Re Sat and Comcare

Case [2004] AATA 334


Administrative

Appeals

Tribunal

 

DECISION AND REASONS FOR DECISION [2004] AATA 334

ADMINISTRATIVE APPEALS TRIBUNAL      )

)          No S2002/394

GENERAL ADMINISTRATIVE DIVISION )
Re SAT

Applicant

And

COMCARE

Respondent

DECISION

Tribunal Deputy President Jarvis and Dr Eriksen, Member

Date29 March 2004

PlaceAdelaide

Decision

The Tribunal:

1.        sets aside the decision under review and in substitution therefor decides that the applicant has a permanent impairment in respect of her psychiatric conditions of 25%;

2.        reserves liberty to apply within 14 days in relation to the costs of the proceedings; and

3.        orders that in the absence of any such application, the respondent pay the costs of the proceedings.

D.G. Jarvis
  (Signed)

Deputy President

CATCHWORDS

COMPENSATION – degree of permanent impairment – acute depression – meaning of “activities of daily living” in the Guide – meaning of “need for some supervision and direction” in activities of daily living – assessment of 25% permanent impairment under Table 5.1 of the Guide – reviewable decision set aside.

Safety, Rehabilitation and Compensation Act 1988, s 24, s 25 and s 28

Guide to the Assessment of the Degree of Permanent Impairment, Table 5.1

Re Emery and Comcare (1992) 15 AAR 477

Commission for the Safety, Rehabilitation and Compensation of Commonwealth Employees v Emery (1993) 32 ALD 147

Re Langston and Comcare (2000) 64 ALD 449

REASONS FOR DECISION

29 March 2004 Deputy President Jarvis and Dr Eriksen, Member

Introduction

1.      The present matter has its origins in a claim made by the applicant in 1991 for a physical injury to both elbows and hands arising from her employment.  Liability was accepted.  Some five years later, on 1 July 1996, Comcare determined that liability was extended to include two psychiatric conditions, namely a depressive illness and adjustment disorder.  On 10 January 1997 Comcare determined that the applicant suffered permanent impairment as a result of her employment related physical injuries and that the degree of that permanent impairment was 19%.

2.      In a later decision dated 7 September 2000 Comcare determined that there was no liability to pay compensation in respect of further permanent impairment in respect of the applicant’s psychiatric conditions, because the conditions were not permanent, she had not undertaken all reasonable rehabilitative treatment, and she had not gained a further 10% increase in her level of permanent impairment, as assessed under the Guide to the Assessment of the Degrees of Permanent Impairment (the “Guide”).  A review officer affirmed this determination on 21 October 2002.  The applicant has applied to this Tribunal for review of this reviewable decision.

3. Mr M Roder appeared for the applicant and Mr A Possingham appeared for the respondent. Oral evidence was given by the applicant and Dr Marcia Fogarty in support of the applicant’s claim, and the respondent called Dr Andris Kalnins to give oral evidence. In addition, the Tribunal received the documents lodged pursuant to s 37 of the Administrative Appeals Tribunal Act 1975 (the “T Documents”), and a number of other documents. After the…

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Details
AGLC
Re Sat and Comcare [2004] AATA 334
Case
[2004] AATA 334
Decision Date

CaseChat Overview and Summary

Re Sat and Comcare involved an applicant, Ms Sat, contesting the determination of her degree of permanent impairment by Comcare, the respondent. The dispute centred around the extent of impairment due to her psychiatric conditions, specifically acute depression, and its impact on her activities of daily living as per the Guide to the Assessment of the Degree of Permanent Impairment. The Administrative Appeals Tribunal (AAT) was tasked with reviewing Comcare’s assessment, which concluded a lower degree of impairment than what Ms Sat claimed.

The central legal issues before the Tribunal were the interpretation and application of specific terms in the Guide, such as "activities of daily living" and "need for some supervision and direction." The Tribunal had to determine whether the applicant's psychiatric conditions warranted a higher degree of permanent impairment, specifically 25%, as claimed, rather than the 10% assessed by Comcare. This involved an analysis of the medical evidence provided, Ms Sat's capacity to perform daily activities independently, and whether the need for supervision and direction in certain circumstances justified a higher impairment rating.

The Tribunal found that the decision by Comcare to assess Ms Sat’s permanent impairment at 10% was flawed. It held that the Tribunal had the authority to review and set aside the decision based on the evidence presented. The Tribunal concluded that Ms Sat’s psychiatric conditions did indeed affect her ability to carry out activities of daily living, necessitating a degree of supervision and direction, thus justifying the higher impairment rating of 25%. The Tribunal’s interpretation of the Guide and the medical evidence supported the applicant's claim, leading to the decision to set aside Comcare's assessment and substitute it with the Tribunal’s own determination.

In light of the Tribunal’s findings, the decision under review was set aside, and Ms Sat was awarded a 25% permanent impairment rating for her psychiatric conditions. The Tribunal reserved the right to consider costs within 14 days, with an order that if no application for costs was made, Comcare would bear the costs of the proceedings. This decision underscored the importance of a comprehensive assessment of psychiatric impairments and the Tribunal's role in ensuring that such assessments align with the statutory guidelines and evidence provided.

Orders

Orders of the court

The Tribunal:

1. sets aside the decision under review and in substitution therefor decides that the applicant has a permanent impairment in respect of her psychiatric conditions of 25%;

2. reserves liberty to apply within 14 days in relation to the costs of the proceedings; and

3. orders that in the absence of any such application, the respondent pay the costs of the proceedings.

Background

Background to the litigation

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Evidence

Evidence Before The Court

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Decision

Reasons for decision

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Ratio Decidendi

Legal Principle Established

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