T2DM (Type II Diabetes Mellitus);

    ·Dr Tate dated 1 October 2015, 2 May 2016, 2 June 2016, and medical certificate dated 14 June 2016 all of which record Mr Nicholls as having diabetes; and

    ·Dr Wen, Consultant Endocrinologist, dated 3 August 2016 which records:

    “This is to certify that Mr Nicholl has type 2 diabetes which is well controlled and stable with insulin and oral tablets.  I saw him today and will continue to review him in Box hill hospital outpatient clinic every three months”.

37. In considering the medical evidence I am satisfied that Mr Nicholls’ diabetes is fully diagnosed, fully treated and fully stabilised and I find accordingly.  In considering the degree of functional impairment from the condition I note the specialist’s opinion that the condition is well controlled and stable with insulin and oral tablets.  I am satisfied that the condition causes minimal if any functional impairment to Mr Nicholls.  I find that the condition attracts an impairment rating of zero points. 

    Sarcoidosis/Neurosarcoidosis

38. In considering whether the condition is fully diagnosed at the time of the relevant period I note the following reports:

    ·Eastern Health Final Discharge Summary of 19 June 2015 which recorded

    “final impression unlikely neurosarcoidosis given minimal improvement on steroids”. 

    ·Dr Tate dated 1 October 2015 which records:

    “He has been a patient of mine for the past 5 years.  He has the misfortune of being diagnosed with neurosarcoidosis causing chronic migraines”;

    ·Dr Tate dated 9 November 2015 which records:

    “Craig has Neurosarcoidosis and is seeing a Rheumatologist at Box Hill hospital for treatment…“;

    ·Dr Tate dated 14 January 2016 which recorded:

    “I have recently stated to treat Mr Nicholls who has a past history of sarcoidosis …”;

    ·Dr Pun, Rheumatologist, dated 14 January 2016 which records:

    “Mr Nicholls with a past history of sarcoidosis continues to have …”; and

    ·Dr Lee, Consultant Neurologist, report dated 9 February 2016 which records:

    “I have been looking after Craig for 8 months due to persistent headache consistent with chronic migraine … He also has chronic pain, and issues of sarcoidosis which is currently managed by a rheumatologist”.

39. Although the Eastern Health Discharge Summary reported an impression that it was unlikely that Mr Nicholls had neurosarcoidosis I am satisfied from the subsequent reports of his GP and the specialist rheumatologist and neurologist that the condition of sarcoidosis/neurosarcoidosis was fully diagnosed at the relevant period.  I find accordingly.

40. In considering the treatment and stability of the condition at the relevant period I note the following reports:

    ·Dr Tate dated 1 October 2015 which records:

    “He has multiple joint pain and is waiting on assessment from the Rheumatologist at Box Hill Hospital”;

    ·Dr Tate dated 9 November 2015 which records:

    “Craig has Neurosarcoidosis and is seeing a Rheumatologist at Box Hill Hospital for treatment”;

    ·Dr Pun, Rheumatologist, dated 14 January 2016  which records:

    “I have recently started to treat Mr Nicholls who has a past history of sarcoidosis … I am commencing him on treatment, initially with prednisolone and Plaquenil “;

    ·Dr Pun also dated 14 January 2016 which records:

    “Mr Nicholls … is under the care of an ophthalmologist and a neurologist”;

    ·Eastern Health Discharge Summary of 31 January 2016 which records:

    “Commenced on Prednisolone 5mg TDS. … Clinically improved with med regime changes, though joint pain persisted – for ongoing review with private rheumatologist. … For d/c (discharge) back home with private Rheumatologist review 1 week post discharge”;

    ·Dr Pun dated 26 February 2016 which records:

    “Mr Nicholls is feeling much better on 25 mg of Prednisolone, which I have asked him to reduce to 20mg per day.  I am starting Methotrexate 10mg weekly in conjunction with Folic Acid 5mg daily “for a steroid-sparing” effect.  I will endeavour to review the MRI films with a radiologist, and I will see Mr Nicholls again in three weeks”;

    ·Dr Atalla, Ophthalmologist, dated 3 March 2016 which records: 

    “Recently, after a flare-up of his sarcoidosis, he was complaining of double vision from each eye.  MRI of the Brain and Orbits revealed…”;

    ·Dr Tate dated 2 May 2016 which records:

    “He has had sarcoidosis and is in remission …”.

41. The medical reports show that at around the relevant period the condition was still being investigated by specialists, and his treatment and medication regime still being altered.  By 2 June 2016 it appears that the condition was in remission.

42. I am satisfied from the medical reports that at the time of the relevant period Mr Nicholls condition of sarcoidosis/neurosarcoidosis was neither fully treated nor fully stabilised and I find accordingly.  As the condition was not fully treated and not fully stabilised it is not permanent in the terms of the Act and I am unable to assign to it an impairment rating.

