Slatyer and Repatriation Commission - [2001] AATA 144

DECISION AND REASONS FOR DECISION [2001] AATA 144

ADMINISTRATIVE APPEALS TRIBUNAL )

) No N1999/136

VETERANS' APPEALS DIVISION       )
           Re      COLIN WILLIAM SLATYER
  Applicant
           And    REPATRIATION COMMISSION
  Respondent

DECISION

Tribunal Dr J D Campbell, Member

Date26 February 2001
PlaceSydney

Decision The Tribunal determines that the decision under review be set aside and in substitution thereof determines that: (1) the Applicant's conditions of generalised anxiety disorder with associated major depression and alcohol dependence are war caused disabilities; and (2) the matter is remitted to the Respondent for assessment of the war caused disabilities.

[Sgd] Dr J D Campbell
Member
CATCHWORDS
Veterans' Entitlements – operational service – psychiatric illness – war caused
Veterans' Entitlement Act 1986, sections 6, 8, 120, 120A, 196B
Repatriation Commission v Deledio (1998) 83 FCR 82
Repatriation Commission v Bey (1997) 149 ALR 721
Repatriation Commission v O'Brien (1985) 155 CLR 422

REASONS FOR DECISION

Dr J D Campbell, Member

Mr Colin Slatyer ("the Applicant") in this matter seeks a review of the decision of the Veterans' Review Board dated 8 December 1998 which rejected the Applicant's claim that his disability of generalised anxiety disorder with associated major depression and alcohol dependence was war caused. In so finding the Veterans' Review Board had amended the Applicant's diagnosis from one of post traumatic stress disorder with associated major depression and alcohol dependence to one of generalised anxiety disorder with associated major depression and alcohol dependence. In this regard, that is the change of diagnosis, the Veterans' Review Board had amended the earlier decision of the Repatriation Commission ("the Respondent") dated 1 April 1998.
A hearing was held before the Tribunal on 23 October 2000 at which the Applicant was represented by Mr Smith of Counsel. The Respondent was represented Mr Modder, an advocate from the Department of Veterans' Affairs. The Applicant presented oral evidence to the Tribunal.

The following documents were placed in evidence before the Tribunal:
Exhibit No  Description                  Date
T1-T18 PP1-102 Documents prepared pursuant to Section 37 of the Administrative Appeals Tribunal Act 1975
A1      Medical report of Dr Dinnen       28 May 1999
A2      Instrument issued under subsection 6D(1) of the Veterans' Entitlement Act 1986
A3      Statement of Mr Slatyer     19 July 1999
A4      Statement of Mr Slatyer together with two attachments, namely a copy of letters from Mr Slatyer while on HMAS ANZAC (incomplete) and a record of ship movements for HMAS ANZAC as annotated by Mr Slatyer     23 October 2000
A5      Applicant's statement of facts and contentions 16 July 1999
R1      Medical report of Dr Lewin 24 June 1999
R2      Medical report of Dr Lewin 29 November 1999

issues

The relevant issue in this matter is whether the Applicant's condition of generalised anxiety disorder with associated major depression and alcohol dependence is a war caused disability.
legislation
The relevant legislation in this matter is:
the Veterans' Entitlement Act 1986 ("the Act") and in particular subsections 6D(1), 8, 120(1), (3),(4), 120B, 196B;,
Statement of Principles No 48 of 1994 as amended by No 275 of 1995, concerning generalised anxiety disorder; and
Statement of Principles No 5 of 1998 concerning psychiatric substance abuse or dependence.

