Voelker and Repatriation Commission (Veterans’ entitlements)
[2016] AATA 427
•24 June 2016
Voelker and Repatriation Commission (Veterans’ entitlements) [2016] AATA 427 (24 June 2016)
Division
VETERANS' APPEALS DIVISION
File Number
2015/0459
Re
Gerhard Herbert Voelker
APPLICANT
And
Repatriation Commission
RESPONDENT
DECISION
Tribunal Deputy President K Bean
Lt Col R Ormston (Rtd) (Member)Date 24 June 2016 Place Adelaide The decision under review is affirmed, that is, the claims for post-traumatic stress disorder, generalised anxiety disorder and alcohol use disorder are refused.
.............. [Sgd] .................................................
Deputy President K Bean
CATCHWORDS
VETERANS' AFFAIRS – Veterans' entitlements – Operational service in Vietnam – Whether veteran suffers from PTSD – No evidence of traumatic event – Deledio steps – Whether veteran suffers from generalised anxiety disorder and alcohol use disorder – Whether conditions war-caused – Decision under review affirmed.
LEGISLATION
Veterans' Entitlements Act 1986, ss 6, 9, 13(1), 120 and 120A
Statement of Principles concerning alcohol use disorder Instrument No. 1 of 2009 (as amended by Instrument No. 29 of 2014)
Statement of Principles concerning posttraumatic stress disorder Instrument No. 5 of 2008
Statement of Principles concerning posttraumatic stress disorder Instrument No. 82 of 2014
Statement of Principles concerning anxiety disorder Instrument No. 102 of 2014CASES
Re Spencer and Repatriation Commission [1997] AATA 358
Bull v Repatriation Commission (2001) 66 ALD 271
Bushell v Repatriation Commission (1992) 175 CLR 408
Repatriation Commission v Deledio (1998) 83 FCR 82
Repatriation Commission v Bawden (2012) 206 FCR 296
McKenna v Repatriation Commission (1999) 86 FCR 144
SECONDARY MATERIALS
American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders (5th ed, 2013)
REASONS FOR DECISION
Deputy President K Bean
Lt Col R Ormston (Rtd) (Member)24 June 2016
INTRODUCTION
The applicant, Mr Voelker, served in the Royal Australian Navy from July 1964 to July 1970, which included four periods of operational service in Vietnam between 19 May 1967 and 13 June 1968.
As a consequence of his service, Mr Voelker suffers from bilateral sensorineural hearing loss and tinnitus, which have been accepted as war-caused and for which he has been receiving a disability pension at 30% of the general rate of disability since December 2005. He also had a condition of malignant neoplasm of the prostrate accepted as war-caused in November 2013.
On 26 June 2012, Mr Voelker lodged a claim for disability pension in relation to post-traumatic stress disorder (PTSD) and anxiety. The Repatriation Commission concluded that the appropriate diagnoses were PTSD, “generalised anxiety disorder” and “alcohol dependence” and refused the claim on 8 May 2013.[1] On 13 May 2014, Mr Voelker applied to the Veterans’ Review Board (VRB) for a review of that decision. On 12 December 2014, the VRB affirmed the decision of the Repatriation Commission refusing Mr Voelker’s claim for PTSD, generalised anxiety disorder and alcohol dependence.
[1] Exhibit 1, T4/27.
On 2 February 2015, Mr Voelker applied to this Tribunal seeking review of the decision by the VRB, and giving rise to these proceedings.
THE LEGAL FRAMEWORK
Subsection 13(1) of the Veterans’ Entitlements Act 1986 (the VE Act) provides, in effect, that where a veteran has become incapacitated from a war-caused injury or a war-caused disease, the Commonwealth is liable to pay a pension by way of compensation to the veteran.
Section 9 of the VE Act provides for when an injury or disease is taken to be war-caused, and provides relevantly as follows:
9 War-caused injuries or diseases
(1) Subject to this section and section 9A, for the purposes of this Act, an injury suffered by a veteran shall be taken to be a war-caused injury, or a disease contracted by a veteran shall be taken to be a war-caused disease, if:
(a)the injury suffered, or disease contracted, by the veteran resulted from an occurrence that happened while the veteran was rendering operational service;
(b)the injury suffered, or disease contracted, by the veteran arose out of, or was attributable to, any eligible war service rendered by the veteran;
…
(e)the injury suffered, or disease contracted, by the veteran:
(i)was suffered or contracted while the veteran was rendering eligible war service, but did not arise out of that service; or
(ii)was suffered or contracted before the commencement of the period, or last period, of eligible war service rendered by the veteran, but not while the veteran was rendering eligible war service;
and, in the opinion of the Commission, the injury or disease was contributed to in a material degree by, or was aggravated by, any eligible war service rendered by the veteran, being service rendered after the veteran suffered that injury or contracted that disease;
but not otherwise.
