Plummer and National Australia Bank Limited (Compensation) - [2020] AATA 3759

Plummer and National Australia Bank Limited (Compensation) [2020] AATA 3759 (25 September 2020)
Division:GENERAL DIVISION
File Number(s): 2019/1960
Re:Michael Plummer
APPLICANT

National Australia Bank LimitedAnd
RESPONDENT

DECISION
Tribunal:The Hon. John Pascoe AC CVO, Deputy President
Date:25 September 2020
Place:Sydney

The reviewable decision of the respondent dated 7 February 2019 is affirmed.
...........................[SGD]............................................
The Hon. John Pascoe AC CVO, Deputy President
CATCHWORDS
WORKERS COMPENSATION – psychological injury – claim for anxiety disorder, panic attacks and agoraphobia – whether the applicant suffers an ailment, or an aggravation of an ailment – whether the ailment, or aggravation of the ailment, was contributed to, to a significant degree, by the applicant’s employment – non-work related stressors affecting the employee’s health – predisposition of employee to ailment, or aggravation of the ailment – whether the respondent is liable to pay compensation – decision under review affirmed
LEGISLATION
Safety, Rehabilitation and Compensation Act 1988 (Cth) ss 5B, 7(4), 14
REASONS FOR DECISION
The Hon. John Pascoe AC CVO, Deputy President
25 September 2020
BACKGROUND

The applicant seeks a review of the reviewable decision of the respondent dated 7 February 2019. This reviewable decision determined that the respondent was not liable under section 14 of the Safety, Rehabilitation and Compensation Act 1988 (Cth) (‘SRC Act’) for the applicant’s claimed “anxiety disorder, panic attacks, agoraphobia” which he attributed to abusive telephone calls with customers he liaised with in his role within the Direct Consumer Servicing Unit whilst working for the respondent, National Australia Bank (‘NAB’).
In this matter there were a large number of medical reports submitted to the Administrative Appeals Tribunal (‘the Tribunal’) and oral evidence was given at the hearing by Dr Christopher Cocks and Mr Pete Potgieter.
A comprehensive summary of the history of the matter and the relevant medical evidence was provided by the respondent, which I have considered and in summary include below. I note this summary is factual and in accordance with the evidence presented at the hearing, in particular the multiple medical reports, although there was dispute between the parties as to the conclusions to be drawn from the evidence. The below summary is broadly in line with what was submitted to the Tribunal by the respondent and was not in dispute at the hearing.
The applicant is 28 years of age. He started working with NAB on 27 February 2017 as a Contact Centre Service Advisor within the Direct Consumer Servicing Unit.
When the applicant resigned from his employment with NAB on 5 February 2020 he had not presented to work since around August 2018.
The applicant submitted a workers compensation claim dated 9 October 2018 for “anxiety disorder, panic attacks, agoraphobia” which he said he first noticed on 5 June 2018. He sought medical treatment for this on the same day.
The respondent’s determination decision of 7 December 2018 found that the applicant’s employment was not a significant contributing factor to either the onset or aggravation of the claimed mental illness. The applicant provided a request for reconsideration dated 4 January 2019. By reviewable decision dated 7 February 2019, the respondent affirmed the determination dated 7 December 2018.
On 25 September 2017, the applicant attended Dr George Quittner, general practitioner, with severe lumbar back pain. He noted that he had played rugby when he was younger and, previous to his work with the respondent, had worked as a marine mechanic for eight years. Dr Quittner diagnosed the applicant with lumbar nerve root compression and referred him to two specialists. The applicant’s asthma and sleep apnoea were also discussed.
In approximately November or December 2017, the applicant had three months off work due to his back pain.
Dr Raoul Pope, neurosurgeon and spine surgeon, wrote to Dr Quittner on 6 November 2017 regarding the applicant’s back. The MRI was normal, and Dr Pope recommended a CT bone scan and a referral to a pain specialist.
The Patient Health Summary of Avenue Road Medical Practice notes Endep was prescribed to the applicant on 12 December 2017.
The applicant saw Dr Irwin Lim, rheumatologist, who provided a report dated 20 December 2017 recommending exercise, anti-inflammatories and noting that sacroiliac injections had not helped. He referred the applicant to a physiotherapy team.
In a report dated 17 January 2018, Dr Nazha noted that the applicant described a nine-month history of back pain. At the time, the applicant weighed 133 kilograms and had gained 20 kilograms over the last 12 months, during which time he had changed jobs. Dr Nazha suggested lifestyle changes and pharmacological treatment, hydrotherapy and physiotherapy.
On 12 March 2018, the applicant’s former fiancée told Dr Quittner the applicant was depressed and never happy like he used to be. His Endep was increased from 75mg to 150mg. On 26 March 2018, Dr Quitter recorded that the applicant’s back pain remained difficult and he had major problems after carrying shopping.
In a report dated 11 April 2018, Dr Nazha stated that the applicant had been experiencing issues with his coccyx but he could now walk 500 metres and sit down without significant pain associated with coccydynia. The applicant also saw Mr Scott Taylor, physiotherapist, who provided him with an exercise program.
On 5 June 2018, the applicant attended Dr Quittner regarding his poor mood, and Dr Quittner noted “unhappy with job” and “has generally been more active” in his notes.
On 19 June 2018, Dr Quittner recorded that both the applicant and his then partner were “quite emotionally flat” as the applicant’s partner was having major problems after weight loss surgeries and the applicant was receiving minimal benefit for his medication. Dr Quittner advised the applicant to double his medication dosage. He suggested the couple get specialist advice if there was no improvement, but they said they had financial difficulties with this. Dr Quittner also referred the applicant to a gastroenterologist for the issues he was experiencing.
On 29 June 2018, the applicant left work early at 10:30am after he took a call with a customer asking for a refund. The applicant sought assistance from NAB Resolve during the call who suggested he escalate it to a team leader. After 25 minutes of not escalating the call, the customer demanded to speak to a manager. The applicant informed his team leader he was upset the customer yelled at him, he was not feeling great about attending work that day and he said personal events outside of work were affecting his work and distracting him, including his then partner’s miscarriage, his father being diagnosed with multiple sclerosis, his partner having significant surgery and suffering infections after her previous surgery and the medication he was taking for depression that made his vision blurry and affected how his mind works and feels.
The applicant did not attend work on 30 June 2018. On 3 July 2018, he said he was confident to return to work and had made an appointment with a psychiatrist to help him manage his emotions while at work.
On 7 July 2018, the applicant saw Dr Ranasinghe-Markus, who noted that the applicant had been taking antidepressants for a year and had: “multifactorial – back pain, dad’s recent diagnosis of MS. Seems to have panic attacks/anxiety attacks at work…recently decompensated”. She noted the applicant had been taking Nexium for a long time without a diagnosis or endoscope.
On 11 July 2018, the applicant had a return to work assessment and Konekt provided a report dated 19 July 2018. The applicant said that he had started experiencing episodes at work approximately two months prior to the assessment, usually after an aggressive phone call but sometimes with no trigger. He said he had experienced several stressors in his personal life lately including chronic lower back pain for 12 months, his partner recently undergoing major surgery and experiencing a significant infection which resulted in hospitalisation for two weeks and his father being diagnosed with multiple sclerosis.
