Salkeld and Repatriation Commission
[2007] AATA 1482
•28 June 2007
Administrative Appeals Tribunal
DECISION AND REASONS FOR DECISION [2007] AATA 1482
ADMINISTRATIVE APPEALS TRIBUNAL )
) No Q2006/285
VETERANS’ APPEALS DIVISION )
Re PETER SALKELD Applicant
And
REPATRIATION COMMISSION
Respondent
DECISION
Tribunal
Mr RG Kenny, Member
Date 28 June 2007
Place Brisbane
Decision
The Tribunal affirms the decision under review.
...................[Sgd]...........................
RG Kenny
Member
CATCHWORDS
VETERANS’ AFFAIRS – disability pension – operational service with Royal Australian Navy – application of Statements of Principles – appropriate diagnosis of psychiatric conditions – generalised anxiety disorder diagnosed – relevance of claustrophobia to development of anxiety disorder – whether claustrophobia a clinically significant psychiatric condition – effects of detonation of scare charges – severe psychosocial stressor – no clinical onset of anxiety disorder within two years – reasonable hypothesis of relevant relationship to service not raised – anxiety disorder not war-caused – decision affirmed
Veterans’ Entitlements Act 1986 (Cth) ss 6A, 7, 9, 14, 69, 120, 120A
Repatriation Commission v Smith (1987) 15 FCR 327
Benjamin v Repatriation Commission (2001) 70 ALD 622
Fogarty v Repatriation Commission (2003) 37 AAR 363
Repatriation Commission v Deledio (1998) 83 FCR 82
Bushell v Repatriation Commission (1992) 175 CLR 408
Byrnes v Repatriation Commission (1993) 177 CLR 564
White v Repatriation Commission [2004] FCA 633
Re Robertson and Repatriation Commission (1998) 50 ALD 668
Repatriation Commission v Cornelius [2002] FCA 750
Lees v Repatriation Commission (2002) 125 FCR 331
Youngnickel v Repatriation Commission [2004] FCA 1691
Hardman v Repatriation Commission [2004] FCA 1174REASONS FOR DECISION
28 June 2007
Mr RG Kenny, Member
Background
1. Peter Salkeld (the applicant) served in the Royal Australian Navy (the RAN) from 25 July 1964 until 24 July 1976. On 12 July 2005, he lodged with the Repatriation Commission (the respondent), in accordance with s 14 of the Veterans’ Entitlements Act 1986 (the Act), a claim for a disability pension for “psychological disorder” which he contended was related to his RAN service. On 29 September 2005, the respondent accepted that Mr Salkeld suffered from anxiety disorder but determined that the condition was not related to his service. On 14 March 2006, the Veterans’ Review Board (the Board) affirmed the decision and Mr Salkeld now seeks review of the Board’s decision by the Administrative Appeals Tribunal (the Tribunal).
Service and Standard of Proof
2. During his RAN service, Mr Salkeld rendered eligible war service in the form of operational service, as provided for in ss 7 and 6A, respectively, of the Act as follows:
from 24 February 1965 until 7 April 1965 on HMAS Melbourne;
from 21 April 1965 until 7 May 1965 on HMAS Melbourne;
from 31 May 1965 until 22 June 1965 on HMAS Melbourne;
from 24 April 1966 until 18 May 1966 on HMAS Sydney;
from 25 May 1966 until 11 June 1966 on HMAS Sydney.
He also served a period of defence service, in accordance with s 69 of the Act, from 7 December 1972 until his discharge in 1976.
3. The standard of proof for determining diagnostic matters under the Act is provided for in s 120(4) thereof and this requires that such matters be determined to the Tribunal’s reasonable satisfaction: see Repatriation Commission v Smith (1987) 15 FCR 327 at 335; Benjamin v Repatriation Commission (2001) 70 ALD 622 at 634; and Fogarty v Repatriation Commission (2003) 37 AAR 363 at 373. That standard also applies to issues of causation in relation to defence service. The standard of proof applicable to issues of causation for operational service is set out in s 120(1) of the Act which reads:
“Where a claim under Part II for a pension in respect of the incapacity from injury or disease of a veteran, or of the death of a veteran, relates to the operational service rendered by the veteran, the Commission shall determine that the injury was a war-caused injury, that the disease was a war-caused disease or that the death of the veteran was war-caused, as the case may be, unless it is satisfied, beyond reasonable doubt, that there is no sufficient ground for making that determination.”