The expression “operational service” is defined in ss 6 to 6F of the VE Act. Under s 6C, a person renders operational service if he or she is, inter alia, allotted for duty in an operational area. It is common ground that Mr Voelker’s periods of service in Vietnam between 19 May 1967 and 13 June 1968 were operational service.
Section 120 of the VE Act provides for the standard of proof applicable to the determination of whether any psychiatric condition suffered by Mr Voelker is war-caused. That section provides relevantly as follows:
120 Standard of proof
(1)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.
Note: This subsection is affected by section 120A.
….
(3) In applying subsection (1) or (2) in respect of the incapacity of a person from injury or disease, or in respect of the death of a person, related to service rendered by the person, the Commission shall be satisfied, beyond reasonable doubt, that there is no sufficient ground for determining:
(a) that the injury was a war-caused injury or a defence-caused injury;
(b)that the disease was a war-caused disease or a defence-caused disease; or
(c)that the death was war-caused or defence-caused;
as the case may be, if the Commission, after consideration of the whole of the material before it, is of the opinion that the material before it does not raise a reasonable hypothesis connecting the injury, disease or death with the circumstances of the particular service rendered by the person.
Note: This subsection is affected by section 120A.
(4) Except in making a determination to which subsection (1) or (2) applies, the Commission shall, in making any determination or decision in respect of a matter arising under this Act or the regulations, including the assessment or re-assessment of the rate of a pension granted under Part II or Part IV, decide the matter to its reasonable satisfaction.
Note: This subsection is affected by section 120B.
Subsection 120(6) provides in effect that neither party has any onus of proving any matter relevant to the determination of the claim.
Subsection 120A(3) provides relevantly:
(3) For the purposes of subsection 120(3), a hypothesis connecting an injury suffered by a person, a disease contracted by a person or the death of a person with the circumstances of any particular service rendered by the person is reasonable only if there is in force:
(a) a Statement of Principles determined under subsection 196B(2) or (11); or
...
that upholds the hypothesis.
The application of subss 120(1) and (3) and 120A(3) of the VE Act was explained in Repatriation Commission v Deledio (1998) 83 FCR 82, where the Full Court of the Federal Court (Beaumont, Hill and O’Connor JJ) said at 97:
1.The Tribunal must consider all the material which is before it and determine whether that material points to a hypothesis connecting the injury, disease or death with the circumstances of the particular service rendered by the person. No question of fact finding arises at this stage. If no such hypothesis arises, the application must fail.
2.If the material does raise such a hypothesis, the Tribunal must then ascertain whether there is in force an SoP determined by the Authority under s 196B(2) or (11). If no such SoP is in force, the hypothesis will be taken not to be reasonable and, in consequence, the application must fail. [2]
3.If an SoP is in force, the Tribunal must then form the opinion whether the hypothesis raised is a reasonable one. It will do so if the hypothesis fits, that is to say, is consistent with the "template" to be found in the SoP. The hypothesis raised before it must thus contain one or more of the factors which the Authority has determined to be the minimum which must exist, and be related to the person’s service (as required by ss 196B(2)(d) and (e)). If the hypothesis does contain these factors, it could neither be said to be contrary to proved or known scientific facts, nor otherwise fanciful. If the hypothesis fails to fit within the template, it will be deemed not to be “reasonable” and the claim will fail.
4.The Tribunal must then proceed to consider under s 120(1) whether it is satisfied beyond reasonable doubt that the death was not war-caused, or in the case of a claim for incapacity, that the incapacity did not arise from a war-caused injury. If not so satisfied, the claim must succeed. If the Tribunal is so satisfied, the claim must fail. It is only at this stage of the process that the Tribunal will be required to find facts from the material before it. In so doing, no question of onus of proof or the application of any presumption will be involved.