On 19 July 2018, Dr Quittner liaised with Konekt and said the applicant would benefit from both psychological and psychiatric support, but he could not afford it. Dr Quittner noted the applicant’s problems appeared to be chronic.
On 23 July 2018, the applicant was still unsure whether he would be well enough to return to full time work. He noted continued stress with difficult customers, stress about his former fiancé’s surgery, insomnia and depression and his former fiancé’s and his difficult living situation.
On 26 July 2018, the applicant saw Dr Ranasinghe-Markus and said he had been on Epilim and Endep without much change. The applicant said he was not getting better. He could not seem to manage at work and was referred to Dr Lee Ingram, psychiatrist.
Dr Ingram provided a report dated 30 July 2018. The applicant informed Dr Ingram he had increasing lower back pain which became particularly debilitating around November 2017 and his mood became progressively low around that time and had been increasingly worse since. The applicant also informed Dr Ingram that there had been a number of stressors in his life, including pain which caused considerable stress in his relationship, avoidant behaviours, his father being diagnosed with multiple sclerosis in April 2018, his then partner’s medical conditions, considerable financial pressures as a result of the medical problems, weight increase since his back pain, obstructive sleep apnoea and other medical problems he had not been able to attend to. He also explained issues in his past with his mother probably having bipolar and having issues with depression and alcohol use disorder, his parents separating when he was young, living with his father and ceasing contact with his mother eventually given her drinking and verbal abuse, bullying in Years seven to nine, having to repeat Year 11 and then dropping out of school. He said there were problems with his boss and management when he worked as a marine mechanic before working for NAB. He also described serious issues with traumatic relationships in the past.
Dr Ingram considered the applicant presented with symptoms of a major depressive disorder (‘MDD’) and co-morbid panic disorder. He also considered that the applicant had a genetic vulnerability to mood disorders and the applicant’s abuse from his mother and bullying would have also increased his vulnerability. He noted the applicant reported stable psychosocial functioning until the onset of back pain and although that pain had improved, the depressive symptoms persisted, and he later developed panic symptoms.
The applicant saw Dr Ranasinghe-Markus on 8 August 2018 who diagnosed him with insomnia. She noted the applicant was unable to work as he became emotional and anxious when dealing with clients, particularly in the call centre as clients can get quite aggressive. She also noted that the applicant’s home situation was bad and that his partner’s father did not want them living with them alongside their financial constraints. Dr Ranasinghe-Markus issued a carer’s leave certificate.
On 20 August 2018, Dr Ingram reviewed the applicant, noting that the applicant thought his mood was better and he had been experiencing enjoyment out of things, but his anxiety had not improved and he was finding it difficult to leave the house.
In a report dated 27 August 2018, Dr Nazha said the applicant had completed a series of platelet rich plasma (‘PRP’) injections bilaterally to his sacroiliac joints. The applicant noticed a statistically significant reduction in his pain in the region of his buttocks and lower back, and no longer had any pain in the coccyx.
On 3 September 2018, the applicant attended Dr Ranasinghe-Markus for back pain, and he recorded that the applicant had seen Dr Ingram, pain specialist Dr Nazha and had PRP injections and discussed nerve ablation. A mental health care plan was also created.
Ms Jeanne Abelson, former treating clinical psychologist, provided a report dated 19 September 2018. She said the applicant presented on 4 September 2018 complaining of back pain and breakdowns. He had had some relief from back pain due to PRP injections, but he had been off work for two months because of the breakdowns. She diagnosed expected panic disorder and agoraphobia. The applicant told Ms Abelson his panic attacks were first brought on by abusive customers at work, and often occurred more randomly including in places with crowds of people. Ms Abelson considered other factors may have contributed and she said the applicant may also suffer depression which could have preceded the panic attacks and could have worsened them. Ms Abelson said the applicant dismissed factors in his upbringing as unimportant, but she considered “these experiences could well have led to depression and indeed back pain and also to a build-up of internal stress and anxiety contributing eventually to the outbreak of panic”.
Dr Quittner first completed a WorkCover certificate on 19 September 2018 and diagnosed the applicant with “anxiety/panic attacks/agoraphobia” with date of injury at 5 June 2018 caused by “reaction to stressful abuse by customers” and noting the applicant had previously been treated for a mood disorder. Dr Quittner certified the applicant unfit for work until 31 December 2018.
On 8 October 2018, Dr Ingram reviewed the applicant who was feeling better in his mood but was still getting panic and anxiety symptoms triggered by crowds and noise. He was seeing a psychologist fortnightly and hoping to increase to weekly if his claim was accepted.
On 15 October 2018, the applicant raised a list of issues with Dr Quittner. He asked about Duromine for weight loss and they discussed weight loss surgery. Dr Quittner wrote to the Anxiety Disorders Foundation about anxiety management.
In his letter to Dr Quittner dated 29 October 2018, Dr Ingram said the applicant reported some improvement in that he was able to manage about half an hour in the grocery store and was more active outside the house. The applicant told Dr Ingram he was going to submit a workers compensation claim and that he had some stress surrounding this.
In his report dated 7 November 2018, Dr Marwat, psychiatrist, stated that the applicant had presented with a five-month history of non-specific anxiety symptoms occurring in the context of a thirteen-month history of underlying depressive symptoms which had been resistant to pharmacological management. Dr Marwat found that the applicant’s symptoms did not meet the diagnostic criteria for a panic attack or Panic Disorder. Instead, he characterised these as “secondary anxiety attacks”. Dr Marwat said the anxiety attacks were precipitated by emotional stress (such as arguing with his fiancée, exposure to loud noises and proximity to crowds of people). The applicant told Dr Marwat that his depression commenced in September 2017, for which he was first treated in December 2017. Dr Marwat noted that in June 2018, the applicant first developed anxiety symptoms in response to abrasive customers at the call centre.
In a report dated 26 November 2018, Dr Ingram stated that the applicant had been active at home and his mood was quite stable overall. The applicant was at times frustrated with his lack of progress with the management of his anxiety but accepted that the treatment can be quite protracted.
The applicant started seeing Mr Pete Potgieter, his current treating mental health social worker, on 5 December 2018 for a “psychological injury at work”. The consultations occur approximately fortnightly and have involved Cognitive Behaviour Therapy (‘CBT’). At the first consultation, Mr Potgieter noted “complex PTSD”. Mr Potgieter recorded that the applicant took abusive calls at work and had not been well enough to return to work since the middle of the year. He also noted that the applicant had pain in his lower back and had described having depression previously including as a result of his parents’ divorce and being bullied at school.
Dr Geoff McDonald, consultant psychiatrist, assessed the applicant at the respondent’s request and provided a report dated 6 December 2018. The applicant told Dr McDonald he suffered from a depressed mood previously, including in the context of a difficult relationship break-up some years prior. Dr McDonald described a previous history of developmental trauma, chronic back pain and psychological disturbance. He considered the applicant met the criteria for an exacerbation of chronic adjustment disorder with depressed and anxious mood.
