Wright and Repatriation Commission

[2005] AATA 123

Administrative

Appeals

Tribunal

 

DECISION AND REASONS FOR DECISION [2005] AATA 123

ADMINISTRATIVE APPEALS TRIBUNAL      )

)          No N2003/63

VETERANS' APPEALS DIVISION		)
Re		GRAHAM WRIGHT

Applicant

And REPATRIATION COMMISSION

Respondent

DECISION

Tribunal Senior Member R Hunt , Member Dr P Lynch

Date9 February 2005

PlaceSydney

Decision The decision under review is affirmed.

[sgd] Ms R Hunt

Senior Member

CATCHWORDS

VETERANS' ENTITLEMENTS - Claim for post traumatic stress disorder (PTSD), Alcohol abuse and Hypertension - Conflicting medical opinions – Hypothesis not reasonable.

LEGISLATION

Veterans' Entitlements Act 1986 ss120, 120A

Statement of Principles concerning PTSD (Instrument No 1 of 2000)

CASE LAW

Repatriation Commission v Deledio (1998) 83 FCR 82

Repatriation Commission v Hancock (2003) 37 AAR 383

Benjamin v Repatriation Commission (2001) 70 ALD 622

Woodward v Repatriation Commission (2003)75 ALD 420

REASONS FOR DECISION

9 February  2005

SUMMARY

Senior Member R Hunt, Member Dr P Lynch

1.      The Applicant, Mr Wright, claims that he suffers from post traumatic stress disorder (PTSD) stemming from traumatic events which occurred during his operational service in the Royal Australian Navy (RAN). He also claims that he is suffering from hypertension. Mr Wright’s service background was unusual in that he was a musician and serving in that capacity. He was a junior musician when performing eligible war service with the Far Eastern Strategic Reserve (FESR) in 1960 and 1963. He was a leading musician, on HMAS Sydney, when the ship was posted to South Vietnam in February and March 1972 and again from 1 November to 30 November 1972. During visits to Vung Tau harbour, Vietnam, Mr Wright said he was stationed as a gunnery lookout. The fear and anxiety he suffered during these visits he claims resulted in his developing PTSD, then alcohol dependence and hypertension. The Tribunal has found that any anxiety disorder, alcohol abuse and hypertension Mr Wright suffers were not related to his operational service. The Tribunal’s detailed findings and reasons are set out below.

ISSUE

2.      The decision subject to the Tribunal’s review is that part of the decision of the Veterans’ Review Board, dated 9 December 2002, that affirmed the decision of the Repatriation Commission on 9 April 2002, to refuse Mr Wright’s claims for recognition of his suffering from an anxiety disorder and for hypertension. The applicant also sought review of the decision to assess his pension at 40% with effect from 8 November 2001.

3.      Mr Wright has claimed, during the Tribunal’s review, that he suffers from chronic PTSD and hypertension since serving in Vietnam in 1972. After his discharge from the RAN on 21 November 1973, this disease led Mr Wright into alcohol dependence. He claims his PTSD and hypertension are war caused diseases. He also claimed an increase in assessment for his pension.

BACKGROUND

4.      Mr Wright served with the FESR on HMAS Melbourne during the Malayan emergency. However, his claim is based only in relation to stressors he suffered while serving on HMAS Sydney in Vietnam during 1972. His agreed periods of eligible war service and operational service during 1972 took place between 14 February to 9 March 1972 and 1 November to 30 November 1972.

LEGISLATION AND ITS APPLICATION

5. Compensation by way of pension may be payable under section 9 of the Veterans’ Entitlements Act 1986 (the Act) where a veteran suffers from injury or disease while rendering operational service or eligible war service.

6.      Section 120 deals with standards of proof. Where a veteran has operational service, subsections 120(1) and (3) and section 120A set out steps to be taken in reaching a decision about the veteran’s eligibility. Section 120 reads, in part:

“(1)     Where a claim under Part II for pension in respect of the incapacity from the 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.