[2] The second sentence of Step 2 in Deledio has been found not to be correct: Bull v Repatriation Commission (2001) 66 ALD 271. Where no SoP is in force, the veteran’s application will not necessarily fail, but must be determined in accordance with subss 120(1) and (3) on the basis of the medical evidence before the Tribunal.
It is also established by the authorities that an hypothesis is a proposition made as a basis for reasoning, without assumption of its truth, or a supposition made as a starting point for further investigation from known facts: Bull v Repatriation Commission (2001) 66 ALD 271 at [17] and [38]. In Bushell v Repatriation Commission (1992) 175 CLR 408, Mason CJ, Deane and McHugh JJ said:
The material will raise a reasonable hypothesis within the meaning of s 120(3) if the material points to some fact or facts (“the raised facts”) which support the hypothesis and if the hypothesis can be regarded as reasonable if the raised facts are true.
THE ISSUES
It follows that in general terms the issues before us are:
(a)whether Mr Voelker suffers from PTSD, generalised anxiety disorder and/or alcohol dependence; and
(b)if so, whether any condition from which he does suffer is war-caused.
We will address each of the claimed conditions in turn.
DOES MR VOELKER HAVE PTSD?
Diagnosis
In addressing this question, we note that the question of diagnosis is anterior to the application of any SoP, and must be addressed by the reference to the “reasonable satisfaction” or “balance of probabilities” standard. The effect of the authorities is that before determining whether any SoP applies, the Tribunal must first determine whether the ‘collection of symptoms’ complained of by a veteran amounts to a disease, having regard to the medical evidence before it and the applicable diagnostic criteria.[3] The Federal Court has acknowledged that when it comes to psychiatric conditions, this will generally involve reference to the applicable manual, which is currently the DSM-5.[4]
[3] Repatriation Commission v Bawden (2012) 206 FCR 296 at 305.
[4] American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders (5th ed, 2013).
The diagnostic criteria for PTSD in DSM-5 relevantly require:
A.Exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the following ways:
1. Directly experiencing the traumatic event(s).
2. Witnessing, in person, the event(s) as it occurred to others.
…
However, before applying these criteria in light of the medical evidence, we should first consider whether Mr Voelker was exposed to a traumatic event or events.
The relevant event(s)
In his evidence to the Tribunal, supplementing his written statements,[5] Mr Voelker said he had no recollection of a specific traumatic event or events relevant to the diagnosis, as he has substantial memory gaps in relation to his military service. He said he has a general recollection of his first and second trips to Vietnam on board HMAS Sydney but no recollection of his third or fourth trips.
[5] Exhibits 3 and 4.
Mr Voelker said that he would have been working below deck for most of the time the ship was in Vietnamese waters, either in the boiler room or maintaining the refrigerators. However, he recalls that when the ship was in Vung Tau harbour on his first and second trips, he could hear charges being regularly detonated near the ship’s side to deter enemy divers from attempting to place mines on the ship’s hull. He said that he was particularly worried because any such mines could have penetrated the ship’s hull and flooded the engine room, endangering him and others working below decks.
In his written statement, Mr Voelker said he recalls going onto the main deck for brief occasions when the ship was at Vung Tau during his first and second trips, from where he saw helicopters ferrying troops and supplies to the shore, and “everyone running around like ants”. He said that during the second trip, the Tet offensive[6] was underway, and that he could see “the red from the explosion of bombs”. He also said he had heard that there was a Viet Cong stronghold nearby. He said he “felt vulnerable and fearful about what danger we were putting ourselves in.”[7]
[6] A major North Vietnamese offensive which included combat operations in and around Saigon.
[7] Exhibit 3, p 3.
Mr Voelker also said that while HMAS Sydney only spent a few hours each trip actually in Vung Tau harbour, loading and unloading troops and supplies, he was apprehensive for much of the trip, worrying about what might happen. He cited going to action stations in the Strait of Malacca, en route to Vietnam on one of his trips, when the ship was “closed down”, which exacerbated his fear and anxiety. He said he recalls that he felt “under threat” for the entire duration of each voyage.
The medical evidence
In a report dated 4 May 2006,[8] Dr Martyn Ewer, Psychiatrist, said that “Mr Voelker’s score results do not indicate he is suffering from Post-Traumatic Stress Disorder”, adding however that “it is difficult to comment upon the cause of Mr Voelker’s problems given that he could not remember when he went to Vietnam and given that he could recall few of the details of his time in Vietnam”.
[8] Exhibit 1, T10/62.
