Question 1 - whether the Tribunal adopted the correct approach
34 On this question, Mr Aslami focused on [60], [61] and [66] of the Tribunal's decision where, so he claimed, the Tribunal found that the definition of the expression "total and permanent disablement" in the Trust Deed required consideration of his qualifications "as at the date he last 'physically worked' for [TAFE] being May 2014". He claimed this misconstrued the terms of that definition because the words "ceased to be at work" in cl 4.4(b) of the Trust Deed referred to the work the member was doing prior to the sickness which caused his or her total and permanent disablement (TPD) to commence, as referred to in cl 4.4(a). Instead, he contended, that definition required consideration of his "existing [education, training or experience] at the date he first ceased to be at work with [TAFE] due to the psychological condition - that is June 2012". He contended that the Tribunal was therefore in error in considering his "[education, training or experience] as at May 2014". He claimed that adopting that date "operates unfairly against [him] in that it impermissibly takes into account [his] efforts to set up a new business, retrain himself in the operations of that business and as a salesperson after the occurrence of disablement from his prior occupation as a teacher" (emphasis removed). Conversely, he claimed that adopting the earlier 2012 date operated fairly in the circumstances because it did not take account of this self-motivated retraining.
35 In response, the Trustee contended that the appropriate date for the assessment of Mr Aslami's education, training or experience was the date he "last physically worked for [TAFE] in May 2014". It contended that Mr Aslami's focus on the words "ceased to be at work" in cl 4.4(b) of the Trust Deed was misplaced because cl 4.4 did not, so it contended, "provide the criteria [Mr Aslami] must meet in order to meet the definition of [total and permanent disablement], rather it is concerned with the date on which an applicant shall be considered [totally and permanently disabled] for the purposes of calculating the benefit to be paid to a person who has been found to be [totally and permanently disabled]" under the terms of the Trust Deed.
36 It claimed that Mr Aslami was placing "an artificial construction on the words 'cease to work' by linking that phrase to the date [he] first started suffering from the injury rather than linking it to the undisputed evidence as to the last day [he] physically worked and consequently from that time 'ceased to work' for the purpose of calculating the benefit sum payable". Finally, it also contended that the Tribunal had made a factual finding that the latter of the two dates expressed in cl 4.4(a) and (b) was the date Mr Aslami ceased to be at work, namely 30 May 2014. It contended that this finding was not open for review in this appeal.
37 In my view, both of these sets of contentions have, to varying degrees, misapprehended what is required by the provisions of cl 4.4 and the definition of "total and permanent disablement" in the Trust Deed. In particular, they have confused the issues that fall to be determined under the first and second paragraphs of that clause.
38 The first paragraph of cl 4.4 fixes when it is that a member becomes entitled to be paid a death or TPD benefit. That is "upon" that member's death or TPD. The question whether such a TPD exists is, in turn, determined by the Trustee forming an opinion in accordance with the definition of the expression "total and permanent disablement" in cl 4. That definition requires the Trustee to form its opinion:
(a) only after obtaining advice; and
(b) obtaining that advice from not fewer than two medical practitioners; and
(c) obtaining it by reference to the question whether "the member [is] unlikely ever to be able to work again in a job for which the member is reasonably qualified by education, training or experience".
39 Furthermore, (c) above requires the Trustee to have regard to whether:
(a) the member is unlikely ever to be able to work again;
(b) in a job; and
(c) for which the member is reasonably qualified by education, training or experience.
40 The second paragraph of cl 4.4, however, deals with an entirely different issue. That is, the date from which a member's entitlement to a TPD benefit is to be calculated. That date is also determined by the Trustee but, in this instance, it is dictated ("shall be considered") by the provisions of subparagraphs (a) and (b). Those subparagraphs, it is important to note, do not focus on the member's TPD itself, but rather on the sickness or injury that caused that disablement. Accordingly, they require the Trustee to calculate the TPD benefit by reference to the latter of the following events:
(a) when the sickness that caused the disablement commenced; or
(b) when the injury that caused the disablement occurred; or
(c) when the member ceased work due to the sickness or injury that caused the disablement.