    Chronic Migraines

43. Citing reports from RMH, Eastern Health, Dr Peter Archer at Maroondah Hospital, Dr Ka Sing Chua, GP, Dr Tate and Dr Lee the Respondent accepts that the condition was fully diagnosed at the relevant period.  I am satisfied that this concession is supported by the medical evidence and I find accordingly.

44. In considering the treatment and stability of the condition at the relevant period I note the following reports:

    ·Dr Ka Sing Chua dated 2 September 2015 which records:

    “Under investigation by Specialists at Box Hill Hospital”;

    ·Dr Tate dated 1 October 2015 which records:

    “He has the misfortune of being diagnosed with neurosarcoidosis causing chronic migraines”;

    ·Job Capacity Assessment Report dated 18 December 2015 which records under the condition of Nervous System – Other:

    “Diagnosis: Medical certificates … verify diagnosis of Neurosarcoidosis …

    Symptoms/functional impacts:  MR (ED Summary, 1/07/15) notes that client has a history of complex migraine and has had multiple hospitalisations in the past for worsening migraines.  … Dr Tate (MC/GP, 23/11/15 & 9/11/15) reports that client is currently experiencing an exacerbation of Neurosarcoidosis condition and current symptoms include chronic headaches…“;

    ·Dr Lee dated 9 February 2016 which records:

    “I have been looking after Craig for 8 months due to persistent headache consistent with chronic migraine.  His headaches fluctuate in intensity, and resulted in hospitalisation on a couple of occasions last year.  This has proved to be fairly disabling for him, restricting his lifestyle and ability to return to work.  He also has chronic pain, and issues of sarcoidosis … “;

    ·Dr Narges Sobhani, Radiologist, dated 24 February 2016 which records:

    “1. Subcortical and occipital peri-ventricular white matter hyper-signal intensity, more pronounced on left side.  White matter hyper-signal intensity in left occipital lobe is faintly enhancing after contrast and shows diffusion restriction which may be in keeping with mild parenchymal involvement by sarcoidosis.

    2. In left temporal lobe at the level of the circle of Willis, there is subtle prominence of Leptomeningeal coverage, which may be suggestive of mild Leptomeningeal inflammation, possible secondary to sarcoidosis”; and

    ·Dr Lee dated 21 April 2016 which records:

    “Thank you for making an appointment for Visual Evoke Response (VER) for this man who has a rather complex history.  He has chronic ischaemic change and possible stroke in left occipital lobe.  … He also has headaches and probable migraine”.

1. In his evidence Mr Nicholls included migraines as one of the conditions caused by his sarcoidosis/neurosarcoidosis.  Dr Tate states clearly that Mr Nicholls’ chronic migraine condition results from his neurosarcoidosis condition.  Dr Lee appears to connect the migraine as one of the issues of sarcoidosis and refers Mr Nicholls for further investigation, including his headaches and probable migraine as symptoms for consideration.

2. From the evidence of Dr Tate and Dr Lee I accept that Mr Nicholls’ migraine results from his sarcoidosis/neurosarcoidosis.  I have already found that the condition of sarcoidosis/neurosarcoidosis was fully diagnosed at the relevant period but not fully treated or stabilised.  As his migraine is a result of his sarcoidosis/neurosarcoidosis it cannot be considered as fully treated or fully stabilised. 

3. I find that the condition of chronic migraine is not fully treated and fully stabilised.  The condition cannot be permanent in the terms of the Impairment Tables.  I am unable to assign an impairment rating to this condition.

   Cardiac Condition

4. In considering whether a cardiac condition has been fully diagnosed I note the following reports:

   ·RMH Discharge Summary of 4 March 2015 which records: “Comorbidities … HTN/Hypercholesterolaemia … sees private cardiologist, no angio/TTE but negative EST (Exercise Stress Test)”;

   ·Eastern Health dated 10 April 2015 which records: “cardiac hx – acute chest pain post septoplasty end 2014; sent to Northern, stress test negative … awaiting to see a private cardiologist next week for a echocardiogram, with hx of recurrent chest pain (organised by GP)”;

   ·Eastern Health dated 29 April 2015 which records: “Chest pain …  prior episodes of chest pain, investigate with Angiogram 21/04/15 – Normal”;

5. The medical evidence provides no diagnosis of a cardiac condition.  I find that the condition is not fully diagnosed at the relevant period.  Consequently it is not permanent in the terms of the Impairment Tables and I am unable to assign an impairment rating to this condition.

   Generalised Sepsis and Gastroenteritis

6. The RMH Discharge Summary of 4 March 2015 recorded a diagnosis of Generalised sepsis and Gastroenteritis.  The Discharge Summary records that Mr Nicholls was discharged on oral azithromycin.  In his report dated 1 October 2015 Dr Tate records “Recent admissions to Box Hill with septicaemia … “.  There are no other references to the condition relating to the relevant period.  There is no evidence that the condition still existed in the relevant period. 