background

The Applicant lodged a claim with the Respondent on 18 February 1998 in which he claimed the disabilities of stress related depression (medical diagnosis of chronic stress reaction) and alcohol dependence (medical diagnosis of chronic alcohol dependence) as being war caused (T4). Accompanying the claim was a report from Dr Altman, a consultant psychiatrist to Dr MacPherson, the Applicant's treating general practitioner, in which he stated:
"…
In summary, in my opinion as a result of his above mentioned stressful experiences in the Navy, Mr Statyer suffers from a chronic post traumatic stress disorder with an associated major depression and alcohol dependence.
…"
(T5, P42)
The Applicant had the following periods of operational service while attached to the Far East Strategic Reserve:
HMAS ANZAC25.3.59 – 28.4.59
  12.5.59 – 9.6.59
  18.6.59 – 17.8.59
  31.8.59 – 9.9.59
  18.9.59 – 10.10.59
  16.11.59 – 5.12.59
HMAS MELBOURNE         24.3.61 – 17.4.61
  (T6, P45)
On 1 April 1998 the Respondent refused the Applicant's claim for post traumatic stress disorder ("PTS") with associated major depression and alcohol dependence (T7).
On 16 July 1998 Dr Altman, a consultant psychiatrist, in a medical report to Dr MacPherson stated:
"…
In my opinion as a result of his navy experiences he more clearly meets the criteria for a Generalized Anxiety Disorder. Due to his navy experiences he has tended to be overly anxious and he has tended to worry excessively about matters – this latter anxiety and tendency to worry excessively has been long-standing. Furthermore he has suffered from such symptoms as generally feeling keyed up and on edge, he has on a long term basis been easily fatigued and irritable, he has suffered from muscle tension – "particularly in the hands – I sleep with fists", he has suffered from long-standing sleep disturbance and he has an exaggerated startle reaction.
…
In summary in my opinion as a result of his navy experiences Mr Slatyer suffers from a Generalized Anxiety Disorder with an associated Major Depression and Alcohol Dependence. In my opinion his psychiatric impairment according to Table 4 from the Guide to Assessment of Rates of Veterans' Pensions (5th Edition) is 33 points."
(T12, PP64-65)