Dr McDonald noted the applicant attributed the onset of his anxiety in June 2018 to work stress and specifically phone calls with difficult or abusive customers at work, but he did not consider work stress was a significant cause of the applicant’s panic and agoraphobia, or exacerbation of adjustment disorder. Dr McDonald listed several multiple pre-disposing and recent triggering non-work stressors that had contributed to the applicant’s adjustment disorder and its recent exacerbation.
The predisposing factors include the applicant’s poor relationship with his mother who was alcohol dependent and abusive, bulling at school, dropping out in Year 11, past abusive relationship with partner who used ice who he obtained an Apprehended Violence Order (‘AVO’) in relation to, long-term back pain at least since teen years which Dr McDonald noted was likely partly anxiety related, clashes with a boss for several years when working as marine mechanic associated with depression and that the applicant’s older brother may have a psychiatric problem. Dr McDonald said triggering factors for the recent exacerbation of his mental illness may include severe disabling back pain, financial stress, his partner’s miscarriage, father’s multiple sclerosis diagnosis in April 2018, partner’s series of operations with post-operative complications, using sedatives for some months, relationship stress, living with partner’s family, including alcohol dependant mother and psychotic aunt, unable to live with father and taking Duromine for weight loss which likely contributes to panic.
Dr McDonald considered the applicant had probably experienced anxiety and depression in various combinations and fluctuating intensity over many years, however, he considered the exacerbation of chronic adjustment disorder was unlikely caused by difficult customers. Rather, he believed it induced a fragile emotional state such that the applicant could not cope at work.
In a report dated 21 December 2018, Dr Ingram noted that the applicant had a panic attack at a concert for about 45 minutes. Dr Ingram noted that the “big issue driving the anxiety and depressive symptoms has been his work cover claim being declined.” The applicant told Dr Ingram that his claim was denied due to his previous use of Duromine and his financial stresses which he said post-dated the claimed injury.
In a report dated 29 January 2019, Dr Ingram stated there had been a progressive deterioration in the applicant’s mood, which he attributed to ongoing life stressors such as financial issues and his partner’s frustration with him. Dr Ingram noted that the applicant reported improvement in his anxiety, and he was able to get out of the house more but was lacking motivation and joy.
The applicant was admitted to Northside Group Cremorne Clinic on 11 February 2019 for “intractable depression” and was discharged on 20 March 2019. The applicant was diagnosed with MDD without psychotic symptoms, panic disorder, anxiety disorder (unspecified), mental and behavioural disorder due to use of cannabinoid and disorders of initiating and maintaining sleep.

In the pre-admission form, it was noted that the applicant was struggling with depression since September 2017 due to back pain, he could not walk more than ten metres at the peak of his back pain in November/December 2017, but that the back symptoms were largely under control.
It was also noted by the applicant in the form that his anxiety began in July 2018 when he was working with the respondent and had “many abusive customers on a daily basis” which caused him to have panic attacks. Further remarks on the form were that the applicant’s father was diagnosed with multiple sclerosis in 2018, his partner had a miscarriage in 2018, he had no suicidal or self-harm thoughts, he was currently on Cymbalta, Endep and Seroquel, he lost contact with his mother when he turned 18, he was bullied at high school and interactions with his boss when he was a marine mechanic “became difficult after five years”.
In a report dated 5 April 2019, Dr Ingram noted the applicant had attended Northside Clinic for four weeks. The applicant arrived feeling depressed and suicidal and “a significant part of this was denial of his claim through WorkCover”. Dr Ingram believed the treatment was successful, as the applicant’s mood and ability to sleep had improved.
In a letter to Dr Quittner dated 6 May 2019, Dr Ingram said the applicant told him he had separated from his fiancé, which was driven by her. They were still talking, but the applicant said it had a “significant effect on his mood”.
Dr Christopher Cocks, consultant psychiatrist, provided a report at the respondent’s request dated 18 February 2020. Dr Cocks diagnosed MDD and Marijuana Use Disorder. He considers that the applicant’s panic attacks were explained by his MDD, as opposed to amounting to a separate diagnosis of Panic Disorder. Dr Cocks considers the MDD emerged in 2017 in the context of functionally debilitating back pain, and the Marijuana Use Disorder in mid-2019 following the breakdown of the applicant’s relationship with his fiancée.
Dr Cocks wrote that the applicant has genetic vulnerability to the development of a mood disorder and considers there are a number of pre-existing and predisposing factors that resulted in the emergence of his MDD in 2017, including back pain, rapid weight gain of 30 kilograms over the course of 2017, obstructive sleep apnoea, impaired attachment to his mother, bullying through school and a complicated romantic relationship.
Dr Cocks said that in June 2018 (the time of the claimed injury), he believes that the applicant already had MDD, and it was causing him to experience panic attacks. He explained there were extensive non-work stressors that have resulted in the exacerbation of the applicant’s psychological condition that were present in 2017 and 2018 and referred to those extensive non-work related factors reported by Dr Ingram and Dr McDonald.
ISSUES
(a)Did the applicant sustain an injury in accordance with the definition in section 5B of the SRC Act, as claimed in his claim for compensation dated 9 October 2018; and.
(b)Is the applicant entitled to compensation under section 14 of the SRC Act for the claimed injury?
The following considerations are relevant to this:
(a) Has the applicant suffered an ailment or aggravation of an ailment as claimed in his claim for compensation dated 9 October 2018 that is outside the boundaries of normal mental functioning;
(b) If so, what is the date the ailment or aggravation occurred; and
(c)Was that ailment or aggravation of the ailment contributed to, to a significant degree, by the applicant’s employment as a Contact Centre Service Advisor with NAB.
LEGISLATIVE FRAMEWORK
The respondent’s general liability to pay compensation is set out in section 14(1) of the SRC Act, which provides as follows:
(1) Subject to this Part, Comcare is liable to pay compensation in accordance with this Act in respect of an injury suffered by an employee if the injury results in death, incapacity for work, or impairment.
The payment of compensation in respect of a ‘disease’ is set out in section 5B of the SRC Act, which relevantly states:
(1) In this Act:
disease means:
(a) an ailment suffered by an employee; or
(b) an aggravation of such an ailment;
that was contributed to, to a significant degree, by the employee’s employment by the Commonwealth or a licensee.
Section 5B(2) of the SRC Act provides that in determining whether an ailment or aggravation of that ailment was contributed to, to a significant degree, by an employee’s employment the following non-exclusive list of matters may be considered:
(a)       the duration of the employment;
(b)       the nature of, and particular tasks involved in, the employment;
(c)       any predisposition of the employee to the ailment or aggravation;
(d)       any activities of the employee not related to the employment; and
(e)       any other matters affecting the employee’s health.
For the purposes of the SRC Act, a ‘significant degree’ means substantially more than material.
Section 7(4) of the SRC Act states that an employee shall be taken to have sustained an injury, being an ailment or aggravation of an ailment, on the day when the employee first sought medical treatment for the ailment or aggravation of the ailment, or on the day when the ailment or aggravation first resulted in incapacity for work or impairment of the employee, whichever happens first.
