Salter and Repatriation Commission

[2003] AATA 231

Administrative

Appeals

Tribunal

 

DECISION AND REASONS FOR DECISION [2003] AATA 231

ADMINISTRATIVE APPEALS TRIBUNAL      )

)          No Q2001/1161

VETERANS' APPEALS  DIVISION		)
Re		JANETTE HELEN SALTER

Applicant

And REPATRIATION COMMISSION

Respondent

DECISION

Tribunal Deputy President Don Muller

Date12 March 2003 

PlaceBrisbane

Decision The Tribunal sets aside the decision under review and in substitution determines that the death of the late veteran, John Salter, on 31 October 1996, was war-caused within the meaning of that term in the Veterans’ Entitlements Act 1986.

..............(Signed)................................

D.W. MULLER

DEPUTY PRESIDENT

CATCHWORDS

Veterans Appeals – war widow pension – whether veteran’s death war-caused – hypertension, ischaemic heart disease – whether Statement of Principles satisfied – whether veteran consumed 12g of salt before clinical worsening of hypertension

Veterans’ Entitlements Act 1986

REASONS FOR DECISION

Deputy President Don Muller       

1.      This is an application by Janette Helen Salter (“the Applicant”) to review a decision of the Repatriation Commission dated 24 February 1997, that the death of her husband, John Salter from myocardial infarction and severe atherosclerosis of the coronary arties, was not war-caused.

2.      This matter was first heard on 1 February 2001 by Deputy President Breen, who determined that he was bound to apply the Statements of Principles applicable at the time the original decision was made.  The relevant Statement of Principles in force at the time the original decision was made was unfavourable to the Applicant’s case.  A later Statement of Principles allowed an hypothesis to be formulated which provided for a link between the veteran’s death and his war service.

3.      The Applicant appealed the Tribunal’s decision to the Federal Court.  The grounds of the appeal were that the Tribunal erred by finding that the later Statement of Principles, Instrument No. 25 of 1999 (Hypertension), could not be applied to the Applicant’s claim.  Kiefel J ordered on 31 October 2001, by consent, that the appeal be upheld and remitted to the Tribunal to be determined according to the law. 

4.      At the second hearing before the Tribunal on 8 November 2002, Mr. Harding of Counsel represented the Applicant and Mr. Smith represented the Respondent.

5.      The hypothesis submitted by Mr. Harding is as follows:

(a)The veteran increased his intake of salt during his operational service in Vietnam both through the extra salt added to his food by the Army and the orders given by the Australian Army that the veteran consume four salt tablets daily.

(b)The increased consumption of salt during his service was a causal factor in the veteran developing an increased salt consumption or salt habit.

(c)The increased salt consumption remained after his service.

(d)The excessive consumption of salt is a risk factor in the development of hypertension, which is itself a risk factor in developing ischaemic heart disease.

6.      There is no dispute about the following facts and the Tribunal finds that:

(a)John Salter was born in the United Kingdom on 6 January 1924.

(b)He served in the British Army from 6 January 1942 until 21 May 1952.

(c)He served in the Australian Army from 20 October 1952 until 31 May 1974.

(d)He had operational service in Vietnam from 3 February 1967 until 1 July 1967.

(e)He had never lived in a tropical area until he went to Vietnam.

(f)He had eligible defence service from 7 December 1972 until 31 May 1974.

(g)He suffered from hypertension before he joined the Australian Army in 1952.

(h)The available medical records show that his blood pressure readings were recorded in the following years:

1952            140/85  1972              130/95

June 1964   145/85  1973              130/90

1965            145/80  1974              150/90

1966            160/85  13 Feb 1996  255/90

1969            160/80  16 Feb 1996  210/90

1970            160/80  

(i)The clinical onset of his heart disease was in 1996.

(j)He died on 31 October 1996, aged 72 years.  The cause of death was recorded in his death certificate as:

“Myocardial infarction, and Severe atherosclerosis of coronary arteries”

7.      The Applicant gave evidence to the following effect:

(a)She first met her husband in 1979.  He told her that he had recently ceased smoking.