On 8 December 1999 the Veterans' Review Board (" the VRB") amended the Applicant's diagnosis of PTSD with associated major depression and alcohol dependence to generalised anxiety disorder with associated major depression and alcohol dependence, but rejected the Applicant's claim that this disability was war caused (T13).
applicant's evidence
The Applicant told the Tribunal that he was born on 26 October 1939, and that he joined the navy in 1958 for a period of nine years. Between August and November 1958 he was stationed at HMAS Cerberus, where he undertook his recruit training and where he met and formed a relationship with a Miss B. The Applicant stated that he had had previous attachments with girls, but they had not lasted beyond a few months.
The Applicant stated that on completion of his recruit training, he returned to Sydney to undertake a radar operators' course at HMAS Watson, between November 1958 and March 1959. During this time he travelled to Melbourne and Miss B. came to Sydney for Christmas. On completion of his course on 10 March 1959, he was posted to HMAS ANZAC and on 16 March the ship sailed to join the Far East Strategic Reserve. On the weekend prior to the ship's departure Miss B came to Sydney and they became engaged, with the Applicant intending to buy an engagement ring during his nine months absence in the Far East.
The Applicant stated that at this stage he had been accepted as an officer candidate and that he would receive material and training while on board, and all this enhanced his idea of a naval career for the future. The Applicant stated that during the early months of his voyage, he wrote to his fiance weekly, indicating his intention to convert to Catholicism and the intention to have their honeymoon in the United Kingdom as his officer training program would be undertaken there.
The Applicant told the Tribunal that prior to joining the navy he had enjoyed the social life of a teenager, playing rugby in winter and surf club activity in summer. He had enjoyed one or two beers after a surf carnival and had been intoxicated on one to two occasions. The Applicant stated that during this period there had been no periods of depression and/or anxiety.
On 23 September 1959, the Applicant stated that he received a letter from his fiance breaking off their relationship. He remembers reading it later and getting upset. He remembers feeling desperately lonely at this stage, and felt he could not go on. He wrote a letter from Singapore, to which he never received an answer. While ashore in Singapore he drank for four to five hours and then broke and swallowed a glass, but this had no effect.
Between 28 September 1959 and 1 October 1959, the Applicant stated that the ship was at sea and he again re-read the letter and considered jumping off the stern of the ship. On return to Singapore he went ashore in company, bought a bottle off rum, drank it, broke the bottle and sliced his wrists. He felt that he needed attention, but in this respect it was not successful. He returned to the ship, where he sought attention from the medical officer, who attended to his wrists and referred him for psychiatric evaluation at BMH Singapore.
Following his assessment at BMH Singapore, he was permitted leave and during his period of leave on 11 October 1959, he became involved in a disturbance with the British Military Police, who returned him to BMH Singapore. On 12 October 1959 he was discharged from BMH Singapore to HMS Terror to face charges for his recalcitrance. This resulted in five days in the cells, following which he was transferred to join his ship in Hong Kong.
On rejoining the HMAS ANZAC he was advised that his officer candidature had been cancelled because of his period in detention. The Applicant stated that in response to this loss of status, he was involved in further brawling with the military police and as a consequence was sentenced to second class for conduct on the 12 November 1959, which remained until a day before arriving in Perth, prior to the ship returning to Sydney on 5 December 1959.
The Applicant stated that he remained in service until 1965, and during this time he would go ashore and drink, but not get drunk. Up to the period in 1964 when he was absent without leave for six months and working in Whyalla, he had no disciplinary problems. In January 1962 he joined the Navy's Mobile Clearance Diving Team and completed a diving course by 23 March 1962. In April 1962 he was involved in a diving fatality, and despite clearance by a Court of Inquiry, the Applicant maintained feelings of guilt. This led to increased drinking while on shore leave, with his mother reporting his drinking behaviour to his commanding officer, who in turn referred him to a Navy doctor in May 1962. He was then in turn referred to
Dr McGeorge, a consultant psychiatrist. The Applicant stated that he continued with the diving team until January 1964, when he withdrew as a result of increased drinking and apprehension associated with a fear of deep diving. The Applicant stated that his discharge on medical grounds in April 1964 was not approved by the Navy Office and as a consequence he was absent without leave for six months prior to surrendering. The Applicant then underwent psychiatric assessment by Dr McGeorge, and he was discharged as medically unfit for service in early 1965.
The Applicant stated that in 1997 his general practitioner Dr MacPherson referred him to Dr Altman, a consulting psychiatrist, because of feeling down and drinking excessively. He used to see Dr Altman monthly until he moved to Morpeth. The Applicant also stated that in looking back over the period since he left the Navy there have been episodes of being down which has resulted in binge drinking activity up to six times a year. This occurred mainly on weekends, for during most of the period he held a responsible job.
The Applicant stated that he has been married twice, with a second marriage occurring some two years ago. He finds that his symptoms are worse at night, when often he wakes up and cannot get back to sleep, as his mind is forever churning. He is generally anxious, sleeps with a sword under his bed and wakes three to four times a night feeling tense and sometimes sweating. During the day the Applicant described himself as irritable with a feeling of friction existing in any interpersonal transactions. He stated that he broke down after his business partnership collapsed and that he threatened to kill the other individual. At this stage he felt more homicidal than suicidal. He states that he has few friends and that his relationships with people have deteriorated. After he left Jackson's he worked successfully as a consultant up to 1990, after which he has progressively become a loner.
In response to questions asked in cross-examination, the Applicant stated that:
(a) he had two earlier relationships at ages 16, 17; he thought the latter might lead to marriage and that he was a bit shattered when the relationship ended, but recovered in a month;
(b) his father was totally permanently incapacitated as a result of a nervous breakdown after the Second World War; that he had trouble settling down after the war and was a heavy drinker;
(c) he started drinking at age 16 (a little), at 17 (occasionally); he was involved in a fight on one occasion at age 18; that when playing rugby union he consumed alcohol regularly during his last season before joining the Navy and that he did not drink at HMAS Cerberus;
(d) he is unable to remember the content of his nightmares, which started and became more apparent in the 1980s and seemed to centre on the diving fatality; and
(e) his post service employment included:
(i) a position at Itoh's for 10 years during which time he was promoted; responsibility for five staff; working well over 40 hours per week and the job was stressful on occasion;
(ii) Jackson's – futures trading; 20 plus staff; 12 hours per day; episodes of physical conflict with staff/partner; reprimanded; conflict with staff; produced results; times of high stress; increased drinking to help him sleep; remained there for nine years.
(iii) requested to go to New Zealand to set up similar financial market operation, in which he was to undertake the risk management role; the company ceased to trade after three years.