4. The application of that provision is affected by the terms of s 120(3) and also by s 120A of the Act which requires that consideration be given to any relevant Statements of Principles that have been published by the Repatriation Medical Authority (RMA). Under s 9(1)(b) of the Act, a condition will be war-caused if it arose out of, or was attributable to, any eligible war service rendered. For a condition which has not been the subject of a determination by the RMA, the matter is to be determined on the basis of medical evidence.
Contentions
5. Mr Jarro submitted that Mr Salkeld was exposed to a severe psychosocial stressor whilst serving on the Sydney when it was in Vung Tau Harbour during the fourth of his periods of operational service. The detonation, he submitted, of two “scare charges” in quick succession while Mr Salkeld was working in the confined spaces of the ship’s laundry caused Mr Salkeld to fear for his life. This, and the requirement for him to return to carry out duties in that confined space, Mr Jarro submitted, caused Mr Salkeld to develop the condition of claustrophobia which, within a short time, generalized into an anxiety disorder. He submitted that the full array of symptoms for that condition developed within two years of the scare charge incident.
6. Mr Kelly submitted that the scare charge incident did not constitute a severe psychosocial stressor such that it would be responsible for the development of anxiety disorder and that, in any event, there was no evidence of the clinical onset of the condition within two years of the occurrence of the incident.
Issues
7. The first issue for determination in this matter is the appropriate diagnosis to apply to Mr Salkeld’s present psychiatric state. The second issue is whether any such condition is related to his eligible war service. It is not in dispute and I am satisfied that defence service played no role in the development of any psychiatric condition in Mr Salkeld.
The Applicant
8. Mr Salkeld gave the following evidence. He was 18 years of age when he joined the RAN for a period of 9 years. He then signed on for a further 3 years of service. After his initial training, he was posted to HMAS Melbourne on which he completed voyages which constituted operational service in Malaysian/Singapore waters. His duties at that time were those of a messman or kitchen hand despite his having completed a 3 month training course which qualified him as an aircraft handler. He was posted to HMAS Sydney on 19 April 1966 and, a few days later, the vessel took him on his first return voyage to South Vietnam during which he worked in the ship’s laundry. He and 2 other seamen were responsible for operating the washing machines and dryers. While Mr Salkeld accepted that the Sydney was a sister ship to the Melbourne, they were different internally because of modifications to the Sydney to enable it to carry out the amended role as a troop carrier.
9. Mr Salkeld described the laundry as a small internal room on deck 5 of the Sydney at about the level of the water-line. There were no windows or port holes. There was a telephone for communication purposes. He could not recall if there was a loudspeaker system to receive messages. When the vessel was in Vung Tau Harbour, it was in “defence watch” mode which meant that the hatches which gave access to the deck above the laundry were closed although they were not locked. The washing and drying machines were extremely noisy and this made oral communication very difficult. On the occasion of the scare charge incident, he had turned off the washing machines and was loading clothes into a dryer when he heard 2 loud explosions in quick succession. He thought that the vessel was under some form of attack and he dived behind one of the washing machines. The other seamen ran to him to question what had happened and he believed that, like him, they were in fear for their lives. He had not been advised of the practice of using scare charges to deter enemy divers. When things settled, he and the others ascended to deck 3 where they were advised of the scare charge procedure. He was told to return to the laundry and did so despite feeling reluctant to return to the confined space. Mr Salkeld was able to complete his work shift. His concern about confined spaces gradually came on him during his return voyage on the Sydney. Nevertheless, he remained on laundry duty for the rest of that voyage and for the subsequent voyage to and from Vietnam. He made no subsequent complaint about working in the laundry and did not seek to be reallocated. Also, he did not report how he had felt when the scare charges were detonated. He found it hard to talk about it because it “was not like being shot by a bullet”. As his concern with confined spaces grew, he took up sleeping on a hammock in an open area of the fo’c’sle rather than in his allotted mess. He considered that the effects of the scare charge incident in 1966 had impacted upon his capacity for improvement in the RAN although he agreed that he had been promoted subsequently.