THE EVIDENCE
The applicant’s evidence
At the hearing, the applicant started by emphasising that prior to working for the respondent, NAB, he was “a functional person” and was obviously considered capable when he was offered employment.
The applicant said that although he understood that there were other contributing factors to his mental health condition, the major contributor was his employment at NAB.
Under cross-examination, the applicant confirmed that he had been employed by NAB as a Contact Centre Service Advisor from 27 February 2017 until he resigned voluntarily on 5 February 2020. During this time, he worked on a rotating roster dealing with customer complaints and enquiries.
The applicant said he regularly dealt with calls in relation to money held in accounts for customers who had been on cruises, where the cruise would hold money from a customer’s account to pay for goods and services used on the cruise and where the balance would subsequently be released following authorisation. Sometimes there were lengthy delays in the refund of the money and the applicant expressed that clients could be extremely angry with NAB when they called. He said that other technical issues at NAB also meant that he received increasingly aggressive client calls and he felt like he was a “punching bag” for NAB’s customers.
The applicant confirmed that he had undergone a twelve-week training period prior to commencing full-time work with NAB. He said he received positive feedback for his work at NAB and had received a customer service award in June 2018 for his achievements.
Ms Jessica Thorley was the applicant’s team leader and direct report, and she was described as supportive and to have an open communication style. The applicant regularly and openly spoke to her about various issues arising in his daily life. The applicant said that he had never had any previous concerns about discussing his back injury with Ms Thorley, nor had there been any problems with him having time off work to deal with various health issues. He had also spoken to Ms Thorley about career progressions within NAB and in particular he had asked Ms Thorley about other roles which did not involve direct dealings with customers.
The applicant confirmed that on 14 June 2018 Ms Thorley had nominated him for a floor walking role, but that he did not want this role as it involved “escalation” calls and he would find this triggering. He said that he did not tell Ms Thorley at the time that he did not want the role or the reasons for not wanting the role, but he had told her that he wanted a non-customer facing role.
The applicant said that he did not want to tell Ms Thorley that he was having difficulties dealing with angry customers nor that he did not like dealing with customers because he was concerned that this would affect his job prospects and future at NAB.
The applicant gave evidence about his employment prior to NAB. He said he worked as a marine mechanic for approximately eight years, which included an apprenticeship of around four years. The applicant said he had experienced issues with his former boss as a result of broken promises, late payment of wages and other issues arising out of his employment. Although he had symptoms of a back injury whilst working as a marine mechanic, he had not made a workers compensation claim as he said his injury did not affect his work at the time. The applicant said that he had resigned from this company to work at NAB as he wanted a job with less manual labour.
Subsequent to starting work with NAB in February 2017, the applicant said he had consulted Dr Quittner in relation to severe back pain he was experiencing. He said he was prescribed Valium as a muscle relaxant but that he did not take it for long. The applicant also had chiropractic treatment in September 2017.
The applicant said that he had told Dr Quittner that his back pain had triggered his bad mood and caused his sleep to be regularly interrupted. He said he was again prescribed Valium in December 2017 and he recalled taking it until January 2018.
During his consultation in November 2017, the applicant agreed that he had told Dr Quittner that he had been suffering from depression as a result of his back pain and he was prescribed Endep to help with depression, a sleep disorder and this back pain.
The applicant said that when he completed his return to work document in January 2018 he was having problems, including continuing sleeping problems and issues with his medication making him drowsy.
The applicant confirmed that he saw Dr Nazha in relation to lower back pain, because the applicant felt that his physical pain was such that he could not go anywhere. He continued to experience severe back pain whilst seeing Dr Nazha in March and April 2018.
The applicant confirmed that when he saw Dr Quittner in March 2018, he was still very depressed and there was no improvement in his mood between March and June 2018. However, once his back started to improve, his mood also improved.
When questioned about his former fiancé, the applicant confirmed that she had had two weight loss surgeries, the second in 2018, that resulted in medical complications. He said that he had taken time off work to care for her but said that he was not worried or stressed about her surgery, as he believed she would be fine. The applicant said that his fiancé’s operation was not weighing heavily on his mind when he spoke to Ms Thorley and that he had rather used it as an excuse to not be at work, without having to tell her that he was struggling with his role in dealing with aggressive customers.
On 5 June 2018, the applicant confirmed that he had attended work but had left before his shift had ended. He confirmed that he had been visibly distressed and crying and that he had told Ms Thorley that his medication was not working. He had told Ms Thorley that he was struggling with his emotions but denied that he spoke to Ms Thorley about “personal life events” and would not have used such words. The applicant said, however, that on that day he really did not want to be at NAB. He said he was scared of talking to customers but agreed that he had not spoken about this directly, including to Ms Thorley or his General Practitioner (‘GP’). The applicant emphasised that he had not spoken to Ms Thorley about his problems with customers because of the way he said NAB ran its call centre like a “revolving door”. This environment made him anxious of his job stability. The applicant confirmed that on 5 June 2018 he had left work prior to taking any calls from customers as a result of experiencing stress and anxiety due to just attending NAB and the call centre environment.
The applicant remembered seeing Dr Quittner that day. Dr Quittner noted that the applicant’s mood had been poor since at least November 2017 and that the applicant was “unhappy at work”. The applicant said that Dr Quittner had failed to note that he was unhappy at work because of the abuse he was receiving from customers.
Under cross-examination, the applicant agreed that there was no objective note prior to June 2018 about the difficulties he said he was having in dealing with difficult customers. When questioned about Ms Thorley’s comment in relation to the applicant not making a formal complaint to her but sometimes “bitching about customers”, the applicant again said that he knew he would be shown the door if he raised his concerns about abusive customers.
He further confirmed that on 9 June 2018 after the lunch break, he had told Ms Thorley that he could not cope and that he was distracted by “other things”. Whilst the applicant had said he was focused on his fiancé’s surgery and his father’s diagnosis with multiple sclerosis at the time, he said that he was not actually overly concerned about these issues.
The applicant confirmed that at his performance review on 20 June 2018 his performance targets had slipped. He went on to explain that those performance targets were dependent on customers completing a customer satisfaction survey, which would require them to take extra time. The applicant said that many customers were happy but did not take the time to complete the survey. When asked whether his performance had been impacted by personal problems, the applicant said that his problems were caused by issues with NAB and aggressive customer calls.
The applicant confirmed that on 19 June 2018 he saw his GP and that he and his fiancé were seen to be “emotionally flat”. He said he could not afford to see a psychiatrist at that time.
When asked whether his fiancé’s miscarriage had been distressing for him, the applicant said that it had been “a blessing in disguise” and that he did not want children and it had saved him spending money on an abortion. When questioned as to why he raised his fiancé’s miscarriage on 29 June 2018 as something that was concerning him, he said that it was a good excuse to not be at work. The applicant said that he used the best thing that he could think of at the time to get out of the stress of work at the call centre as an avoidance behaviour stemming from his underlying anxiety.
