Ross Kennedy and Comcare

Case [2015] AATA 334


[2015] AATA 334  

Division GENERAL ADMINISTRATIVE DIVISION

File Numbers

2012/5878; 2013/0026

Re

Ross Kennedy

APPLICANT

And

Comcare

RESPONDENT

DECISION

Tribunal

Deputy President PE Hack SC

Date 18 May 2015  
Place Canberra

In each application the decision under review is affirmed.

...................[Sgd]....................................................

Deputy President PE Hack SC

CATCHWORDS

COMPENSATION – definition of “injury” – “connected with his or her employment” – terms of representations – whether wilful and false – adjustment disorder with depression and anxiety – failure to disclose previous psychiatric history – representations knowingly false – decisions under review affirmed.

LEGISLATION

Safety, Compensation and Rehabilitation Act 1988 (Cth), ss 5A, 5B, 7(7), 14

CASES

Inco Ships Pty Ltd v Hardman (2007) 167 FCR 294; [2007] FCA 1138

Comcare v Porter (1996) 70 FCR 139

National Australia Bank v Georgoulas (2013) 217 FCR 382; [2013] FCA 1412

REASONS FOR DECISION

Deputy President PE Hack SC
18 May 2015

Introduction

  1. Mr Ross Kennedy was, at all material times, employed by the Commonwealth Department of Industry, Innovation, Science, Research and Tertiary Education. In March 2012 he lodged claims with Comcare for compensation pursuant to the Safety, Compensation and Rehabilitation Act 1988 (Cth) for a condition he described as adjustment disorder with depression and anxiety,[1] first experienced in March/April 2011 and experienced again in November 2011.

    [1]Section 37 documents, pages 46 and 60.

  2. The claims were refused by Comcare in July 2012 and those decisions were affirmed on reconsideration by reviewable decisions made on 21 November 2012. Mr Kennedy has sought a review by the Tribunal of those decisions.

  3. Comcare refused the claims, and contends its decisions ought be affirmed, on the basis that Mr Kennedy’s condition does not satisfy the definition of “injury” in the Act. It also contends that the claims are defeated by operation of s 7(7) of the Act because, it alleges, Mr Kennedy made wilful and false representations that he did not suffer from, or had not previously suffered from, the disease which Mr Kennedy claims constitutes his injury.

  4. On 3 February 2015 the Tribunal, constituted by Senior Member McCabe, directed that the application of s 7(7) of the Act be determined at a preliminary hearing. For the reasons that follow I have concluded that Comcare’s contention is correct and that the reviewable decisions ought be affirmed.

    The legislative setting

  5. By virtue of s 14 of the Act Comcare is liable to pay compensation in accordance with the Act in respect of an “injury” suffered by an employee if the injury results in death, incapacity for work or impairment. The term “injury” is defined by s 5A(1) of the Act to encompass (a) a disease suffered by an employee and (b) an injury (other than a disease) suffered by an employee arising out of, or in the course of, the employee’s employment. There is an exception, however its terms are not relevant to the present application. The term “disease” is defined by s 5B(1) of the Act to mean an ailment suffered by an employee,…

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AGLC
Ross Kennedy and Comcare [2015] AATA 334
Case
[2015] AATA 334
Decision Date

CaseChat Overview and Summary

Ross Kennedy brought claims against Comcare for compensation under the Public Sector Superannuation (Commonwealth Employees) Act 1991. Kennedy argued that he suffered from adjustment disorder with depression and anxiety, which he claimed was connected with his employment. Comcare contested the claims, asserting that Kennedy had wilfully and falsely represented that he had not previously suffered from depression, which would disqualify him from compensation under the Act. The court was required to determine whether Kennedy's representations were indeed wilful and false and if his ailment was an injury as defined in the Act.

The court examined the representations Kennedy made in medical assessments in October 2005 and February 2008, where he denied having any history of depression. Given that Kennedy had seen a doctor only months before the October 2005 assessment, the court concluded that his answer was wilfully false. It was also deemed impossible that Kennedy overlooked his extensive psychiatric history when he answered the same question in February 2008. The court found that Kennedy had made false representations for purposes connected with his employment, which led to the conclusion that his ailment was not an injury under the Act.

Based on the medical evidence, the court determined that Kennedy's ailment was best described as major depressive disorder rather than adjustment disorder. Dr Zsadanyi's revised diagnosis, after being informed of Kennedy's psychiatric history, aligned with Dr Knox's opinion of a long-term pattern of depression. The court found no distinction between depression and depressive disorder for the purposes of the Act. Consequently, Kennedy's ailment did not qualify as an injury under the Act, and Comcare was not liable to pay compensation. The decisions under review were affirmed, dismissing Kennedy's claims.

Orders

Orders of the court

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Background

Background to the litigation

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Evidence

Evidence Before The Court

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Decision

Reasons for decision

It remains to consider the representations in the medical assessments of October 2005 and February 2008. On each occasion he answered “no” to the question whether he had, or had ever had, depression. Given that he had seen Dr Horgan again in only May 2005 the answer in October 2005 cannot be other than wilfully false. And it is impossible to accept that Mr Kennedy may have overlooked his long history of depression when he came to answer the same question in February 2008.Conclusions I am then satisfied that on each of the occasions identified by Comcare Mr Kennedy, for purposes connected with his employment or proposed employment by the Commonwealth, made a wilful and false representation that he had not previously suffered from depression. Whilst his claims are expressed to be for adjustment disorder with depression and anxiety, the better view of the medical evidence is that the ailment that afflicted him was depression. Initially, Dr Zsadanyi, uninformed by Mr Kennedy’s extensive psychiatric history, concluded that Mr Kennedy suffered from adjustment disorder with depressed mood. Having been informed of Mr Kennedy’s history, Dr Zsadanyi, in his November 2014 report, concluded that the appropriate diagnosis was major depressive disorder. That diagnosis accords with that of Dr Knox who also spoke of a “long-term pattern of depression”.[25][25] Exhibit 14, page 2. There is no relevant distinction to be drawn for present purposes between depression and depressive disorder. The consequence is that s 7(7) of the Act operates to deem Mr Kennedy’s ailment not to be an injury as that term is defined in the Act with the further consequence that Comcare is not liable to pay Mr Kennedy compensation in respect of his ailment. It follows that, in each application, the decision under review ought be affirmed.

Ratio Decidendi

Legal Principle Established

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