10. Mr Salkeld described two other distressing situations that occurred to him after his experiences on the Sydney. The first was whilst serving on the Melbourne as a member of the flight-deck party. In June 1967, a Fairey Gannet aircraft completed an emergency landing. It failed to connect with an arrestor wire and was stopped by a webbing barrier. The aircraft slewed across the deck towards where Mr Salkeld was standing and came to a stop about 10 feet in front of him with its propellers still spinning. Mr Salkeld was not able to move from his position and believed that the aircraft would kill him. The second situation occurred shortly after the Gannet incident. He had been on shore leave in Manila and was involved in an altercation with a RAN officer. He was subsequently convicted, in July 1967, of offences which resulted in his being confined in a cell on the Melbourne for a period of 10 days. He described the cell as being one of four in the bow of the Melbourne. Each was approximately 2 metres by 1½ metres in size, with limited ventilation and with no windows except for a peep-hole. He remained in the cell all day and night apart from toilet breaks and a 20 minute exercise period. There were no further disciplinary proceedings against him in the RAN.
11. After leaving the RAN, Mr Salkeld work in various capacities including a brief period as a barman at an RSL club and then a period of 12 years as a tradesman’s assistant, rigger and crane driver in a mining operation in Western Australia. He then worked for a removalist firm in Queensland for about 10 years until 2003.
Medical Evidence
12. Since 2005, Mr Salkeld has been treated by psychiatrist, Dr Janis Carter. She gave evidence and provided reports dated 9 August 2005 and 31 August 2006.
13. In her first report, Dr Carter identified four stressors. These were:
·the scare charge incident on the Sydney;
·working in confined spaces on the Sydney;
·the Gannet incident on the Melbourne; and
·confinement in the cell on the Melbourne.
14. Dr Carter diagnosed Mr Salkeld with generalized anxiety disorder. She did not make a diagnosis of post traumatic stress disorder but, on the stressors noted above, considered that the Gannett incident, “in particular”, may well have matched diagnostic criterion A as a relevant stressful event for that condition. Mr Salkeld provided her with a psychiatric history of being anxious during his period of service and, “especially”, in relation to the Gannett incident. He indicated to her that his anxiety had waxed and waned over the years and had become intolerable by the end of his working life. As part of that first report, Dr Carter completed a medical impairment worksheet in which she recorded the subjective distress now experienced by Mr Salkeld and this included flashback episodes to working in enclosed spaces and the incident with the Gannet. No reference is made in that assessment to the scare charge incident.
15. Dr Carter’s later report is expressed in terms significantly different from those of the first report. While she maintained the diagnosis of generalized anxiety disorder, she also added that Mr Salkeld had suffered from a specific phobia of being in enclosed spaces (claustrophobia). Dr Carter described this as a direct result of his being in the laundry when the scare charges were detonated. She wrote:
He said within a matter of weeks the anxiety of this specific situation had generalised to a lot of situations, and he just found himself unable to take pressure, and when pressure was put on him he avoided it, because he would develop the symptoms of a more generalized anxiety disorder. In my previous report I didn’t give the history of the specific phobia ante-dating the presentation of a more generalized anxiety disorder, because I did not specifically tease that out from the generalized anxiety disorder and get the history of the specific phobia presenting.
So in terms of the Statement of Principles, the specific phobia came first, and then the generalized anxiety disorder developed as a result of the specific phobia and the ongoing tension that he was experiencing, and it generalized to not only been closed down in the hatch with noises but to being enclosed in general, and he hates enclosed shopping centres, movie theatres, anywhere where he feels enclosed in any space where he cannot get out easily, and it then generalized to having pressure put on him.
16. Dr Carter’s second report makes no reference to the Gannett incident or to the occasion when Mr Salkeld spent 10 days in confinement.
17. The Board had only Dr Carter’s first report before it when it decided that Mr Salkeld’s anxiety disorder was not related to his service. In its published reasons for making that decision, the Board referred to the Gannet incident and found that it had not occurred during a period of operational service and that, therefore, it could not be taken into account when considering matters of causation under the Act. As part of providing evidence at the Tribunal, it was put to Dr Carter that she had removed the references to the 1967 Gannet and confinement incidents because of the Board’s finding. Dr Carter agreed she had read the decision of the Board but was not aware that those later incidents did not occur during eligible service. She said that she had read the decision quickly, that it was a legal document and that aspects of service had “not stuck in [her] mind”. She said that, when she spoke with Mr Salkeld for the purposes of preparing her second report, those later incidents “did not jump out at [her] as being of interest to [her]". She denied that she had approached the task with a “mind set of dropping out the Gannet”.
18. In her evidence, Dr Carter said that the Gannet incident and the period of confinement on the Melbourne had worsened the generalized anxiety disorder which existed at that time. She denied that either of those was responsible as the initial cause of the generalized anxiety disorder. She confirmed her opinion that the claustrophobia developed first and that, within weeks, this “heralded in” generalized anxiety disorder.