7. I find that at the relevant period the condition was not fully diagnosed, fully treated or fully stabilised.  Accordingly the condition is not permanent in the terms of the Impairment Tables and I cannot assign an impairment rating to the condition.

   Irritable Bowel Syndrome

8. In his application for DSP Mr Nicholls lists Irritable bowel as one of his illnesses.  There are no references to this condition in medical reports related to the relevant period. 

9. I find that at the relevant period the condition was not fully diagnosed and therefore not permanent in the terms of the Impairment Tables.  Accordingly I am unable to assign impairment points to the condition. 

   Chronic Back Pain

10. Dr Ka Sing Chua’s medical certificate of 2 September 2015 includes chronic back pain as another medical condition which impacts on Mr Nicholls’ capacity to work or study.  I accept Dr Chua’s diagnosis and find that the condition is fully diagnosed in the relevant period. 

11. In considering treatment for the condition I note that on 17 March 2016 Mr Nicholls attended MonashHealth for elevated lumbar pressure.  On 17 May 2016 Mr Nicholls was booked for a lumbar puncture at the Monash Medical Centre.  There is no evidence regarding the results of the investigation.  There is no evidence of any treatment following the investigation.  Nor is there evidence that the condition was stabilised.  In any case the investigation was already beyond the relevant period.

12. I note that in her report of 14 January 2016 Dr Pun records “I have recently started to treat Mr Nicholls who has a past history of sarcoidosis, and presents with severe generalised body pains”.  It may be that Mr Nicholls’ chronic back pain results from his sarcoidosis/neurosarcoidosis.  I have already found that that condition was fully diagnosed at the relevant period but not fully treated or stabilised.  Accordingly, even if his chronic back pain resulted from his condition of sarcoidosis/neurosarcoidosis it cannot be considered as fully treated or fully stabilised. 

13. I find that the condition of chronic back pain is not fully treated and fully stabilised.  The condition cannot be permanent in the terms of the Impairment Tables.  I am unable to assign an impairment rating to this condition.

    Auto-immune Disease

14. In his medical certificates dated 4 January 2016 and 14 June 2016 Dr Tate lists autoimmune disease as one of the conditions which impact on Mr Nicholls’ capacity for work or study.  There are no further references to this condition in reports related to the relevant period.  In particular there are no reports from medical specialists referring to an auto-immune disease.  There is no evidence of treatment in relation to the condition.  Nor is there evidence that the condition may be stabilised. 

15. Without further medical evidence I do not accept that the condition was fully diagnosed, fully treated or fully stabilised and I find accordingly.  Consequently the condition is not permanent in the terms of the Impairment Tables and I am unable to assign an impairment rating to the condition.

    Elevated Lumbar Pressure

16. The medical evidence regarding this condition is confined to the report from MonashHealth dated 17 March 2016 and the booking for a lumbar puncture made for 17 May 2016.

17. I find that at the time of the relevant period the condition was not fully diagnosed, not fully treated and not fully stabilised.  Accordingly the condition was no permanent in the terms of the Impairment Tables and I cannot assign an impairment rating. 

    Total of Impairment Ratings

18. In considering the assignment of impairment ratings I have found the following in regard to the claimed conditions:

    ·Stroke – zero impairment points;

    ·Diabetes – zero impairment points;

    ·Sarcoidosis/neurosarcoidosis – fully diagnosed but not fully treated or fully stabilised; unable to assign an impairment rating;

    ·Chronic migraines – fully diagnosed but not fully treated or fully stabilised; unable to assign an impairment rating;

    ·Cardiac condition – not fully diagnosed, fully treated or fully stabilised; unable to assign an impairment rating;

    ·Generalised sepsis and gastroenteritis – at the relevant period not fully diagnosed, fully treated or fully stabilised; unable to assign an impairment rating;

    ·Irritable bowel syndrome – not fully diagnosed, fully treated or fully stabilised; unable to assign an impairment rating;

    ·Chronic back pain – not fully treated or fully stabilised; unable to assign an impairment rating;

    ·Auto-immune disease – not fully diagnosed, fully treated or fully stabilised; and

    ·Elevated lumbar pressure – at the relevant period not fully diagnosed, fully treated or fully stabilised; unable to assign an impairment rating.

19. At the relevant period the assigned impairment points are zero. 

    CONCLUSION

20. The impairments attract a rating of zero points.  As a result Mr Nicholls does not satisfy the requirements of subsection 94(1)(b) of the Act.  In order to qualify for DSP all of the subsections of section 94(1) of the Act must be satisfied.  This means that at the relevant period Mr Nicholls is not qualified for the receipt of the DSP.

    DECISION

21. I affirm the decision under review.

I certify that the preceding 65 (sixty-five) paragraphs are a true copy of the reasons for the decision herein of Mr Conrad Ermert, Member

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Associate

Dated   15 November 2016

Date of hearing	24 October 2016
Applicant	In person
Advocate for the Respondent	Mr Pietro Nacion
Solicitors for the Respondent	Sparke Helmore