Rounsevell and Comcare

Administrative

Appeals

Tribunal

 

DECISION AND REASONS FOR DECISION [2004] AATA 918

ADMINISTRATIVE APPEALS TRIBUNAL      )

)          No N2003/1558

GENERAL ADMINISTRATIVE  DIVISION		)
Re		FRANK ROUNSEVELL

Applicant

And COMCARE

Respondent

DECISION

Tribunal Mr S. Webb, Member

Date9 August 2004

PlaceSydney

Decision For the reasons given orally at the hearing in this matter, the decision under review is affirmed.

..............................................

Mr S. Webb   Member

13.     The Merck Manual (17^th edition) lists the following risk factors in relation to open angle glaucoma (T89 folio 147):

“Table 100-2.  Risk factors for Primary Open-Angle Glaucoma

Elevated intraocular pressure

Older age

Family history

Black race

Diabetes

Hypertension

Myopia

Use of cortico-steroids”

14.     I understand that Mr Rounsevell, in consideration of that and other similar lists, excludes all but hypertension as relevant in his case.  However, such an approach, while perhaps understandable from a layman’s perspective, has no medical basis.  Plainly, on the evidence hypertension is but one of a number of possible risk factors that may be operative in the causation of open angle glaucoma.  However, Dr Delaney’s evidence is compelling.  His evidence was that other factors than those listed above, such as genetic or anatomic factors, may play a role in the causation of open angle glaucoma.  He stated that 2 percent of the population over 60 years of age suffer from glaucoma, many of whom do not exhibit any of the known risk factors.  The question of causation of glaucoma remains open and is an inquiry for medical science.  As Dr Delaney observed, there are many people with hypertension that do not suffer from glaucoma and there are others who suffer from glaucoma without apparent cause.  His evidence was that there is no specific test to ascertain whether hypertension is the operative factor in any case.

15.     It follows that relying on lists of risk factors that are published in documents such as those in evidence before me is an exercise of possibilities that is fraught with risk and should not be relied upon.

16.     Dr Delaney gave evidence that age was likely to be an operative factor in Mr Rounsevell’s case.  I note that he was first diagnosed with open angle glaucoma at the age of 61, which is well past the notional 50 year risk threshold for glaucoma that is listed in the “WebMd Medical Reference” (Exhibit A1, Attachment 6).  Plainly, Dr Delaney’s evidence does not exclude hypertension as a possible factor in the causation of Mr Rounsevell’s glaucoma.  Nor does the likelihood that age is an operative factor extinguish Mr Rounsevell’s claim.  In the case of Treloar v Australian Telecommunications Commission (1990) 26 FCR 316, the Full Federal Court said at 323:

“…the section [s.4 definition of “disease”] is not brought into play unless it be established by evidence that features of the employment did in fact and in truth contribute to the condition complained of.  The causal connection must be established on the probabilities and not left in the area of possibility or conjecture.…