19. Dr Carter expressed the opinion that all of the features of generalized anxiety disorder, as set out in part 8 of the relevant Statement of Principles, were present in Mr Salkeld within two years of the scare charge incident. Dr Carter conceded that her clinical notes did not include information about all of those features but she did note that he had not been able to cope with RAN responsibilities and said that this was important because he was unable to gain promotion in the service.
Diagnosis and Statements of Principles
20. The RMA has published Instrument No. 1 of 2000 as the relevant Statement of Principles for generalized anxiety disorder. It lists six criteria for diagnosing the condition. Dr Carter’s opinion in 2005 and since then is that Mr Salkeld meets those requirements. I am reasonably satisfied that this is the condition which answers Mr Salkeld’s initial claim. Dr Carter also referred to claustrophobia as a psychiatric condition from which Mr Salkeld suffered immediately after the scare charge incident and which generalized into his present anxiety disorder. The ICD-10-AM coding for claustrophobia is F40.2. This is not included in the Statement of Principles for anxiety disorder which embraces the ICD-10-AM codes F06.4, F41.1, F41.8 and F41.9. Claustrophobia has not been the subject of a determination by the Repatriation Medical Authority.
Principles of Causation
21. The Federal Court, in Repatriation Commission v Deledio (1998) 83 FCR 82 at 97-98, set out a four-step procedure for determining issues of causation in relation to operational service. The first of these requires that there be an hypothesis of connection between a claimed condition and service. From the contentions of Mr Jarro and the evidence of Dr Carter, I accept that two separate hypotheses may be identified. These are that Mr Salkeld’s anxiety disorder resulted directly from the scare charge incident, occurring in the context of the confined laundry space, or that the anxiety disorder resulted indirectly from that incident in that it caused Mr Salkeld to suffer from claustrophobia which then generalized into anxiety disorder.
22. The second of the four Deledio steps requires identification of any relevant Statement of Principles as published by the RMA. As noted above, Instrument No. 1 of 2000 is the Statement of Principles published by the RMA for anxiety disorder. In so far as relevant to the hypotheses noted above, the factors of causation and associated definitions read:
5(a)(ii) experiencing a severe psychosocial stressor within the two years immediately before the clinical onset of anxiety disorder;
5(a)(iii) having a clinically significant psychiatric condition within the two years immediately before the clinical onset of anxiety disorder;
“severe psychosocial stressor” means an identifiable occurrence that evokes feelings of substantial distress in an individual, for example, being shot at, death or serious injury of a close friend or relative, assault (including sexual assault), major illness or injury, experiencing a loss such as divorce or separation, loss of employment, major financial problems or legal problems;
“clinically significant” means sufficient to warrant ongoing management by a psychiatrist, clinical psychologist or General Practitioner;
23. The third Deledio step does not involve the making of findings of fact but requires a consideration of each advanced hypothesis to determine whether it is reasonable in the sense that there is some material which calls for a determination under subsection 120(1) of the Act: see Bushell v Repatriation Commission (1992) 175 CLR 408 at 415. This requirement will be met if the hypothesis fits, in the sense of being consistent with, the template provided by the relevant factor and associated definition contained in the Statement of Principles. If an hypothesis is found to be reasonable, it will then be necessary to consider the fourth of the Deledio steps.
24. There is no Statement of Principles for claustrophobia. Accordingly, a reasonable hypothesis of a relationship between that condition and service will be raised if, after considering all of the available evidence, that material points to some fact or facts which support the hypothesis: see Bushell (supra) and Byrnes v Repatriation Commission (1993) 177 CLR 564.
Reasonableness of Hypotheses
anxiety disorder: factor 5(a)(iii) – indirect effect of psychosocial stressor
25. The evidence of Dr Carter points to the presence of claustrophobia shortly after and because of the scare charge incident occurring as it did while Mr Salkeld was in the confined space of the laundry room. However, for that condition to form a link in the chain of causation for anxiety disorder, there must be material which points to it as being “clinically significant” as that term is defined in the Statement of Principles. That is not the case with the material relating to claustrophobia. There is no material which would support the contention that, in the brief period before it generalized into anxiety disorder or, indeed, at any subsequent time, claustrophobia was of sufficient severity to warrant ongoing management by a psychiatrist, clinical psychologist or general practitioner, as required by the Statement of Principles. In his evidence, Mr Salkeld described the incident and his feelings as being “hard to talk about” and he also said that he was able to cope by putting everything “on the back burner”. There is no material which points to complaints being made during Mr Salkeld’s subsequent service about the condition or about the confined spaces in which he continued to work. Indeed, the material points to a complete absence of any medical intervention, or the need for such intervention, prior to Mr Salkeld’s consultation with Dr Carter in 2005.