41 The timing of the formation of the opinion under the first paragraph will depend on numerous factors. First, and most obviously, it will depend upon when the member concerned makes his or her claim for a TPD benefit. Among other things, that step will likely be affected by variations in the degree and extent of the disablement concerned. Further, once such a claim is made, it will obviously take some time for the Trustee to obtain the advices of the two medical practitioners and, having obtained those advices, to form its opinion. In that process, particularly where a fluctuating condition is involved, the Trustee may also be justified in waiting to ascertain when or whether the resultant disablement becomes total or permanent. Accordingly, the Trustee's opinion about whether a member has a TPD is likely to be formed many months, if not years, after the disablement concerned first becomes apparent. For example, in this matter, it took almost two years (see [10] above).
42 Because the entitlement to a TPD benefit is dependent on the Trustee forming its opinion under the first paragraph of cl 4.4, the second paragraph is not likely to come into operation until such a TPD is determined, by that opinion, to exist. In this respect, I interpose to note the curiosity arising from the fact that the amount of Mr Aslami's TPD benefit appears to be agreed (see at [23] above). However, once that opinion is formed, the potential for further delay is likely to be limited. That is so because the date from which the TPD benefit becomes payable under that paragraph is almost entirely fixed by subparagraphs (a) and (b). I say "almost entirely fixed" because it is conceivable that there may be some delay in the ascertainment of the causative effects of the sickness or injury concerned. Nonetheless, that issue will depend on past events, namely the onset of the sickness, or the occurrence of the injury, and is therefore unlikely to be affected by the sorts of delays mentioned above associated with the formation of the Trustee's opinion.
43 So, in summary, the first paragraph of cl 4.4 is directed to whether or not a TPD exists and that issue is determined by the Trustee forming an opinion in accordance with the criteria contained in the definition of the expression "total and permanent disablement" in cl 4. In contrast, the second paragraph of cl 4.4 is directed to the sickness or injury that caused the disablement concerned and fixing a date associated with the causative effect of that sickness or injury from which a TPD benefit is to be calculated. The timing of the former is not fixed by cl 4.4 and will depend, among other things, on the nature and stability of the disablement concerned. However, the timing of the latter, whilst affected by the former, is, to a large extent, fixed by the second paragraph of cl 4.4, particularly subparagraphs (a) and (b) thereof and unlikely to be associated with any significant delay.
44 For present purposes, two things follow from these conclusions about of the provisions of cl 4.4. First, the second paragraph of that clause does not fix the date upon which a member's TPD is determined to exist, but rather it concerns the date from which that member is entitled to be paid the TPD benefit once that state of affairs is so determined. It follows that the date of assessment of a member's education, training or experience for the purposes of the definition of the expression "total and permanent disablement" is not fixed by the dates or events in that second paragraph. Secondly, and relatedly, the date on which Mr Aslami "ceased to be at work" under subparagraph (b) of the second paragraph and the date he began to suffer from his sickness under subparagraph (a) therefore have no relevant bearing on the assessment of his education, training or experience for the purposes of the definition of the expression "total and permanent disablement" in cl 4 of the Trust Deed.
45 It follows that most of Mr Aslami's contentions above (at [34]) must be rejected. It may also be noted that the Trustee (at [35] above) and the Tribunal made similar errors in their construction of the second paragraph of cl 4.4 of the Trust Deed. On the Tribunal's part, it used the date fixed by subparagraph (b) at various points in its reasons (see, for example, [60]-[61] and [66]-[67]) as the point in time at which it assessed Mr Aslami's education, training and experience. However, for the reasons that will emerge below, I do not consider that error ultimately distracted the Tribunal from its primary function of reviewing the Trustee's decision to determine whether it was fair and reasonable as it affected Mr Aslami.