In a report dated 21 January 2013,[9] Mr Voelker’s treating Psychiatrist, Dr Dan Short, said:
I have no evidence, but strongly suspect that [Mr Voelker’s] memory disturbance is a function of some form of underlying mental health disorder, such as Post Traumatic Stress Disorder … but at this point in time, we have been unable to uncover any evidence of history of exposure to traumatic incidents.
[9] Exhibit 1, T15/80.
In a further report dated 16 September 2014,[10] Dr Short stated:
In my opinion, during his operational service, Mr Voelker was operating in [a] threatening, hostile, hazardous and/or menacing environment before the clinical onset of his Post Traumatic Stress Disorder. (emphasis in original).
However, Dr Short made no mention of any specific traumatic event or events.
[10] Exhibit 1, T17/97.
In a report dated 17 December 2015,[11] in response to a letter from the respondent seeking further opinion, Dr Short explained:
… we have gradually been able to piece together some of [Mr Voelker’s] experiences whilst serving, particularly on the HMAS Sydney and it is during this time that I believe he experienced the traumatic event(s), which led to him developing Post Traumatic Stress Disorder.
He added “As a result of his memory disturbance we have not yet been able to describe any specific incidents fulfilling the diagnostic criteria”.
[11] Exhibit 2.
Consideration
The first issue for us to determine is whether Mr Voelker experienced a traumatic event or events during his operational service, necessary to support a diagnosis of PTSD in accordance with the DSM-5.
Mr Miller, who appeared as counsel for Mr Voelker, conceded that Mr Voelker had no recollection of experiencing a traumatic event or events during his operational service. However, he argued that Mr Voelker should not be penalised for his loss of memory and that it would be appropriate for the Tribunal to conclude that Mr Voelker had experienced a traumatic event or events during his operational service.
Mr Crowe, representing the respondent, noted that subs 119(1)(h) of the VE Act requires the Commission, and the Tribunal, to “take into account any difficulties that, for any reason, lie in the way of ascertaining the existence of any fact, matter, cause or circumstance”. However, he argued that that does not extend to substituting a presumption of what might have happened where evidence does not exist, citing Re Spencer and Repatriation Commission [1997] AATA 358 at [46] where it was held that “there must be something in the material before the Tribunal before it can take into account the direction given by paragraph (h) [of subsection 119(1)].”
After considering the evidence, we acknowledge the difficulties faced by Mr Voelker in recalling the circumstances of his operational service which occurred nearly 50 years ago. However, the Full Federal Court made clear in Repatriation Commission v Bawden (2012) 206 FCR 296 at 307 that “a finding that a traumatic event has occurred is indispensable to a diagnosis of PTSD.” In the absence of any evidence that Mr Voelker experienced a traumatic event or events during his operational service, we are not satisfied that he meets the diagnostic criteria for PTSD specified in DSM-5. Accordingly, we are not satisfied he suffers from PTSD, or suffered from PTSD at any relevant time.
WAS ANY SUCH CONDITION WAR-CAUSED?
While we have concluded that Mr Voelker has not met the diagnostic criteria for PTSD, for completeness we will briefly address the issue of whether any such condition may have been war-caused, which depends upon our consideration of the issues raised at each of the four Deledio steps outlined earlier. We will accordingly address each of those steps in turn, by reference to the material before us and the contentions of the parties.
Does the material point to an hypothesis connecting Mr Voelker’s diagnosis with his service?
Mr Voelker’s hypothesis is that he was “under constant threat” during his operational service in Vietnam which led to the development of a psychiatric disorder, either during or shortly after the end of his operational service.
We are satisfied that the material points to facts which support this hypothesis. Accordingly, we consider that step 1 of the Deledio test is satisfied.
Is there an applicable SOP?
There is a SoP currently in force relating to PTSD, namely Instrument No. 82 of 2014. It relevantly provides as follows:
Factors
6.The factor that must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting posttraumatic stress disorder or death from posttraumatic stress disorder with the circumstances of a person’s relevant service is:
(a)experiencing a category 1A stressor before the clinical onset of posttraumatic stress disorder; or
(b)experiencing a category 1B stressor before the clinical onset of posttraumatic stress disorder; or
(c)living or working in a hostile or life-threatening environment for a period of at least four weeks before the clinical onset of posttraumatic stress disorder;
…
We note that Instrument No. 5 of 2008, which was in force at the time his claim was lodged, could also be relied upon by Mr Voelker, however its provisions are relevantly less favourable than the current instrument. Instrument No. 19 of 2014, which came into effect on 19 December 2013 as an amendment to Instrument No. 5 of 2008, is not relevant as it was replaced by Instrument No. 82 of 2014.[12]
[12] See Repatriation Commission v Thomas (2002) 71 ALD 289 at [36] – [37]; Repatriation Commission v Gorton (2001) 65 ALD 609 at [66].