26. As the material does not point to the presence of a clinically significant psychiatric condition, no reasonable hypothesis of a relationship to service is raised per medium of factor 5(a)(iii) in the Statement of Principles for anxiety disorder.
anxiety disorder: factor 5(a)(ii) – direct effect of severe psychosocial stressor
27. The severe psychological stressor requires an identifiable occurrence. That term imports the notion of a recognisable event. The examples of identifiable occurrences contemplated by the Statement of Principles as psychosocial stressors cover a wide range of events suggesting resultant feelings which extend over a time-frame and which, thereby, have a social dimension to them. The only relevant “occurrence” in this matter is the scare charge incident while Mr Salkeld was in the confined space of the laundry room. Any subsequent duty undertaken by Mr Salkeld in the laundry room or in any other confined space does not constitute an identifiable occurrence or recognisable event as required by the definition of a severe psychosocial stressor and factor 5(a)(ii) in the Statement of Principles. The identifiable occurrence must be one which, subjectively, evoked feelings of substantial distress in Mr Salkeld as well as one which, objectively, would evoke such feelings in a person exposed to that occurrence: White v Repatriation Commission [2004] FCA 633.
28. The material before me does not point to a situation in which, objectively, a person similarly placed to Mr Salkeld would suffer substantial distress. The vessel in question was not one of the smaller RAN destroyers or frigates; rather it was an aircraft carrier. In evidence were plans of the sister ship, the Melbourne, which shows the laundry area not to be adjacent to the outer hull where the sound and effect of the scare charge may expect to be greater than in the laundry area. While Mr Salkeld referred to internal modifications to the Sydney so that it was not identical to its sister ship the Melbourne, it was, nevertheless, his evidence that the laundry was an internal room and, therefore not immediately adjacent to the water. The incident was of short duration. Contrary to the submission of Mr Jarro, the evidence of Mr Salkeld was that the laundry area was not below the waterline but, rather, that it was at about that level. Contrary to the reference in Dr Carter’s second report, Mr Salkeld was not in a situation where he “wasn’t able to get out” of the laundry. His evidence was that the hatches were closed but not locked and, indeed, he and the other seamen were able to leave and did leave the laundry to investigate what had occurred. They were able to return to the laundry after learning of the cause of the sounds and were able to complete their normal shift. That material may point to a person in Mr Salkeld’s position feeling some concern at what had occurred but it, nevertheless, does not point to such a person experiencing “substantial distress” even though his evidence was that, subjectively, he feared the vessel was under attack. Accordingly, the material does not point to a “severe psychosocial stressor” as defined in the Statement of Principles.
29. In addition to the need for a severe psychosocial stressor, factor 5(a)(ii) in the Statement of Principles for anxiety disorder requires that there be material which points to the clinical onset of the condition within two years of experiencing the stressor. The term “clinical onset” has not been defined by the RMA but the requirement will be met if symptoms have been described to a medical practitioner who is then able to state that the presence of those symptoms at a particular time indicates that the condition was present at that time: see Re Robertson and Repatriation Commission (1998) 50 ALD 668 at 670 and Repatriation Commission v Cornelius [2002] FCA 750. Also, all of the diagnostic criteria of the disease need to be shown within the two year period: see Lees v Repatriation Commission (2002) 125 FCR 331 and Youngnickel v Repatriation Commission [2004] FCA 1691. The consideration of clinical onset is not confined to the matters favourable to the applicant: see Hardman v Repatriation Commission[2004] FCA 1174. The evidence of Dr Carter is that the condition of anxiety disorder was present within weeks of the scare charge incident. Without making any findings of fact in that regard, I accept that her description points to the clinical onset of anxiety disorder within the time-frame required by the Statement of Principles.
30. Despite that, on the basis of the foregoing analysis of severe psychosocial stressor, it follows that a reasonable hypothesis of a relationship between Mr Salkeld’s anxiety disorder and his service is not raised. This means that step 4 of the Deledio procedure need not be considered. Nevertheless, because of the reference above to the clinical onset of the condition, I have considered that matter below.
Deledio Step 4: Is the Condition War-Caused?