…

(3)       In applying subsection (1) … in respect of the incapacity of a person from injury or disease … 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)…;

(d)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.”

7.      Subsection 120A(3) provides, in relation to claims made after 1 June 1994, that an hypothesis connecting a disease with the circumstances of any particular service rendered by the person is reasonable only if there is a Statement of Principles (“SoP”) determined under subsection 196B(2) that upholds the hypothesis. 

8.      The parties debated which SoPs covered PTSD, hypertension and alcohol dependence in the present case. Mr Wright’s representative referred in the Facts and Contentions lodged with the Tribunal to SoP No 1 of 2000 for generalised anxiety disorder (GAD) and to No 31 of 2001 for hypertension. He said at the hearing that Mr Wright was relying on the SoP for PTSD that applied at the time of his claim.

9.      The Respondent referred a series of SoPs, including Instruments 76 and 77 of 1998, Instruments 1 and 2 of 2000, Instrument 3 of 1999 as amended by Instrument 54 of 1999 and Instrument 4 of 1999. In addition, the Respondent referred to Instruments 35 of 2003 as amended by Instrument 3 of 2004 and Instrument 36 of 2003 as amended by Instruments 31 and 32 of 2001. The Respondent argued that as alcohol dependence was said to have caused Mr Wright’s hypertension, the appropriate SoPs for alcohol dependence must also be examined. Instrument 3 of 1999 as amended by Instrument 54 of 1999 concerns PTSD and applied at the time of Mr Wright’s application. The Tribunal considered the evidence against these criteria. The Tribunal also identifies the following SoPs as relevant:

·     General Anxiety Disorder   No 1 of 2000

·     Alcohol Abuse  No 76 of 1998

·     Hypertension   No 35 of 2003

DISCUSSION OF EVIDENCE

General

10.      The first step that the Tribunal is required to take is to consider all of the material before it and determine whether that material pointed to a hypothesis or hypotheses connecting Mr Wright’s disease with the circumstances of the particular service rendered by him. The hypothesis proposed in this claim is that Mr Wright developed PTSD from stress during operational service when he was aboard HMAS Sydney during 2 journeys in February / March and November 1972 and anchored in Vung Tau harbour, Vietnam. Further, as a result of this disorder he began to drink excessive amounts of alcohol, which in turn caused him to develop alcohol abuse, which in turn caused him to develop hypertension.

11.      Submissions by Mr Wright’s representative suggested the obligation was restricted to conform to the template of the SoP for anxiety disorder and PTSD. This is not in accord with McKenna v Repatriation Commission (1999) 86 FCR 144. The Tribunal has, in accordance with McKenna, examined whether each sub-hypothesis is supported by a SoP.

12.      The initial task for the Tribunal is to establish the diagnosis to the level of probability of any psychiatric disorder, alcohol abuse / dependence and hypertension. If the diagnosis of PTSD is not accepted then the Tribunal will consider the alternative diagnosis of general anxiety disorder. The Tribunal must approach its task as explained by the Full Court of the Federal Court in Repatriation Commission v Deledio (1998) 83 FCR 82 at 97.

Facts

13.      The Tribunal reviewed all the material made available and derived the following facts:

• Mr Wright had an emotionally deprived childhood, which probably increased his vulnerability to stress.

• He joined the RAN to become a member of the Navy Band. He was trained as a bandsman and also as an aircraft spotter on the gunnery platform. He did both these tasks competently during his service initially for 12 years (1957 – 1969) and a subsequent period of nearly 2 years (1971 –1973). Despite both these periods including operational service, it is only the second period he retrospectively claimed caused him any stress.

• Mr Wright had experiences in 1972 of being aboard HMAS Sydney when she anchored in Vung Tau Harbour. The first series were on 28 February for 14 hours and on 1 March for 10 hours. Again, the ship entered the harbour on 23 and 24 November for 11 hours and 8 hours respectively. It was routine for HMAS Sydney to steam out to sea overnight. In addition the ship “closed up” for nearly 4 hours before, during and after each of these 2-day deployments into Vung Tau.