On 29 June 2018, the applicant said that he had received a very abusive call from a woman who had been on a cruise. He said that the customer had abused him and that he broke down. He said that he had been “the punching bag” of NAB. At the time, he told Ms Thorley about other issues that were worrying him, namely his fiancé’s surgery and his father’s multiple sclerosis.
The applicant recalled asking Ms Thorley on 29 June 2018 at 8:40AM about whether she had heard of any other positions that might be available to him at NAB. After asking this question he said he left work at around 10:30AM.
The applicant saw Dr McDonald on 6 December 2018 and, amongst other things, told him he wanted to get his fiancé’s surgery behind him before returning to work. By that time, he had been away from work for a few months. When questioned, the applicant said that his fiancé’s surgery was not really weighing on his mind but that he had limited functioning ability and felt his life was falling apart. The applicant said he did not go to hospital to see his fiancé because of his anxiety.
The applicant was questioned about his visit to Dr Ranasinghe-Markus who he saw when Dr Quittner was not available. He agreed that he had spoken to her about his problems with his fiancé and his father and had told her that he was taking anti-depressants at the time. He also said that he would have told her about the problems he was experiencing at work, although he said that she had not noted them specifically in her contemporaneous short notes.
On 23 July 2018, the applicant said that he had visited Dr Quittner and he had told him about his fiancé’s surgery, but he said that he had just used this as an excuse to get out of work and disagreed with Dr Quittner’s note that he had said that he was stressed about his fiancé’s surgery.
The applicant gave evidence that he had seen Dr Ingram on 30 July 2018, and he had told Dr Ingram about his back pain that had caused him stress. He had also talked about his relationship issues, his father’s diagnosis of multiple sclerosis, his fiancé’s surgery and the various financial pressures that he was facing. The applicant agreed with Dr Ingram’s note about his panic attacks, which were said to be “largely related to work” but also occurred on the weekend.
The applicant also agreed that he had seen Ms Abelson but he felt that she did not listen. Ms Abelson gave a report where she suggested the applicant make a claim under work cover for his anxiety. Again, the applicant said that although he had discussed all of the various issues related to his family, fiancé and various other extraneous non-work related factors in his life, it really had not affected his mental state and his problems had really commenced when he started working for NAB.
The applicant said that the date of his mental breakdown was 5 June 2018. He agreed that he had not had any abusive customer calls that day and that just the effect of being in the call centre was enough to cause the break down.
When taken under cross-examination to the reports of Dr McDonald and Dr Cocks, the applicant said that although he had told them the various things noted, he did not agree with the way in which those matters had been written and that essentially he had used issues such as his fiancé’s and father’s health as an excuse not to go to work.
Mr Pete Potiger’s evidence
Mr Potiger gave evidence to the Tribunal that he was a mental health social worker and that he had regularly seen the applicant over the past two years.
Mr Potiger said that, in his opinion, the applicant’s mental health issues and stress factors related to his employment at NAB. He said the applicant now suffers from severe social anxiety and depression. He said that as a result of no longer being able to work, the applicant was on a disability insurance benefit and suffering from financial stress.
When asked for his opinion as to the applicant’s mental health and stress factors, Mr Potiger said that the applicant had been stressed by his employment at NAB and could not return. He said he now suffered from severe social anxiety, depression and financial stress. In his statement to the Tribunal dated 17 April 2020, Mr Potiger noted:
[The applicant] states that his ability to manage the severe psychosocial stressor of receiving abusive phone calls had declined progressively. His emotional resilience had decreased and he increasingly became severely defensively aroused by the triggering phone calls he had received, to the point where he could not calm himself down anymore after such calls and he had to leave work. He describes this as “fleeing”.
Mr Potiger said that the applicant was emotional when he leaves home and his psychosocial functioning has not improved over time. Mr Potiger considered the applicant’s treatment to date had not been very effective and that he had not seen any lift in the applicant’s depression. He said that the applicant is now unable to work, which he attributes as directly referable to the repeated abusive phone calls from NAB customers in the course of the applicant’s employment with NAB.
I note that Mr Potiger is not a qualified medical practitioner or psychiatrist and that his expertise is more based on counselling, including CBT and assistance to his patients.
When cross-examined, Mr Potiger said that he had largely been using CBT to treat the applicant and, in his statement dated 17 April 2020, he said that he had participated in some 29 CBT treatment sessions.

When questioned about the accuracy of his notes, Mr Potiger said that his notes were not a complete recording but were just an ‘aide-mémoire’.
I note that the respondent questioned Mr Potiger’s independence on the basis of a call he had made to the Tribunal on 26 August 2020 where he had asked the Tribunal if there were any further documents or evidence he should submit on the applicant’s behalf. I do not accept that contention. I find Mr Potiger to be an honest witness.
Ms Jessica Thorley’s evidence
Ms Thorley gave evidence that she commenced worked at NAB in November 2012 and in around October 2016 she started working as a team leader until 2020. She affirmed her statement dated 31 January 2020.
Ms Thorley described herself as having a good professional relationship with the applicant and said that their conversations were honest and open. She described the applicant as a “high achiever” who “really wanted to do well and go places” and she said that the applicant was given a Customer Experience Award on 21 June 2018 in light of his achievements.
At the hearing, Ms Thorley said that the best way to describe the applicant was someone who was “very sensitive”. She said he was very open and shared a great deal of information, even in coaching sessions. She said he was easy to work with and someone she could trust.
Ms Thorley said that during the course of the applicant’s employment at NAB on a number of occasions he would discuss non-work related things, such as things that were exciting to him including buying a new car and proposing to his girlfriend as well as problems he was facing in his personal life, such as issues with his fiancé and his father. Particularly, for instance, he did this in their discussion on 29 June 2018. She recalled the applicant raising issues around his fiancé’s miscarriage and issues he was having with her.
Ms Thorley recalled the applicant requesting a new role on 1 June 2018. Ms Thorley said that he had emailed her seeking to discuss his career path because he felt that he had outgrown his current role and wanted to progress to a back-end role that was not customer facing. She said, however, that she did not recall the applicant raising concerns regarding aggressive customers with her prior to 29 June 2018.
Ms Thorley noted that she routinely offered the applicant additional support, but that this had been denied on a number of occasions. She said in her statement that she “was therefore surprised to learn that he reported in his workers compensation claim that he had been adversely affected by abusive customers”.
Ms Thorley gave evidence as to the procedure at NAB call centres whereby particularly aggressive and unpleasant calls were escalated within the call centre. Ms Thorley said that there would be daily escalations of aggressive calls from the customer service officers to the team leaders, and the team leaders such as herself would divide those escalated calls equally. Ms Thorley said that she regularly listened to calls of her team members during her role but said that the applicant did not stand out to her as someone who often had to escalate calls or took many aggressive calls.
Ms Thorley said that she was aware that the applicant had been injured at his previous place of employment and he had told her his desk was exacerbating his back injury. Ms Thorley said that NAB had gone to a lot of effort to try to assist him by ensuring that he had an ergonomic chair and that his workstation was appropriately set up. She said that he would often leave work early due to back pain and in about November or December 2017 he had taken three months’ off work due to his back pain. Under cross-examination, Ms Thorley said that she had heard about the applicant making a workers compensation with NAB for his back injury. However, she confirmed that she was not aware of any objective evidence that the applicant had actually raised this claim with NAB.