Does the hypothesis fit the SOP?
Having regard to the terms of the SoP (Instrument No. 82 of 2014), and the material before us, the answer to this question depends in turn upon whether the material points to the existence of “a category 1A stressor” [clause 6(a)] or “a category 1B stressor” [clause 6(b)] or “living or working in a hostile or life-threatening environment for a period of at least four weeks” [clause 6(c)]. If the material points to the existence of any of those factors, the hypothesis can be regarded as containing those factors, and therefore fitting the SoP.
The SoP relevantly defines these terms as:
“a category 1A stressor” means one the following severe traumatic events:
(a)experiencing a life-threatening event; or
(b)being subject to a serious physical attack or assault …
…
“a category 1B stressor” means one of the following severe traumatic events:
(a)being an eyewitness to a person being killed or critically injured;
(b)viewing corpses or critically injured casualties as an eyewitness;
….
“a hostile or life-threatening environment” means a situation or setting which is characterised by a pervasive threat to life or bodily integrity, such as would be experienced in the following circumstances:
(a)experiencing or being under threat of artillery, missile, rocket, mine or bomb attack;
…
There is no material, nor any contention by Mr Voelker, pointing to him experiencing either a category 1A or 1B stressor during his operational service. In his evidence, Mr Voelker contended that he felt “under constant threat” for the entire duration of each of his four voyages on HMAS Sydney to and from Vietnam, which totalled 27, 31, 31 and 24 days respectively. Mr Voelker also said that he was particularly worried by the threat of mines while HMAS Sydney was in Vietnamese waters, including the possibility of mines or other explosive charges being placed against the ship’s hull while it was in Vung Tau harbour.
Mr Voelker also said that on his second trip, he could see “the red from the explosion of bombs”, which he explained in responding to a question from the Tribunal was from artillery or similar munitions detonating on the land. There was no suggestion in his evidence that these explosions presented any threat to HMAS Sydney, or that the ship was at any time under threat from any form of artillery, missile, rocket or bomb attack.
The Tribunal notes that an official account of HMAS Sydney’s role in the war[13] contended that “there was very little enemy main force activity around Vung Tau, which rendered it a ‘safe’ port.” Regardless, it is understandable that Mr Voelker would have been concerned. However, we do not consider that the seemingly low possibility that a mine attack might eventuate could be construed as “a pervasive threat to life or bodily integrity”.
[13] Exhibit 6, p 107.
Nor, given that HMAS Sydney generally spent less than one day in Vung Tau harbour and only a number of days in Vietnamese waters on each trip, could it be considered that Mr Voelker was “living or working in a hostile or life-threatening environment for a period of at least four weeks”, even if the days spent in Vietnamese waters on each trip were considered cumulatively, which we do not think was the intent of the factor at clause 6(c).
The material before us therefore does not point to Mr Voelker having experienced at least one of the factors that must be related to service, as set out in clause 6 of the relevant SoP. Accordingly, we have concluded that the hypothesis raised is not a reasonable one as it does not contain any of the factors in the SoP. It follows that the hypothesis that any PTSD condition suffered by Mr Voelker may have been war-caused fails at step 3 of the Deledio test.
ARE MR VOELKER’S OTHER CONDITIONS WAR-CAUSED?
We will also address whether Mr Voelker suffers from other conditions which are war-caused, namely generalised anxiety disorder and alcohol dependence.
Does Mr Voelker suffer from generalised anxiety disorder which is war-caused?
Mr Crowe conceded that Mr Voelker suffers from generalised anxiety disorder, as diagnosed by Dr Short in his report dated 21 January 2013.[14] However, he noted that Mr Voelker said he first became aware of its signs and symptoms in 1979, in his claim for disability pension dated 20 March 2006.[15] In a subsequent claim dated 4 October 2011,[16] Dr Short noted that Mr Voelker first consulted him for PTSD/anxiety on 18 July 2011.