(b)The veteran ate at least a dessert spoon of salt on all of his meals including breakfast, every day.

(c)The veteran would sometimes pour salt on to his hand and eat it after mowing the lawn;

(d)The veteran told his wife that he required a lot of salt “since being in the tropics” and that the doctors in Vietnam told him that he should have salt in the tropics;

(e)Even though she had heated discussions with her husband about his excessive salt consumption he never reduced his salt intake even when he was later diagnosed with hypertension and ischaemic heart disease.

8.      The veterans’ colleague and friend, Roger Mattiske, gave the following evidence:

(a)He had known the veteran since January 1957;

(b)During their service in Vietnam they were both ordered to take four salt tablets daily in order to help preserve body fluids;

(c)He witnessed the veteran while in service and later at his home, pour salt on to his hand and eat it;

(d)He noticed during the mess meals he shared with the veteran, after their service in Vietnam, that the veteran’s first move was towards the salt shaker;

(e)His own experience was that he had also developed a high salt diet after his service but had managed to reduce his salt intake 20 years ago.

9.      Dr. Robert Goodwin provided a report dated 17 November 2000 and gave oral evidence.  His report on the veteran states:

“….he had a well established (albeit borderline) hypertension before service in Vietnam.

Clinical worsening (of hypertension) is more significantly evident by such clinical markers of organ damage.  This may be indicated by the evidence of cardiac enlargement… or as in this instance myocardial infarction and death.

During his service in the Australian Army, he acquired a habit of excessive salt ingestion.  This had an adverse effect on hypertension that finally led to clinical deterioration with myocardial infarction and death.”

10.     The Tribunal notes the evidence of Dr. Kenardy who said that in his view, based on experiments with animals, the habit of eating excessive salt is not the same as a habit developed from taking certain types of drugs.  He said that it should be possible for a person to reduce their salt intake, whereas it might not be possible for a person to control their craving for a drug.

11.     Nevertheless, if a member of the Army has been told that it is good for his health to take extra salt and the taking of the extra salt causes the veteran to develop either a taste habit, or a belief that salt is good for him, the root cause of the veteran’s habit of ingesting excessive quantities of salt is to be found in his Army service.

12.     The Statement of Principles and factors therein relevant to this review are:

(a)Statement of Principles, Instrument No. 31 of 2001 (Hypertension) Factor 5(q) which states:

“Ingesting at least 12 grams (200 mmol) of salt supplements per day on average for a continuous period of at least six months immediately before the clinical worsening of hypertension.”

(b)Factor 5(a) from Instrument No. 38 of 1999 for Ischaemic Heart Disease which states:

“The presence of hypertension before the clinical onset of ischaemic heart disease.”

13.     The Tribunal is satisfied that the veteran developed a habit of ingesting at least 12 grams of salt supplements per day on average continuously from the time of his service in Vietnam in 1967.

14.     The Tribunal is also satisfied that the veteran’s habit of ingesting excessive salt was caused by his war service in Vietnam

15. The Tribunal finds that the hypothesis connecting the veteran’s death with the circumstances of his Vietnam service, as set out in paragraph 5 above, is consistent with the relevant Statements of Principles and is a reasonable hypothesis within the meaning of that term in the Veterans’ Entitlements Act 1986.

16.     The decision under review is set aside and in substitution the Tribunal determines that the death of the late veteran, John Salter, who died on 30 October 1996, was war-caused.

I certify that the 16 preceding paragraphs are a true copy of the reasons for the decision herein of Deputy President Don Muller

Signed:         .......................................................................................
           C. O’Donovan, Associate

Date/s of Hearing  8 November 2002
Date of Decision  12 March 2003
Counsel for the Applicant         Mr. A. Harding
Solicitor for the Applicant          Gilshenan and Luton
Respondent  Mr. M. Smith, departmental advocate