46 The issue in Mr Aslami's contentions above that is not addressed by these conclusions is his claim that the Tribunal "unfairly" took account of, what may be described as, the self-motivated job creation which he achieved when he established his own business from about 2013. That is so because that issue is not determined by the timing of the assessment of Mr Aslami's education, training or experience, but rather by the broader consideration of fairness which is at the heart of the Tribunal's review function under s 37 of the Complaints Act (see at [16] above).
47 In Fernance v Wreckair Pty Ltd (No 2) (1992) 43 IR 300, Hungerford J was required to consider whether the plaintiff was "reasonably qualified" by education, training or experience for an alternative occupation. At 329, his Honour observed:
Inherent in those findings of unfairness is my conclusion that the definition of "totally and permanently disabled", by referring to "any occupation or work for which he is reasonably qualified by education training or experience" makes the assessment of the relevant incapacity as at the time of the assessment and not after retraining. In other words, whether a member is unlikely ever to engage in work is to be determined according to his qualifications, after the period of six consecutive months absence, at that time and not at some future time as a result of retraining … The definition does not admit, in my view of it, qualifications by education, training or experience which the member may or may not be able to obtain in the future. If it did, I would think it to be surprising because that would involve an amount of speculation and an anticipated capacity in a member from possible future efforts by him. I consider the definition does not so speculate but rather takes a member as he is as a result of the injury occasioned to him …
(Emphasis added)
48 In Jones v United Super Pty Limited [2016] NSWSC 1551, Brereton J was required to consider a similar issue with respect to the phrase "education, training or experience", namely whether the plaintiff "is unlikely ever to be able to engage in any [r]egular [r]emunerative [w]ork". Pertinent to this matter, his Honour made the following observations (at [70]-[71]):
70 … it is well-established that a claimant is not to be regarded as fitted by education, training or experience for an occupation for which he or she would be suited only after retraining.
71 … The [education, training or experience] clause confines the scope of the "regular remunerative work" from which the insured is disabled to that for which the insured is reasonably fitted by education, training or experience. In that phrase, the word "by" is important - it postulates a connection between the suggested future work, and the insured's past education, training and experience … The purpose of the provision is to provide a benefit for those who are disabled from following the vocations for which their past education, training and experience has prepared them - not any occupation which may be conceived, however far removed from his or her vocational history, which can be performed without further education, training or experience …
(Footnote omitted; italics in original; emphasis added)
49 In Board of Trustees of the State Public Sector Superannuation Scheme v Gomez [2018] QCA 67, the Queensland Court of Appeal (Henry J, with Sofronoff P and Fraser JA agreeing) made the following observations about the phrase "for which the member is reasonably qualified by education, training or experience":
[66] The need for certificates in this job was a potentially concerning issue for the Board. In Hannover Life Re Of Australasia v Colella Garde AJA, with whom Ashley JA and Beach JA agreed, observed:
"It has been accepted that inability to perform work does not (apart from a short qualifying or refresher course) require a claimant to undergo a course of retraining in order to make him or her employable. Rather the assessment of TPD takes into account any job or occupation for which the claimant is reasonably fitted having regard to his then current education, training or (sic-and) experience." (citations omitted)
[67] In Hannover Life Re Of Australasia Ltd and Anor v Dargan, Bathurst CJ, with whom MacFarlan JA, Meagher JA, Hoeben JA and Tobias JA agreed, reasoned that the word "reasonably" informs the extent of existing qualification required. He concluded an experienced former truck driver who had the education, training and experience to capably pass a test required to hold a certificate to work as a taxi driver was reasonably fitted by his education, training and experience to work as a taxi driver. His Honour acknowledged the need for caution in referring to cases involving differently worded tests - there the relevant words were "reasonably fitted by education, training or experience". However, his Honour's reasoning adopted the reasoning of Hodgson J in Chammas v Harwood Nominees Pty Ltd, where the relevant words were, "reasonably qualified by education, training or experience". They are the same words as the test here.