I find Ms Thorley to be a credible and honest witness, although she had some limited recollection of time spent managing the applicant because of the exigencies in her job at NAB, the busy schedule she had at the time and the number of people she needed to manage.
Evidence of Dr Chris Cocks
Dr Chris Cocks gave evidence that he was a forensic psychiatrist admitted in 2013 and that he had started to practice in 2014. He confirmed that he had prepared a report at the respondent’s request dated 18 February 2020 based on an assessment of the applicant.
Dr Cocks confirmed the diagnosis made in that report and said he had no corrections to make to it. He noted that the applicant had suffered from a Vitamin D deficiency in 2017 and he was diagnosed with sleep apnoea. He did not believe that either of those issues were a factor which was relevant to his current opinion, although he noted that sleep apnoea was one of a number of factors that could contribute to mental illness.
When questioned by the applicant, Dr Cocks said that the applicant’s history had been taken into account in arriving at his diagnosis, including the applicant’s work at NAB and other pre-existing and predisposing factors.
When questioned by the applicant as to the problems with his back that he had suffered whilst at the NAB, Dr Cocks acknowledged the problems that the applicant had experienced and said that those problems had been dealt with by his employer and the applicant had been able to return to work.
Dr Cocks referred particularly to the report of Dr Ingram dated 30 July 2018 and noted that whilst the applicant said that work was the cause of all of his problems, Dr Ingram gave a very different account. Dr Cocks said that this report was particularly important because it shows that at that time the applicant relayed to his treating psychiatrist that non-work factors were really affecting him. Dr Cocks said it was a very important factor in coming to a diagnosis that when the applicant saw Dr Ingram he focused on non-work stressors, whereas when he saw Dr Cocks he focused on his difficulties at NAB and minimised the impact of any non-work stressors.
Dr Cocks said that the extensive non-work stressors would have resulted in the exacerbation of the applicant’s psychological condition that were present in 2017 and 2018. He said as follows:
[The applicant’s] condition continues to be exacerbated by ongoing non-work related stressors. Specifically, the breakdown of his relationship with his fiancée and the subsequent development of marijuana dependency have perpetuated his condition. Therefore, in my opinion, there are significant pre-existing and non-work related factors that are contributing to the onset of his condition and its perpetuation.
THE JUDGMENT
The first issue to be determined by the Tribunal is whether the applicant suffered an ailment, or aggravation of an ailment, within the terms of section 5B of the SRC Act and, if so, the date at which the applicant sustained this. The second issue for determination is then whether this was contributed to, to a significant degree, by the applicant’s employment with the respondent so as to entitle the applicant to compensation under section 14 of the SRC Act.
I have previously set out in detail a chronology of the applicant’s history, including his medical history, to provide context for understanding the development and progress of the applicant’s medical condition(s).
What was the psychological condition and at what date was this sustained?
The applicant claims that he developed “anxiety disorder, panic attacks, agoraphobia” which he said he first noticed on 5 June 2018 and attributed to abusive telephone calls with customers he liaised with in his role within the Direct Consumer Servicing Unit.
The respondent accepted that the applicant has a psychological condition, however, believes this to be MDD, as diagnosed by Dr Ingram and Dr Cocks. Ms Abelson, former treating psychologist, also suggested that the applicant had depression. MDD was also among the diagnoses of Northside Cremorne Clinic.
In this case the injury claimed is a mental illness, which was first diagnosed in or about November 2017. The diagnosis of depression and anxiety first came about in the context of the applicant suffering chronic back pain. I find the circumstances which led to his back pain at NAB together with his mental health issues are as follows.
Prior to this period of employment with NAB, the applicant had worked for a marine engineering company. He had suffered a back injury whilst working as a marine mechanic but said that it did not affect his work at the time. He left his previous employer to work at NAB as he wanted to change his career direction. The applicant commenced work with NAB on 2 February 2017 as a Contact Centre Service Provider.
In September 2017, the applicant sought assistance for severe lumbar back pain. At the time he was struggling with obesity and he had experienced a dramatic weight gain when he moved from his former job to a more sedentary occupation at NAB. The applicant had struggled with severe back pain for a long time since teenage years, which he told Dr Quittner was in part due to playing rugby union football.
Dr Raoul Pope, neurosurgeon and spine surgeon, completed a medical report dated 6 November 2017 which notes that the applicant was struggling with lower back pain over period of six months in 2017. In the letter Dr Pope states, “symptoms have plateaued and he is not coping”.
Dr Ingram also noted in her report that the applicant had Cortisone injections for his back pain. She noted that the applicant developed back pain in the twelve months prior to his assessment in June 2018 and that there was an association between the applicant’s back pain and the deterioration of his mood in November 2017.
The applicant’s GP, Dr Quittner, prescribed antidepressants for the applicant in December 2017.
The applicant did not make a workers compensations claim in relation to his back injury but had rather worked with NAB to resolve the issues. Indeed, the evidence would indicate that NAB spent time and effort assisting the applicant to overcome and address the applicant’s and his physiotherapist’s concerns with the applicant’s back pain and to ensure that there was no exacerbation of his condition so that he could continue to work. The applicant had a meeting at work with an ergonomics specialist to arrange a return to work program, including the correct set up of his workspace and a chair to accommodate his physiotherapist’s instructions. The applicant said he could not walk more than 50 meters, could not stand longer than three minutes and could not sit in the chairs at work for probably more than two hours. NAB organised disabled parking and workplace changes, worked with him to move his seat closer to the lifts and worked with an ergonomics specialist to try and remedy the aggravation that his working environment was having on his back pain.
In Dr Cock’s expert opinion, which I accept, the applicant’s chronic back pain in November 2017 exacerbated an underlying depressive illness which included symptoms of anxiety and panic and that illness was further exacerbated over the course of 2018 and beyond by a range of stressors, which were primarily non-work related over the course of 2018 and 2019.
These stressors were extensively documented by a number of medical practitioners seen by the applicant over this period, including Dr Quittner, Dr Ingram and Dr McDonald.
On 25 September 2017, the applicant attended his GP Dr George Quittner with severe lumbar back pain and afterwards saw a pain specialist, rheumatologist and neurosurgeon and spine surgeon. Dr Ranasinghe-Markus, a colleague of Dr Quittner’s, noted in September 2018 that the applicant had been taking anti-depressants for a year. The applicant was prescribed the antidepressant Endep on 12 December 2017.
The evidence of both Dr Ingram and Dr Cocks is that the applicant was suffering from a major depressive illness from around November 2017. The medical evidence also states that the applicant had a number of pre-existing non-related work issues that were relevant to the onset of his MDD, which in their professional opinion, first emerged in late 2017 and continued from that time until the present.
Both Dr Ingram and Dr Cocks outline in their reports that the applicant had an impaired attachment to his mother, that he struggled socially and academically throughout his High School years, that he had a past abusive relationship with a previous partner and that he had a difficult relationship with his father. Dr McDonald also identified similar factors in his report.