• This operational service was different to any previous operational service of Mr Wright, being in a War Zone. However, Mr Wright was a sailor with some 13 years experience and an adult of 33 years. Contrary to his oral evidence, he was trained for the tasks he was required to do and he was objectively well equipped to deal with the additional apprehension of these brief exposures to incident free deployment aboard HMAS Sydney into Vung Tau Harbour.

• There were no incidents, which would provoke intense fear, horror or helplessness and Mr Wright claimed no such feelings, as he only claimed a fear of what could possibly happen and that his fear abated on the journey home.

• Mr Wright was diagnosed as having symptoms of depression in the period between his first and second voyages to Vietnam. However a  RAN medical report, dated 22 June 1972, indicates he was coping with the help of Naval staff. The cause of the problem was financial difficulties he was having with meeting his commitment to his daughter. This brief report does suggest his current difficulty was not service related and as he was coping his symptoms didn’t reach the level of a disorder.

• Mr Wright served a further 11-12 months in the RAN after these operational experiences and sought a free release discharge, because he was older than the other bandsmen and he hadn’t achieved the promotion he expected. He also told Dr McClure he resigned, as he was disappointed in not being re-posted to HMAS Sydney for an anticipated trip to the USA.

• At the time of his resignation, he had the opportunity to report any adverse psychological experiences during his RAN service but he made no complaint. He had been granted an early release from his service commitment and was under no obvious pressure not to complain.

• After his first discharge from the RAN, Mr Wright worked as a chauffeur for the ABC and during this time he developed a residual apprehension about driving a limousine after he was involved in a motor vehicle accident. He was re-deployed sorting mail and, as a result, he resigned from this job and rejoined the RAN.

• After his second discharge from the RAN, Mr Wright returned to Tasmania and worked driving a school bus and working in a social club for some 7 months. He then moved to Sydney.

• He gained employment with the help of his ex-wife as a head cleaner at a RSL club and was later made sub-assistant manager. He changed employment after several years and worked for an RSL club until the end of 1975 when his second wife helped him find a job with Sydney Electrical. He advanced with time, experience and undergoing training in this employment until he was made redundant in 1994. This was a 20-year period of stability for Mr Wright as he married happily and made significant advancement during 18 years in this employment.

• He then became a driver, initially as a courier, then driving a Novotel courtesy bus, then a Koala Tour coach. At this time (Jan.1996), he had a nervous breakdown because of a 4-months work disruption and a perceived demotion. He sought psychiatric help (from Dr Yeoh) for the first time and the condition resolved rapidly mainly by resigning from this employment, which indicates it was a work related situation problem.

• He continued driving after a short break. His evidence suggested a combination of coach, bus and maintenance work, which again produced some stress reaction in Mr Wright, during 1998, related to the long hours of work. This was resolved by him changing to largely part-time work mainly driving children to and from school.

• Mr Wright’s driving career came to an abrupt halt when, in late 2002, after a trivial accident, he was breathalysed and registered 0.1.alcohol level. He was fined $600 and lost his licence for 9 months. He hasn’t worked since except for short- term, temporary, poorly paid delivery work in recent times.

• In December 2002, he attempted suicide, taking 10 prescribed tablets plus alcohol but, as a result of early simple emetic treatment, he recovered quickly and was referred for a period of inpatient psychiatric treatment. The cause of this psychiatric episode was a combination of his driving under the influence charge and the rejection of his reconsideration appeal against the rejection of his claim for war caused anxiety disorder. This decision also removed his entitlement for the “Gold Card” and requires him to make some repayments. He claims the later element was the major cause of his suicide attempt.