[14] Exhibit 1, T15/89.
[15] Exhibit 1, T6/46.
[16] Exhibit 1, T3/18.
Mr Crowe pointed out that in the “factors that must be related to service” at clause 6 of the relevant SoP[17], the relevant factor(s) must exist within the five years before the clinical onset of anxiety disorder. Mr Voelker’s assertion that he first became aware of its signs and symptoms in 1979 means that the factor(s) would need to have existed in or after 1974 to establish causality. However, Mr Voelker’s last trip to Vietnam was in June 1968, which is much earlier than the timing required by the SoP.
[17] Statement of Principles concerning anxiety disorder No. 102 of 2014. The earlier SoPs are relevantly less favourable than the current instrument.
As we understand it, Mr Voelker’s hypothesis is that his generalised anxiety disorder is attributable to events and experiences during his operational service. However, there is no material pointing to Mr Voelker’s anxiety disorder having its clinical onset within five years of his Vietnam service, which is an essential element of the relevant factors in the SoP. It follows that his hypothesis does not contain any of the factors in the SoP, and therefore step 3 of the Deledio test is not satisfied. We have therefore concluded that Mr Voelker’s anxiety disorder is not war-caused.
Does Mr Voelker suffer from alcohol use disorder which is war-caused?
Mr Crowe said he did not dispute that Mr Voelker suffers from alcohol dependence, currently known as “alcohol use disorder”.[18] However, he pointed out that the “factors that must be related to service” at clause 6 of the relevant SoP[19] require “a clinically significant psychiatric condition at the time of the clinical onset of alcohol use disorder” or experiencing a category 1A or 1B stressor within the five years before the clinical onset.
[18] Amendment Statement of Principles concerning alcohol use disorder No. 29 of 2014 changed the name of Instrument No. 1 of 2009 and replaced the phrase “alcohol dependence and alcohol abuse” with “alcohol use disorder”.
[19] Statement of Principles concerning alcohol use disorder No. 1 of 2009, as amended by Instrument No. 29 of 2014.
In the absence of material pointing to a category 1A or 1B stressor, Mr Crowe argued that Mr Voelker’s condition could only be accepted as war-caused if he had been diagnosed with PTSD or a similar service-related condition at the time of clinical onset of alcohol use disorder. Mr Miller contended that it would be open for the Tribunal to assume that a relevant condition may have existed undiagnosed.
We note that to argue clinical worsening in accordance with clause 6(g), Mr Voelker would have had to point to material supportive of clinical worsening of alcohol use disorder, which was not argued by Mr Miller. Nor did Mr Miller put forward any date of clinical onset, or clinical worsening, although we note Dr Short’s opinion that Mr Voelker’s alcohol use disorder developed after and as a result of his PTSD.[20]
[20] Exhibit 1, T17/97.
As we understand it, Mr Voelker’s hypothesis is that his alcohol use disorder developed as a result of his PTSD or anxiety disorder, rather than as a result of a relevant stressor. However, the material before us does not point to Mr Voelker suffering from a service-related psychiatric condition as at the date of the onset of his alcohol use disorder, as at the date of any clinical worsening of that condition, or indeed at any time.[21]
[21] See McKenna v Repatriation Commission (1999) 86 FCR 144.
Mr Voelker’s hypothesis therefore does not contain any of the factors in the SoP, and step 3 of the Deledio test is also not satisfied in respect of this condition.
We have therefore also concluded that Mr Voelker’s alcohol use disorder is not war-caused.
CONCLUSION
We have concluded that Mr Voelker has not met the diagnostic criteria for PTSD, and even if he had, this condition could not be considered to be war-caused. We have also concluded that his generalised anxiety disorder and alcohol use disorder are not war-caused.
DECISION
The decision under review is affirmed, that is, the claims for PTSD, generalised anxiety disorder and alcohol use disorder are refused.
I certify that the preceding 52 (fifty-two) paragraphs are a true copy of the reasons for the decision herein of Deputy President K Bean and Lt Col R Ormston (Rtd) (Member) .......... [Sgd] ............................................
Associate
Dated 24 June 2016
Date of hearing 28 April 2016 Counsel for the Applicant Mr J Miller Solicitors for the Applicant Tindall Gask Bentley Lawyers Advocate for the Respondent Mr A Crowe
Department of Veterans’ Affairs Advocacy Section
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