31. The clinical onset of a condition requires that all of the diagnostic criteria of the condition be met. Those criteria for anxiety disorder are listed in the Statement of Principles as follows:
A. Excessive anxiety and worry (apprehensive expectation), which occur on more days than not for a continuous period of at least six months, about a number of events or activities; and
B. The person finds it difficult to control the worry; and
C. The anxiety and worry are associated with three or more of the following six symptoms, with at least some symptoms present for more days than not during the previous six month period:
(1). restlessness or feeling keyed up or on edge
(2). being easily fatigued
(3). difficulty concentrating or mind going blank
(4). irritability
(5). muscle tension
(6). difficulty falling or staying asleep, or restless unsatisfying sleep; and
D. The focus of the anxiety and worry is not confined to features of any other Axis I disorder; and
E. The anxiety, worry, or physical symptoms (as described in C. above) cause clinically significant distress or impairment in social, occupational, or other important areas of functioning; and
F. The anxiety and worry are not due to the direct physiological effects of a substance or a general medical condition and do not occur exclusively during a mood disorder, a psychotic disorder, or a pervasive developmental disorder.
32. Dr Carter’s evidence in this matter is characterized by inconsistency. Her attempt to diminish the significance of the findings of the Board in relation to the status of Mr Salkeld’s service during the Gannet incident and the confinement period were unconvincing. The first of those was the main stressor described in her first report. It was not mentioned in her second report. This is despite her oral evidence that it contributed to Mr Salkeld’s present psychiatric state by aggravating the condition in 1967. Furthermore, the significance to Mr Salkeld of the Gannet incident became apparent during the hearing. He was able to describe the incident involving the scare charges in a calm manner but was unable to do so in relation to the Gannet incident. In the latter case, he began to cry uncontrollably whilst describing his feelings at that time and was unable to continue with his evidence without a break. That is consistent with the first of Dr Carter’s reports where the major emphasis was the stressful effect of the Gannet incident.
33. In her first report, completed in 2005, Dr Carter listed various symptoms which were manifest in Mr Salkeld at that time. Thus, she reports that he feels restless, becomes easily fatigued, has difficulty concentrating, becomes quite irritable, has muscle tension and sleep disturbances. All of those are expressed in the present tense. Further, she provides examples of some of those symptoms and, again, these are examples of recent problems. She described difficulty for Mr Salkeld in preparing the statement of stressors for her; and she described his difficulty in dealing with the public such that it caused him to cease work. Dr Carter was unable to identify in her clinical notes instances where these problems arose within two years of the scare charge incident. She considered that it was significant that he had not received promotions after his service in Vietnam even though she made reference to these in her second report. Mr Salkeld’s record of service, which was in evidence, shows that he continued to serve in the RAN for another 10 years and this included a 3 year re-engagement. In his evidence to the Board, he said that he was promoted to leading hand and his service record, after his re-engagement, reveals that he was a fire crewmen in January 1973 and fire crew captain until October 1975. He then undertook hangar duties and, on 1 April 1976, was hangar bosun. That history is not consistent, in particular, with diagnostic criterion E listed above. Neither is his capacity to undertake 2 periods of engagement, each of at least 10 years, in private employment after leaving the RAN.
34. Also in evidence were medical examination records completed after Mr Salkeld’s return from Vietnam. None of the entries contained in those records suggests that his psychiatric status was anything but normal at that time or through the rest of his service. I have also noted that Dr Carter described his symptoms as waxing and waning throughout his life and as increasing “towards the end of his working life” when they “became intolerable”.
35. Although I have identified Dr Carter’s opinion as pointing to the clinical onset of anxiety disorder within two years of the scare charge incident, I am satisfied beyond reasonable doubt, on all of the evidence before me, that the clinical onset of the condition did not occur within that time-frame.
Decision
36. Mr Salkeld’s anxiety disorder is not war-caused as there is no reasonable hypothesis of a relationship to his service. This is because the material does not point to the presence of a severe psychosocial stressor. Even if a reasonable hypothesis were raised, Mr Salkeld’s anxiety disorder would not be war-caused because I am satisfied beyond reasonable doubt that the clinical onset did not occur within the relevant time frame as noted above.
37. The decision under review is affirmed.
I certify that the preceding 37 paragraphs are a true copy of the reasons for the decision herein of Mr RG Kenny, Member
Signed: ............................................................
Legal Research Officer
Date/s of Hearing 30 May 2007
Date of Decision 28 June 2007
Counsel for the Applicant Mr N Jarro
Solicitor for the Applicant Haney Lawyers
Representative for the Respondent Mr J Kelly
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