• Mr Wright’s alcohol history was rather vague in the detail and there were considerable inconsistencies in the various accounts he had given to medical personnel and answers to questionnaires. The Tribunal accepts this as a common presentation of recollections of alcohol consumption and not a factor on which to base a judgement of Mr Wright’s credibility. However, it makes the Tribunal’s task of assessing the chronology and quantification of alcohol complex. As it is the best evidence before the Tribunal, on balance, we accept this evidence. This lack of precise detail requires the Tribunal to take a broad overview of all the available evidence of alcohol consumption and balance this with evidence of behavioural manifestations and recorded incidents indicating the presence of alcohol abuse.

• In broad terms, Mr Wright’s evidence suggests he drank very little alcohol during the entire period of his naval service. He stated he didn’t like beer and drank about half of his beer ration. His consumption increased marginally during 1973 but was not excessive and he indicated he began to drink more regularly towards the end of his Naval service. There is no evidence that he drank heavily in the 7 months when he was in Tasmania. He stated he began drinking “seriously” during his employment in Sydney, which commenced in late 1974, initially as a cleaner and subsequently as an assistant sub-manager. This was a situation when he had access to free beer at lunchtime and after work to the extent of up to 3 schooners per day. It is unclear when he actually started this intake or whether this was every day. However, presuming he didn’t work everyday and accepting his declared habit of hiding his alcohol consumption from his wife, we consider it unlikely that he would take 3 schooners every day. As well, this supply of free alcohol only lasted for 3 years. He told Mr Cipriani, a psychologist, that this pattern continued for about 15 years. Then his alcohol consumption increased when he changed to drinking wine regularly and this was around 1989. This consumption increased over time to the extent that he registered 0.06 alcohol level whilst driving in 1992. This incident didn’t modify his alcohol intake and he continued to hide his drinking habits from his wife and, ultimately, in 2002, he was again found to have a blood alcohol level of 0.1, while driving a bus full of school children.
• There were a series of non-service related stressors experienced by Mr Wright, which were significant, particularly considering his vulnerability to stress. In 1966, his wife left him for another man, taking their 2 young children, and he divorced her. This he described as “devastating” but he coped and he sought no psychiatric help. In 1970, he was involved in a motor vehicle accident, while driving an ABC limousine. This resulted in his being apprehensive about driving this vehicle and he was transferred to office duties, which he disliked, so he resigned and, soon after, rejoined the RAN. In 1972, he had an episode of financial extravagance and had financial difficulty meeting his commitments, particularly in relation to his daughter. In 1976, soon after his second marriage, his 7-year-old stepdaughter died of a brain tumour but the marriage survived this crisis and became a stable and emotionally happy relationship to the present. Then, in 1996, he had a mental breakdown, related to work problems, and saw Dr Yeoh, a psychiatrist, for the first time. In 1998, he had further work problems related to excessive hours and stress, which was resolved by working part-time. In 2002, he was involved in a minor motor vehicle accident, while driving a school bus, but was discovered to have a blood alcohol level of 0.1. He was fined $600 and lost his job and his driver’s licence on 9 December. Soon after this, his veteran’s pension was reduced, he lost his Gold Card and he attempted suicide.
• Since 2002, Mr Wright has been admitted twice for inpatient psychiatric treatment. However, no reports are available to the Tribunal to confirm the nature of treatment or the diagnosis.

MEDICAL EVIDENCE

14.      Medical evidence available to the Tribunal was contained in reports of Dr Hordern and Dr Haik, who also gave concurrent evidence before the Tribunal. Additional reports supplied to the Tribunal included psychiatric reports of Dr Laws, Dr Koller and Dr McClure plus a report by Mr Cipriani, a psychologist. In addition, 2 sets of clinical notes, from Dr Yeoh (Psychiatrist) and from Dr Vyas (Mr Wright’s GP), were made available to the Tribunal. 