medical evidence

The following are psychiatric opinions rendered during the Applicant's Naval service:

(a) psychiatrist – British Military Hospital Singapore (12 October 1958):
"…
OPINION. This patient has considerable intelligence and ability, but is insufficiently mature to pursue a stable course, frequently reverting to impulsive anti-social conduct especially in response to stress. While desiring close personal relationship, he is unable to trust himself with people and confide in them but built up a satisfying friendship to a girl who has recently given him up. As a result he could see no point in anything, became depressed and considered suicide.
During admission these points have been discussed with him and he showed some improvement. He was given a pass and failed to return for some hours. There are charges contemplated for this and it is necessary to discharge him at once from hospital.
Diagnosis: Reactive depression." (T3, 21)
b) psychiatrist – Dr Stephens, 11 February 1960:
"In my opinion this rating does not exhibit any undue depression; any psychosis, or psychoneurosis at present. His behaviour while overseas was that of an immature personality he is chronologically very young. His service in the tropics and his exposure to alcohol and female company increased his emotional stress. I do not think that the suicidal attempt was significant. Apart from the immaturity he seems a good type. His recent experience and the passage of time should make him a reliable unit in the Service. In my opinion he does not require any special psychiatric treatment at present, and his retention in the Service for a probationary period is justifiable. He could be reviewed in six months time."
(T3, P29)

(c) psychiatrist – Dr McGeorge, 11 May 1962:
"History of Singapore episode and suicidal expressions noted. He admitts [sic] to excessive drinking lately. Denies any worries. This seems to be recurrence of a similar outburst to that in Singapore, which was apparently caused by a love affair that went wrong, and was regarded then as evidence of immaturity. Blames his mother for bringing him under medical attention, as she was worried about his drinking. He claims that he only drinks with friends at the weekend. In view of the fact that his father is an alcoholic his mother may be over anxious. There is an element of disappointment that after the successful Radar Course he was reverted to A.B. If he did so well it seems a pity that he was not given an opportunity for further progress. However, as a diver he will probably make the grade. It is possible that his drinking is a form of defiance of his Mother's attitude of concern. I see no reason that he should not continue diving about which he is keen."
(T3, P29)
(d) psychiatrist – Dr McGeorge, 5 February 1965:
"Adrift for 7/12 after his dissappointment [sic] at not being discharged when he believed he would be. This conduct is in keeping with his previous bout of depression when logic is discarded and the impulse of the moment is obeyed. His over indulgence – alcohol the refuge of the unstable still persists. It is obvious that this continuous drinking indicates a degree of instability, which explains his desertion. In view of the history of depression in Singapore it is quite likely that detention and trial will produce a relapse. Further compulsion to serve is likely to produce the same result. I would therefore recommend his discharge from the service before there is some more serious psychiatric manifestation."
(T3, P29)