Dr Ingram also identified the applicant’s genetic vulnerability to stressors. Dr Ingram said that the applicant has a family history of psychiatric illness on the maternal side and identified that his history of early parental separation and bullying would also have been factors in his development of a mood disorder.
The applicant also had obstructive sleep anomia, which Dr Cocks said is: “known to be associated with depression and anxiety and chronic sleep deprivation”.
Dr Alan Nazha in a letter dated 17 January 2018 wrote about the applicant’s psychometric test scores as follows:
Absent for anxiety and positive for moderate depression and moderate stress on the DASS21 6, 20, 20.
In a letter dated 7 November 2018, Dr Omar Marwart, psychiatrist, noted that:
[The applicant] reported that his depression commenced in September 2017 and he first received treatment in December 2017. He gradually returned to work in January 2018 as his mood and back pain were slowly improving (but not remitted). In June 2018 [the applicant] first developed anxiety symptoms in response to abrasive customers at the call centre (he had dealt with abrasive and abusive customers in the past with no significant problems). From that time, he has experienced his aforementioned anxiety symptoms.
Dr Ingram’s diagnosis was that the applicant’s panic attacks both at work and outside of work are properly explained by the depressive illness he was suffering throughout 2018. Dr Cocks also said that the applicant’s abuse of benzodiazepine contributed to his panic attacks. Dr Cocks refers in particular to Dr Ingram’s report of the applicant taking up to 10 milligrams of Lorazepam (benzodiazepine) at a music festival and then experiencing anxiety on his return to work. In Dr Cock’s opinion, the anxiety may reflect his withdrawal from benzodiazepine. Furthermore, Dr Cocks thought the anxiety attacks were explained by another disorder, namely his depressive disorder, rather than the applicant meeting the diagnostic criteria for panic disorder. I note that Dr Cocks was of the opinion that the applicant also suffered from marijuana use disorder.
As Dr Cocks said in the report in relation to the applicant’s medical condition:
An important differential diagnosis to consider in [the applicant’s] case is Panic Disorder. A Panic Disorder is defined as recurrent, unexpected panic attacks. The term ‘unexpected’ is important as this refers to the panic attacks as coming on without any known situational precipitants. In [the applicant’s] case he experienced episodic panic attacks in response to known precipitants – aggressive phone calls from customers and exposure to crowded places (Kirribilli Markets / a music festival). Individuals with other mental disorders can experience panic attacks. What differentiates this from a Panic Disorder is that the response is expected when a person is exposed to their feared situation. The DSM-5 specifies this under the diagnosis of Panic Disorder at point D stating;
“The disturbance is not better explained by another mental disorder.”
In my opinion, the panic attacks experienced by [the applicant] both within and outside of his employment at NAB in 2018, can be explained by another mental disorder. In my opinion the panic attacks he suffered are better explained by the depressive illness he was suffering in 2018. It is also plausible that [the applicant’s] abuse of benzodiazepine medication contributed to the reported panic attacks. I note Dr Ingram referred to [the applicant] requiring up to 10mg of Lorazepam (benzodiazepine) at a music festival and then experiencing anxiety on his return to work. This could reflect anxiety brought on by withdrawing from a benzodiazepine medication. In my opinion, [the applicant’s] reported anxiety attacks can better explained by another mental disorder (major depression and substance abuse) as opposed to meeting diagnostic criteria for Panic Disorder.
I find that there is clear and objective medical evidence which strongly supports a finding that the applicant’s illness was sustained in around November 2017 in the context of debilitating back pain and anxiety symptoms and that the illness was MDD.
Contribution of the applicant’s employment
In light of the evidence as to the date of commencement of the applicant’s condition, in order to uphold his claim the Tribunal must find that the development or aggravation of the applicant’s condition was to a significant degree caused by his work with NAB, rather than a situation whereby his employment was the scene in which his symptoms played out. In summary, the injury must have been contributed to, to a significant degree, by the applicant’s employment as a Contact Centre Service Advisor with NAB for the respondent to be liable for compensation under section 14 of the SRC Act.
There are a number of non-exhaustive factors set out in section 5B(2) of the SRC Act which the Tribunal may consider in determining whether an ailment or aggravation was contributed to, to a significant degree, by an employee’s employment. I have discussed the relevant issues within the context of the judgement overall.
I note that the applicant agreed that Dr Cock’s history was accurate, with the exception of some material related to weight gain, which is not particularly relevant.
During the course of 2018, the applicant detailed a number of very significant stress factors which he told his supervisor, Ms Thorley, were affecting his capacity to work. These stress factors included the following:
(a)his father’s diagnosis with multiple sclerosis;
(b)his partner’s upcoming weight surgery and the previous post-surgical complications;
(c)the medication he was taking for depression which made his vision blurry and affected his mind;
(d)his partner’s miscarriage; and
(e)financial difficulties.
These issues were referred to in Ms Thorley’s evidence. Both in her oral evidence and in her statement, Ms Thorley refers to the applicant as “honest and open”. Ms Thorley noted in her statement that customer concerns were not raised with her prior to 26 June 2018. I accept Ms Thorley’s evidence which is quite consistent with the applicant’s own evidence that he did not feel able to raise these issues.
The applicant gave evidence that at the time he had not raised his issues with aggressive customers with Ms Thorley or in the work environment because he was concerned about job stability. The applicant referred to NAB as “a revolving door”. Ms Thorley said that there was “nothing unusual about the number of people who came and went”. She felt that the applicant was a sensitive person and that he shared a great deal of personal information with her, and said she was “surprised” when she found out that he had raised a workers compensation claim against NAB for aggressive customer calls.
In her statement dated 31 January 2020, Ms Thorley said as follows:
After [the applicant] lodged his workers compensation claim and cited aggressive customer calls as contributing to his injury, I reviewed many of the last calls he had taken on the days he left work early. Aside from one occasion on 29 June 2018, [the applicant] had never raised having problems with any customer calls with me. I was therefore surprised to learn that he reported in his workers compensation claim that he had been adversely affected by abusive customers.
On 5 June 2018, the last call [the applicant] took was a home loan enquiry from a customer who was very friendly and calm throughout the call. The call had dropped out and he did not attempt to call the customer back - he just left work. [the applicant] also left work early on 9 June 2018 and the last call he took before he left was with a very friendly customer. When he left, he just said his inner thoughts were distracting him.
On 12 June 2018 [the applicant] told me he was completely fit to return to work and perform at his best. He did not tell me what if anything had changed. He declined my offer of additional support. In these conversations, I routinely offered him additional support, but if it was declined, I generally did not make a note of the declination.
On 15 June 2018 [the applicant] left work early. I do not think I was at work that day, but I checked his last call later and it was with a bubbly customer with whom he shared a laugh. I presume he did not speak to any of my peers about the reason he left early, as I suspect they would have told me when I was next in.
I found there were occasions when [the applicant] left work early after taking a pleasant customer call, which gave me the impression, in light of him often saying he was distracted by his thoughts, that there was something outside of work troubling him. [The applicant] opened up to me about his concerns for [his partner] who was undergoing weight loss surgery, and his father who had been diagnosed with multiple sclerosis.