15.      Dr Haik’s report contained a detailed and balanced account of the history of events, as assessed by the Tribunal. During the concurrent evidence session before the Tribunal, Dr Haik argued that the diagnosis of PTSD wasn’t justified because the stressor experienced by Mr Wright was not provoked by any event and his subsequent stable marriage and employment was convincing evidence of an inadequate level of disability to support the diagnosis of such a serious and disabling condition as PTSD.

16.      The history Dr Haik obtained from Mr Wright regarding the stressor, which might have triggered PTSD, lacked detail because Mr Wright’s answers were often “I don’t know”. Dr Haik did establish that Mr Wright felt apprehensive and “started getting depressed”. Also, Dr Haik obtained a history of no incident involving enemy action nor of any injury to anyone but only a fear and apprehension by Mr Wright as to what could have happened. Regarding the subsequent effects of Mr Wright’s Vietnam experience, Dr Haik elicited a history of thoughts but not dreams about being on a ship in Vietnam. He recorded Mr Wright as saying this was in black and white, being in the mess and in the bowels of the ship. These symptoms were infrequent until 10 years ago but have become daily since. Dr Haik diagnosed Mr Wright as having episodic GAD, provoked by real social stressors, which were unrelated to his operational service

17.      Dr Hordern held resolutely to the opinion that Mr Wright suffered a severe stressor during the brief 2 day periods aboard HMAS Sydney in Vung Tau Harbour. In the view of the Tribunal, he failed to answer convincingly the challenge by Dr Haik that there was no evidence of severe disability as a result of this stressor. Dr Hordern’s written report is very generalised, touches on symptoms, but supplies little detail to identify the nature, timing, frequency or severity of any disability. This applies to his report regarding Mr Wright’s intrusive recollections, nightmares, flashbacks, avoidance behaviour and hyper-vigilance. Given the opportunity in the concurrent hearing to justify his conclusions, he stated Mr Wright suffered and met all the requirements of the SoP for PTSD, but he didn’t justify his opinions to the satisfaction of the Tribunal.

18.      Dr Hordern placed much reliance on the written statement supplied by Mr Wright, which was appended to Dr Hordern’s report. This statement of Mr Wright did not impress the Tribunal and we do not consider it worthy of the weight given to it by Dr Hordern as it was in many ways inconsistent with Mr Wright’s oral evidence. We did not find Dr Hordern’s opinion helpful in evaluating Mr Wright’s condition. 

19.      The report of Dr McClure, psychiatrist, is a detailed and well reasoned report. The report considered the stressor experienced by Mr Wright as an appropriate and significant response to the circumstances of his service in a war zone. Importantly, Dr McClure states these stresses “contributed significantly to his anxiety symptoms” and “This gentleman’s service in South Vietnam was accordingly associated with great fear of the unknown, rumours and a general sense of dread and apprehension”. In addition, Dr McClure reported: “However, he considered that while Mr Wright described (appropriate) fearfulness and anxiety during his experiences in South Vietnam, these were not ever the focus of treatment and he was not exposed to a stressful event as such. On the other hand, the general environment was undoubtedly stressful.”

20.      Dr McClure also reports: “Mr Wright told me that his anxiety symptoms have been essentially in remission between the end of second trip to South Vietnam on board HMAS Sydney and the episode on New Year’s Day, 1996”.  However, he considered Mr Wright had all the symptoms of GAD except muscle tension and there was no evidence of PTSD.

21.      Dr Koller’s and Dr Laws’ reports were both brief and lacking detail but their diagnosis was GAD. Dr Koller specifically responded to legal questions regarding his suggestion the existence of some symptoms of PTSD and categorically stated “Mr Wright does not have PTSD”. Both specialists considered the GAD had been present for an unspecified long time and thereby considered the disorder had a causal connection to Mr Wright’s Navy service. However, their brief reports gave no detailed evidence supporting this connection and, therefore, their reports were of little help to the Tribunal in considering the claim and its compliance with the SoP.