…
[90] As is apparent from the earlier discussed authorities, the word "reasonably" in the phrase "for which the member is reasonably qualified by education, training or experience" may provide some latitude in respect of requirements for on-the-job training and certification. Nonetheless, the phrase focusses upon the extent of the member's existing rather than future qualifications. The provision of Ms Hague's contradictory opinion, supported by an ostensibly straightforward explanation, should have made it obvious to the Board's delegate that at the time of the second decision there had in truth been insufficient information available about the substance of what was required for certification. On the whole of the evidence the true demands of the certification requirement are unclear. In the absence of such information, properly informed consideration could not be given to whether Mr Gomez was reasonably qualified to work as a Pathology Collector.
(Footnotes omitted; emphasis added)
See also Citicorp Life Insurance Ltd v Smith [2005] FCAFC 102 at [19] which reinforces fairness as the central focus of the Tribunal's review.
50 With due allowance for the differences in the terminology used in the various tests under consideration, these authorities establish a number of basic principles. First, the overriding consideration is whether the decision under review was fair or reasonable as it affected the appellant. Secondly, and maintaining that central focus, the expression "education, training or experience" is directed to the member's existing qualifications. Thirdly, and conversely, the possibility of the member undertaking future retraining is not a relevant consideration.
51 It is apparent from the Tribunal's reasons that it was clearly alert to its central function to assess the fairness and reasonableness of the Trustee's decision as it affected Mr Aslami (see at [26] above). It is also apparent that the Tribunal was well aware that Mr Aslami's existing education, training or experience was the relevant consideration and not any retraining he may be able to undertake in the future (see the emphasised part of [60] set out at [27] above).
52 Finally, and most importantly, it is apparent from the following findings and conclusions that the Tribunal maintained its focus on its central function and had due regard to the abovementioned considerations in making its assessment of Mr Aslami's education, training or experience:
(a) first, it made the necessary factual findings concerning that expression (at [46]-[48] set out at [25] above);
(b) secondly, it relied on those findings to conclude that Mr Aslami's education, training or experience combined to enable him to operate his own business in the electrical field (at [61] set out at [28] above);
(c) thirdly, it adopted the Trustee's submissions before it to the effect that Mr Aslami's previous roles as an electrician for 12 years and as a TAFE teacher for seven years not only afforded him the "technical knowledge to supervise installation on large projects but also the knowledge and skills to liaise with staff, customers and regulatory authorities in his day to day work" (at [69] set out at [31] above);
(d) fourthly, and further to the above, it adopted the Tribunal's submissions that Mr Aslami "was clearly utilising his education, training and experience prior to his cessation of employment with [TAFE] in 2014" (emphasis removed) (at [69] set out at [31] above);
(e) fifthly, it concluded that, in the operation of his business, Mr Aslami utilised the skills he had "acquired through his education, training and experience prior to ceasing work with [TAFE]" (at [71] set out at [32] above); and
(f) finally, the Tribunal reached its ultimate and most critical conclusions that it was unable to find any unfairness or unreasonableness in the Trustee's decision (at [73] set out at [33] above) and that "the decision, in its operation in relation to [Mr Aslami], was fair and reasonable in the circumstances" (at [74] set out at [33] above).
53 The following important features emerge from this review of the Tribunal's reasons. First, in assessing Mr Aslami's education, training and experience, the Tribunal did not consider any future retraining Mr Aslami may be able to undertake. Secondly, it focused firmly on his existing education, training and experience as an electrician and an electrical teacher and the use he had made of the skills acquired in those occupations. Thirdly, it concluded that Mr Aslami had used those existing skills to establish and operate his business in the same field, namely the electrical field. Its conclusions may well have been different if Mr Aslami had chosen to establish and operate a business in a field in which he made no use of his pre-existing skills, but that was not what happened.
54 For these reasons, I consider that the Tribunal properly conducted its review function under s 37 of the Complaints Act and duly decided to affirm the Trustee's decision to refuse Mr Aslami's application for a TPD benefit. This question, therefore, provides no basis for interfering with that decision.