Ms Thorley’s evidence is entirely consistent with the various medical reports. In particular, the applicant raised a number of other non-work related issues with his treating doctors at the time he sustained his psychological injury, which he said were causing him distress whilst problems he experienced with customers were predominately raised after he had lodged his workers compensation claim. I find his failure to raise work related concerns with his doctors to be significant as the doctors provided a safe environment for the applicant to discuss these problems without any threat to his ongoing employment.
Dr Ingram in her letter dated 30 July 2018 identifies a number of stressors impacting the applicant, including his father’s diagnosis with multiple sclerosis in April 2018, his fiancé’s medical issues and financial problems. In this report, Dr Ingram notes that the applicant has suffered from a number of panic attacks, which he said were “largely related to work, however, they also occurred at the weekend when he was at the Kirribilli markets”. Dr Ingram also said that the applicant reported stable psycho-social functioning until the back pain. In a further letter on 20 August 2018, Dr Ingram said the applicant’s anxiety did not improve and that he was using lorazepam most days for anxiety. No specific work-related issues for the applicant’s anxiety were noted.
Dr Ingram wrote a further letter on 30 September 2018, in which she noted that the applicant needed to use up to 10 milligrams of lorazepam at a music festival he attended on the weekend. Dr Ingram noted that the applicant’s anxiety was affecting his capacity to leave the home and that he developed anxiety about returning to work. In a letter dated 8 October 2018, Dr Ingram said that the applicant continued to experience anxiety and panic symptoms that are triggered by crowds and noise. She said that the applicant struggled to go to shopping centres like Woolworths.
On 19 September 2018, Ms Abelson wrote a report diagnosing the applicant as someone who suffers from panic disorder and agoraphobia. She identified a number of factors apart from work which may have contributed to the applicant’s mental health issues.
In December 2018, Dr McDonald diagnosed the applicant as meeting criteria for an exacerbation of chronic adjustment disorder with depressed or anxious mood. Dr McDonald noted multiple factors contributing to the applicant’s condition and its recent exacerbation which were not related to his work. In particular, Dr McDonald identified the applicant’s long-term back pain and the poor relationship he had with his former employer, financial stress, the applicant’s fiancé’s miscarriage, the applicant’s father’s diagnosis with multiple sclerosis in 2018, his fiancé’s multiple operations and post-operative complications, his use of sedatives and interpersonal problems with his fiancé and her extended family.
As previously indicated, I place considerable weight on the fact that the applicant did not tell his employer that problems with aggressive customers were causing him to miss work and were the cause of his anxiety and depression, and that he also did not present this issue as the major cause of his underlying mental health issues when discussing his problems with his treating doctors at the time he sustained his injury.
Although Mr Potiger gave evidence that, in his opinion, the applicant’s problems were all or significantly caused by his employment at NAB, Mr Potiger did not start seeing the applicant until December 2018 after which time the applicant had already lodged his workers compensation claim. By this time, the applicant had, in my opinion, become very focused on his time at NAB whilst diminishing the other stressors that he had talked about at length with his treating doctors.
In considering the factors set out in section 5B(2) of the SRC Act, it is relevant that the applicant’s employment with NAB was relatively short and moreover he had periods of absence during this employment. The manifestation/onset of his psychological condition started soon after he commenced his employment with NAB in approximately November 2017 and he effectively stopped attending work some 10 months later in August 2018. There is no evidence before the Tribunal that the duration of the applicant’s employment had a bearing on his injury: section 5B(2)(a) of the SRC Act.
In considering section 5B(2)(b), the nature of the applicant’s tasks during the course of his employment were described by both Ms Thorley and the applicant in their evidence set out in the judgement. Although the applicant clearly did have dealings with difficult and angry customers and may have seen himself as a “punching bag” for NAB, I note that Ms Thorley gave evidence that from her experience the applicant did not have a particularly heavy exposure to difficult or aggressive customers as opposed to others in the team, that difficult calls could be “escalated” to the team leader and that there were chances to discuss issues arising with her or in debriefing. Ms Thorley had not noted any particular problems the applicant was having with his job in handling aggressive customers in her contemporaneous notes on 1, 5, 9, 12, 15 and 20 June 2018 but rather had noted that the applicant said personal events outside work were affecting his work and distracting him, rather than the aggressive customer calls and the nature of his role.
Furthermore, the applicant had a number of predisposing factors which I have also set out in the context of the medical reports. This is something I may consider under section 5B(2)(c) of the SRC Act in determining the extent to which the employee’s employment contributed to, to a significant degree to his mental health issues and the other factors impacting the development or aggravation of the applicant’s condition. Dr Cocks, Dr McDonald, Dr Ingram and Ms Abelson indicated there were several predisposing factors to the applicant’s mental health condition. For instance, the applicant told Dr Ingram that his mother probably has bipolar disorder and certainly had issues with depression and alcohol use disorder, he said his parents separated when he was young and he ceased contact with his mother when he was 18 as she was drinking and verbally abusive. He was subjected to bullying in Years seven to nine and in Year 11 he dropped out of school. Dr Ingram concluded that the applicant had a genetic vulnerability to mood disorders and the applicant’s abuse from his mother and bullying would have also increased his vulnerability.
It is also relevant in considering the matters in section 5B(2)(d) and section 5B(2)(e) of the SRC Act that there were a number of issues which affected the applicant’s health that were unrelated to his employment. At the risk of repetition, as discussed earlier in the context of the various medical experts’ evidence and that of Ms Thorley, these non-work related stressors included family issues, problems with medication, pain, other medical issues, the problems with his former fiancé and drug taking, amongst other things. I find these non-work stressors were the primary factors which affected the progress of the applicant’s mental health issues and that although his employment may also have had some effect, it was not a significant contributing factor to the development or aggravation of the applicant’s condition as required by the legislation.
Having considered all of the evidence as outlined above, I find that there were a number of significant pre-existing and predisposing factors that resulted in the applicant’s MDD and anxiety symptoms being sustained and treated in around November 2017. I am not satisfied that the applicant’s employment with NAB contributed, to a significant degree, to the claimed condition as required by section 5B of the SRC Act. In particular, the reports of Dr Ingram around the time the applicant developed his psychological condition focused on significant non-work related factors as causative of the applicant’s condition, rather than work-related issues. This is in line with Ms Thorley’s evidence and the diagnosis of Dr Cocks.
DECISION
The correct or preferable decision is to affirm the reviewable decision of the respondent dated 7 February 2019.

I certify that the preceding 155 (one hundred and fifty-five) paragraphs are a true copy of the reasons for the decision herein of The Hon. John Pascoe AC CVO, Deputy President

..................................[sgd]......................................
Associate
Dated: 25 September 2020

Dates of hearing: 9 and 10 September 2020

Applicant: In person (by video conference)

Respondent’s representative:
Ms A Bortone, Sparke Helmore Lawyers

Dates of hearing:	9 and 10 September 2020
Applicant:	In person (by video conference)
Respondent’s representative:	Ms A Bortone, Sparke Helmore Lawyers