22.      The clinical notes of Dr Yeoh, a psychiatrist who treated Mr Wright at the time of his major clinical “breakdown” in January 1996, made no diagnosis and focused on the immediate problem. This contemporaneous evidence offers no support for Mr Wright’s claim for a war caused psychiatric condition as his RAN service wasn’t discussed other than as a chronological event and a need to “know what he is doing from week to week” in his current employment.  This clinical episode, which occurred 20 years after his RAN service, is significant as it is the first occasion Mr Wright sought psychiatric treatment. As it resolved, after 3 sessions of treatment, Mr Wright stopped taking his Muralax medication. These clinical notes indicate the crisis was produced by a perceived demotion and insecurity about his role at work for some 4 months. The main factor in his rapid recovery was his decision to resign and thereby resolve the workplace situation.      

23.      The Tribunal next considered the clinical notes of Dr Vyas (Mr Wright’s GP since 1995):

a)    Psychiatric matters.

Dr Vyas indicates his initial diagnosis was depression and he started treatment with Muralax and referred him to Dr Yeoh. Symptoms were still present at the end of January, for example, “trembling in a.m. but otherwise well”. In June he reported: “wondering about PTSD as sleep disturbance and long term irritability (unspecified)”. Dr Vyas referred Mr Wright to Dr Koller at his patient’s request, complaining of marital and family problems and being tearful.

b)    Hypertension

Documentation of Prothiaden taken at night by Dr Vyas indicates high blood pressure readings from August 1995 to 1998 but Dr Vyas made a clinical decision not to start treatment until June 1999. The treatment was effective. This evidence indicates the clinical onset of mild hypertension was June 1999.

c)    Alcohol

There is little information except “2 cans per day after work and 6 at weekends.”  

24.      The Tribunal also was asked to consider a letter from Mr Rod Himbury. This letter was an attachment to the report of Dr Hordern. Mr Himbury was a fellow bandsman and close friend to Mr Wright. This non-medical overview adds little to the Tribunal’s understanding of Mr Wright’s disability but gives an independent account regarding any personality changes and Mr Wright’s alcohol consumption. The letter indicates that, in 1972, Mr Wright was depressed. We note this is a lay opinion. The letter also tells of more regular contacts around 1983 and the observation that Mr Wright was “going alright”, having married a second time. Mr Limbury emphatically describes Mr Wright’s drinking at this stage as his being a social drinker only, which he contrasts with the situation in 2002, when he learnt of his drink driving charge and, later, when he became aware of the suicide attempt. Mr Limbury also described how, in 2000, Mr Wright was edgy and uptight.  

FINDINGS

25.      Mr Wright is claiming PTSD, alcohol abuse or alcohol dependence and hypertension. We have considered these claims under the headings below:

Psychiatric

26.     The evidence and the majority of the psychiatric opinions support the diagnosis on the balance of probabilities, not as PTSD but as GAD. The Tribunal has reached this conclusion after considering the nature of the stressor claimed, namely, the stressful environment in which Mr Wright was placed during his brief experience of a real war zone. His response to this was not one of horror and helplessness but he did experience a degree of fear and apprehension, which was appropriate and of short duration. We considered Dr McClure’s analysis of Mr Wright’s increased vulnerability to stress and the increase in his anxiety symptoms. Also, the Tribunal considered his duties during this war zone experience. Mr Wright had previous experience of these tasks during his first 12 years of service and he acknowledged that this experience wasn’t stressful. He said he experienced stress at the tasks he was expected to carry out during the ship’s “closed up” operations. His claims in his written statement that this later operation caused him concern suggested a degree of embellishment of the situation. He may by then have had time to think and worry about the possible danger. However, the lack of any disability to carry out his tasks at the time and in the following 12 months in the RAN and his eventual reasons for leaving the service, all indicates he was not affected by the brief war zone experiences.