The psychiatric opinion of Dr Altman has already been detailed earlier in this decision.
Dr Lewin
In a report dated 24 June 1999 Dr Lewin, a consultant psychiatrist, concludes:
"…
In my opinion the drinking problem is the primary problem. He describes intermittent symptoms of anxiety, but he has been drinking steadily on a daily basis for at least a couple of decades. The history suggests a pattern of heavier drinking over a longer period.
Mr Slatyer reports intermittent anxiety symptoms. I did not diagnose a separate anxiety disorder because it is likely that the pattern of symptoms he describes can be accounted for in terms of the drinking problem alone. When he stops drinking he feels more apprehensive. It is very common indeed for people who withdraw from alcohol to experience anxiety, anger and similar emotional symptoms. Where there is a clear organic explanation for psychological symptoms, it is most unwise to propose a psychological explanation.
In my opinion Mr Slatyer's alcoholism arises out of inherent causes and is quite unrelated to the period of Naval Service he describes. A broken engagement would not be regarded as a common causal factor giving rise to an alcoholic problem. The causal hypothesis that Mr Slatyer suggests is in my opinion a very unlikely explanation. I noted his tendency to play down the importance of the drinking problem. This is a common response of most people who have a drinking problem. I do not attribute the causation of these life long problems to his period of Naval Service in general, or to his period of Operational Service in particular."
(Exhibit R1)

Dr Dinnen

In a report dated 28 May 1999, Dr Dinnen, a consultant psychiatrist, made the following comments and stated the following opinion:
"…
From the patient's account and the review of the documentation it seems that there were two stressful events during service. The first was the broken engagement, occurring while the patient was on operational service, in that period documented by the Department (3) between March and October 1959. The second was the death of the diver in April 1962.
It is highly significant in my opinion that both these stressful events led to psychiatric consultation during service. To my way of thinking this provides a clear nexus between the conditions of his service and the onset of psychiatric illness. The diagnosis of reactive depression appears to have been made appropriately, with the diagnosis being "watered down" in order to enable this patient to remain in the Navy. Clearly his personality and performance of duty was at least satisfactory enough for efforts to be made to rehabilitate him, a form of management which in my view is far better than "counselling".
Opinion: I believe that the Statement of Principles for generalised anxiety disorder does apply, with regard to paragraph 1(B) and that the patient currently suffers from an anxiety disorder associated with depressive symptoms and alcohol abuse, much in accord with the condition described in the psychiatric reports during service.
…"
(Exhibit A1)

submissions
the applicant:

Counsel for the Applicant submitted that the Applicant suffers both from a generalised anxiety disorder with depression and alcohol dependence. Further Counsel contends that the Applicant experienced a stressful event while on operational service and that as a consequence of this stressful event he was admitted to and received psychiatric evaluation and treatment at BMH Singapore. He was further psychiatrically evaluated in February 1960, again in May 1962 and February 1965. Further it is contended that a further stressful event was experienced by the Applicant when in April 1962 he was involved in a naval diving team member's death. Counsel further submits that the Applicant's subsequent behaviour after the first stressful incident, his need for psychiatric evaluation and hospitalisation and his continuing behaviour thereafter is consistent with a diagnosis of generalised anxiety disorder with depression and alcohol dependence. Further Counsel submits that a hypothesis is established from the facts in relation to both a generalised anxiety disorder with depression and alcohol dependence and that both hypotheses are reasonable in that they satisfy the appropriate Statement of Principles, and that they are neither speculative fanciful or tenuous.
respondent:
The Respondent submits that there is an issue of diagnosis, in that it is contended that the correct diagnosis is alcohol dependence and that, in relying upon this opinion, it is not war caused, with the Applicant's alcohol pattern being established prior to service.
In the alternate, the Respondent contends that the circumstances surrounding the initiating stressful event are too tenuous for a finding that a reasonable hypothesis exists, and as such the Applicant's claim must be rejected.
consideration and findings
In initial comment the Tribunal finds the Applicant's narration of events to the Tribunal to be consistent both with the records contained in the "T" documents and with those documented by the psychiatrists that he has had recourse to visit. Further, in recognising that neither party bears the onus of proof in such matters at this stage the Tribunal, having considered all the evidence placed before it details the following findings of facts:
(a) that the Applicant did commence drinking before service with a gradual increase in quantity between ages 16 and 18 years;
(b) that there is no evidence to support an opinion that the Applicant had a psychiatric or alcohol problem prior to service;
(c) that the Applicant received a letter from his fiance ending their relationship while at sea aboard HMAS ANZAC on 23 September 1959;
(d)     that the receipt of the letter and his reaction to and behaviour following such a receipt occurred during a period of operational service;
(e)      that the need for hospitalisation and psychiatric evaluation at BMH Singapore arose directly from his emotional and behavioural responses to the news contained within the letter;
(f)       that the Applicant's continuing emotional and behavioural problems after his discharge from BMH Singapore, including his drinking and behaviour towards military police, was a continuance of his response to the loss of the relationship.
(g)      that this continued until he returned to Australia and following redeployment to diving and further psychiatric evaluation the Applicant was placed on probation for six months and then undertook service on HMAS Melbourne prior to joining the diving team in January 1962;
(h)      that the diving fatality incident in April 1962 was clearly a stressful incident, which led to increasing binge alcohol consumption, notification of his drinking problem to his commanding officer by his mother and subsequent referral to a psychiatrist in May 1962;
(i)        that for reasons associated with the Applicant's apprehension about deep diving, his increased drinking habits, he withdrew from the diving team in January 1964;
(j) that the Applicant was discharged on medical grounds following further psychiatric evaluation in February 1965, the psychiatric evaluation being undertaken as a consequence of the long period that the Applicant was absent without leave, this being his response to the Navy Board refusing an earlier medical board's recommendation for a discharge in early 1964;
(k) that the Applicant had particular psychiatric diagnosis made during his service, which included reactive depression, immature personality and a well-established drinking habit; and
(l) that his post service history clearly demonstrates a continuance of his drinking problems and a defined history of interpersonal difficulties with staff, demonstrated by uncontrollable aggression, increasing difficulty with sleep, tension, nightmares, irritability and difficulties with concentration.
In considering the above findings of fact, and the opinions of the various psychiatrists listed earlier in this decision, the Tribunal is satisfied on the balance of probabilities that the Applicant has the following diagnosis:
(a) generalised anxiety disorder with depression, and
(b) alcohol dependence.
In nominating the above diagnosis the Tribunal has paid particular attention to the diagnostic criteria nominated in paragraph 4 of Statement of Principles Instrument No 48 of 1994, as amended by Instrument No 274 of 1995 concerning generalised anxiety disorder, and paragraph 4 of Instrument No 5 of 1994 concerning psychoactive substance abuse or dependence. The Tribunal finds that the necessary criteria have been met for the diagnosis to be made, and having assessed the clinical evidence and opinions is satisfied that alcohol dependence should stand alone as a separate diagnosis, as a consequence of the clear evidence of a significant and long standing drinking habit.
In turning again to the facts that may be pointed to in consideration of all the evidence before the Tribunal, the Tribunal observes that two hypotheses may be postulated which rely upon such facts, namely:
(a) that the Applicant was subject to a stressful incident, namely the receipt of a letter advising him of a termination of a relationship with his fiance; that this event occurred while on operational service and that as a consequence of the event he developed a generalised anxiety disorder, which was characterised by excessive worry and anxiety, which he was unable to control as evidenced by his behaviour in the succeeding weeks and months, and the development of an associated reactive depression; and
(b) that as a consequence of his generalised anxiety disorder, the Applicant developed a binge drinking habit, which was evidenced initially by his behaviour on shore leave after the incident and which further continued after his return to Australia and certainly was of sufficient intensity for his mother to notify the Commanding Officer in the weeks following the diving fatality in April 1962 and for the Applicant to be referred to a psychiatrist for evaluation; and that the facts also point to a continuing and gradual worsening of his alcohol consumption and associated behaviour in the years at Jackson's and thereafter.
The Tribunal, in considering the elements of the first hypothesis, is satisfied that the factual situation which created the hypothesis is congruent with the requirements nominated in the Statement of Principles Instrument No 48 of 1994 as amended by Instrument No 275 of 1995. The Applicant experienced a stressful event, the term stressful event being defined in the Instrument to mean an occurrence which evokes feelings of anxiety or stress, and the Applicant developed a generalised anxiety disorder within days of the stressful event. This has continued thereafter with periods of amelioration and exacerbation. Therefore the Applicant satisfies factor 1(b) of the instrument.
The Tribunal, having satisfied itself that the first hypothesis meets the template laid down in the appropriate Statement of Principle, moves to a consideration of the Respondent's contentions that the hypothesis was too remote or too tenuous, in that the receipt of the letter and the Applicant's subsequent reading and reactions was not an incident associated with operational service. Rather they were an incident unrelated with his operational service, but which coincidentally occurred while being on operational service.
In addressing the contention, the Tribunal would consider that separation is an incident of service, and as such of operational service. If indeed by virtue of that separation particular events occur, which are made known to the servicemen at a time that he is engaging in operational service and the serviceman's response to the circumstances advised involves the development of a psychiatric illness, the Tribunal would view such a development as an incident arising from the nature of his operational service. In so finding the Tribunal has considered and followed the reasoning nominated in O'Brien v Repatriation Commission (1985) 165 CLR 142.
As a consequence of the Tribunal's considerations, the Tribunal finds that the hypothesis is neither too remote nor tenuous and accordingly concludes that the hypothesis is reasonable and that subsection 120(3) of the Act is satisfied.
In considering whether one or more of the facts necessary to support the hypothesis are disproved beyond reasonable doubt, or whether the truth of a fact inconsistent with the hypothesis is proved beyond reasonable doubt, the Tribunal observes the particulars of diagnosis and opinion contained within Dr Lewin's two reports and in particular when he considers the Applicant's major problem to be one of alcohol dependence with associated features of intermittent anxiety. The Tribunal, while noting Dr Lewin's opinion and those of the other psychiatrists stated earlier in the decision finds that the opinion of Dr Lewin does not provide the necessary level of evidence which would permit the Tribunal to be satisfied that one or more of the facts necessary to support the hypothesis are disproved beyond reasonable doubt or whether the truth of a fact inconsistent with the hypothesis is proved beyond reasonable doubt. In summary the Tribunal is not satisfied beyond reasonable doubt that the incapacity was not war caused and as a consequence the Tribunal finds that the Applicant's condition of generalised anxiety disorder with associated major depression is a war caused disability.
In relation to the second hypothesis, the Tribunal observes that the nominated facts constituting the hypothesis are congruent with factor 1(b) contained within Statement of Principles Instrument No 5 of 1994, concerning psychoactive substance abuse or dependence, in that the Applicant had a psychiatric condition prior to the clinical onset of psychoactive substance abuse or dependence
The Tribunal finds that a reasonable hypothesis exists in relation to the second hypothesis. In considering whether it is satisfied beyond reasonable doubt that the disability was not war caused, the Tribunal, in noting the evidence of Dr Lewin that the causal connection between the Applicant's alcohol dependence and his service or operational service is very unlikely, is not satisfied that this opinion is of such imperial evidentary weight as to persuade the Tribunal that any of the facts which constitute the hypothesis are disproved beyond reasonable doubt or other facts inconsistent with the hypothesis are proved beyond reasonable doubt.
In summary the Tribunal finds that the Applicant's condition of alcohol dependence is a war caused disability.
determination
The Tribunal determines that the decision under review be set aside and in substitution thereof determines that:
(1) the Applicant's conditions of generalised anxiety disorder with associated major depression and alcohol dependence are war caused disabilities; and
(2) the matter is remitted to the Respondent for assessment of the two war caused disabilities.

I certify that the 42 preceding paragraphs are a true copy of the reasons for the decision herein of DR J D CAMPBELL, Member
Signed:         .....................................................................................
  Associate
Date of Hearing  23 October 2000
Date of Decision  26 February 2001
Counsel for the Applicant        Mr Smith
Solicitor for the Applicant         Mr Higginbottom
Advocate for the Respondent Mr Modder