27.      Mr Wright’s post RAN experiences, reviewed in the Tribunal’s finding of facts above, support the history he gave to Dr McClure that his anxiety symptoms had essentially been in remission between his second trip to Vietnam and 1996. Dr Haik pointed to his long and successful second marriage, his stable employment, particularly his 18 years with Sydney Electricity, and this ended because of redundancy. He quickly found work as a driver. The 1996 incident, which was clearly the result of a perceived demotion and other work related stressors, marked the onset of the psychiatric disorder.

28.      Before this time, Mr Wright had symptoms of Depression and Anxiety associated with social and non-service related events and these never reached the level of a diagnosable disorder. This refers to the divorce in 1966, his motor vehicle accident around 1968 while driving for the ABC, and his symptoms of depression in 1972.

29.      The only diagnosis of PTSD before the Tribunal is that of Dr Hordern and the Tribunal considers his opinion not of the calibre to justify the rejection of the opinions of Dr’s McClure, Haik, Laws and Koller. The Tribunal determines the diagnosis on the balance of probabilities is that Mr Wright suffers from GAD.

30.      The hypothesis now is that Mr Wright’s GAD, which caused excessive alcohol intake, which caused alcohol abuse / dependence, which caused hypertension, is related to his operational service. The steps in the assessment, as dictated by Delidio, require the Tribunal firstly to consider whether the hypothesis is fanciful or not. The Tribunal considers the hypothesis is not fanciful.

31.      The second step is to identify whether there exists an SoP relating to the disorder. The Tribunal has already identified the following SoPs as relevant to the hypothesis:

·General Anxiety Disorder  No 1 of 2000

·Alcohol Abuse  No 76 of 1998

·Hypertension   No 35 of 2003

32.      The third step is to determine whether the disease or disorder fits the template
of the SoP, which determines the factors that must exit, before it can be said that a reasonable hypothesis has been raised connecting the anxiety with the circumstances of a person’s relevant service. Clearly, Mr Wright ‘s anxiety does not fit the template which requires, at Factor 5 (a) (ii), experiencing a severe psychosocial stressor within the two years immediately before the clinical onset of the anxiety disorder. The medical evidence clearly indicates Mr Wright first sought psychiatric treatment and was diagnosed as having an anxiety disorder in 1996.  His relevant operational service ended in 30 November 1972.  Therefore, the Tribunal finds the hypothesis is unreasonable.

33.      The Tribunal considered alcohol abuse as a separate claim. The evidence indicates Mr Wright satisfies two of the diagnostic criteria of having alcohol abuse as he drinks excessively. As well, despite his opinion, he cannot stop drinking even when it creates a threat to his marriage and his drink driving offences and associated conviction have caused him to lose his job. However, the onset of his alcohol abuse is estimated on the evidence available to the Tribunal as being somewhere around 1990. This is deduced from the fact of his first drink driving offence occurred in 1992 and regular drinking pattern of 15 years from 1974.

34.      The onset of alcohol abuse, as determined, means Mr Wright does not satisfy any of the factors of the SoP No 78 of 1998. Therefore, he has not established a connection to his operational service

35.      The Tribunal next considered hypertension as a separate claim. The evidence is clear that Mr Wright satisfies the definition of hypertension with his blood pressure readings as recorded by Dr Vyas and the regular anti-hypertensive treatment commenced in June 1999. However, the factor he has argued, connecting his hypertension to his operational service, is alcohol abuse and the Tribunal has determined the alcohol abuse is not related to his operational service. Therefore, his claim fails to satisfy Clause 4 of the relevant SoP.

36.      Consequently, the Tribunal finds that Mr Wright has not established any of the claims under review and the decision of the Board should be affirmed.

I certify that the 36 preceding paragraphs are a true copy of the reasons for the decision herein of Robin Hunt, Senior Member and Dr P Lynch, Member.

Signed:         .....................................................................................
  Associate: Reuben Mansour

Date of hearing  14 October 2004
Date of decision     9 February 2005

Representative for the Applicant  Fairbairn Lawyers

Advocate for the Respondent  Department of Veterans’ Affairs