Entitlement to incapacity payments
9 Mr Davis served during peacetime as a part-time Reservist in the ADF. He claims the period of his service was from 28 November 2011 until 19 February 2019. Although nothing turns on it in the current proceeding, documents filed by the Commission refer to his service commencing from 23 November 2017: First Cooper Affidavit LJC-4. In the course of his service, Mr Davis was injured and medically discharged from the ADF. It is not disputed that, as a result of his injuries, Mr Davis was, and remains, entitled to compensation from the Commonwealth for incapacity for work: MRCA ss 118(1) and 319(1). It is also apparent that his injuries are accepted by the Commission to amount to a total permanent incapacity.
10 The amount of Mr Davis' incapacity payments is determined according to his Normal Earnings (NE). In the role of a part-time Reservist, engaged in civilian work, his NE were calculated, for a weekly period, according to the formula set out at s 153(1) of the MRCA, reproduced below:
11 The relevant history of Mr Davis' entitlement to incapacity payments can be stated shortly. On 4 February 2019, by his initial "Claim for Incapacity for Service/Work" received on 7 December 2018, the Commission determined the civilian component of Mr Davis' NE according to his casual employment with the DHA, which was calculated to be $749.38 gross per week. Mr Davis last received earnings for hours worked at the DHA on 24 January 2019.
12 Mr Davis subsequently applied for review of the 4 February 2019 decision, which had incorrectly determined his discharge date as 22 January 2019, rather than 19 February 2019. By a decision of 9 April 2020, the 4 February 2019 decision was set aside, and Mr Davis' entitlement to incapacity payments was recalculated. The civilian component of Mr Davis' NE was determined based on his payslips from F&SI, calculated as $1,442.31 gross per week. Mr Davis had begun working at F&SI on 28 January 2019, with an annual income of $75,000.
13 Having sought a further review of the decisions of 4 February 2019 and 9 April 2020, a decision dated 29 May 2020 set aside both prior decisions, due to "a higher history of reserve days". Mr Davis' entitlement was, again, recalculated, and the civilian component of his NE was, again, determined according to his F&SI earnings. Following the 29 May 2020 decision, on 10 June 2020, Mr Davis withdrew his appeal to the Veterans' Review Board (VRB), on the basis that,
[t]he DVA have issued a new determination letter under S347 MRCA dated 29/05/2020 and I am satisfied with this written decision and how my incapacity payments are being calculated.
14 For reasons that are unexplained, some three years later, Mr Davis apparently became aware that wages from his past casual employment with the DHA were not (but, allegedly, should have been) accounted for in the civilian component of his NE. On 1 May 2023, he emailed the General Enquiries email address of the DVA, advising that "the Delegate calculating [his] discharge pay (Military and Civilian) did not offer the opportunity to calculate [his] 'casual' work" and that this "[had] therefore impacted calculations moving forward". Mr Davis asked for the "correct form to be completed" to rectify the alleged miscalculation of his entitlement.
15 On 11 May 2023, Mr Davis submitted the relevant "Claim for Incapacity for Service/Work" to the DVA, seeking that his NE be recalculated to account for his DHA wages. He also provided payslips from the DHA that represented a 12 week period of employment from 1 November 2018 to 20 February 2019, and a breakdown of wages paid during that period. That breakdown, however, showed that Mr Davis had not worked any hours for the DHA after 30 December 2018, nor received any earnings from 25 January 2019 to 19 February 2019. Relevantly, Mr Davis calculated the total of his additional earnings from the DHA to be $4,961.71, which he divided by 12 weeks, the quotient of which (being $212.41) he claims represents his weekly earnings from DHA to be accounted for in the calculation of the civilian component of his NE.
16 On 17 May 2023, a delegate from the DVA informed Mr Davis by letter dated 15 May 2023 that, pursuant to s 131 of the MRCA, his "Claim for Incapacity for Service/Work" had been denied, on the basis that "the current rate of [his] incapacity payment taking into account [his] civilian component of Normal Earnings is correct". Relevantly, that letter also stated:
The Veteran Review Board re-assessed your entitlement from the commencement of your incapacity payments and determined that it would be more beneficial to calculate the civilian component of your normal weekly earnings based on Fire & Safety Industries. This resulted in a weekly civilian earnings calculation of $1,442.31 gross per week.
Your employment with the Department of Home Affairs and Fire & Safety Industries are viewed as two separate employment periods and do not overlap. As a result the Veteran Review Board have used the more financially beneficial employment period being your full time employment with Fire & Safety Industries.
…
I have determined the current rate of your incapacity payment continues to be $1,403.70 pre-tax per week for the period from 11 May 2023 to 18 August 2047 …
…
If you would like us to review this decision
You can ask for a review within 12 months of receiving this letter. Please set out your response in writing and email to [xxxx]@dva.gov.au or post to GPO Box [XXX], Brisbane QLD 4001. You can go to www.dva.gov.au/appeals for details.
(Emphasis added.)
17 The reference to the "Veteran Review Board" in the first sentence of the letter as set out above is an error. Mr Davis had applied to the VRB for a review of the decisions dated 4 February 2019 and 9 April 2020. As is apparent from the 29 May 2020 decision referred to at [13] above, a Review Officer decided to set aside the decisions before Mr Davis' application reached the VRB for determination. Mr Davis was then invited to either seek a review of the Review Officer's decision by the VRB, or to withdraw his application. On 10 June 2020, as has already been mentioned, he took the latter course.
18 In response to the delegate's email of 17 May 2023, Mr Davis responded on the same day, asserting that, in substance, the decision to deny the claim did not properly account for ss 157(1) and (2) of the MRCA:
Good morning
Had you contacted me prior in accordance with DVA's Natural Justice Consideration and Prior Warning of Adverse Decisions policy I could have further explained the situation with regard to Home Affairs.
The periods did over lap.
My earnings in January were impacted by a workplace fall (as per the documents provided). I took the last two weeks of January off to have a break, and during the first two weeks at Fire and Safety Industries I was required to travel away from Brisbane.
MRCA s157(1) being applied to the scenario I actually earned $631.87 on 7 February 2019. Which should provide compensation of $315.93 per week.
MRCA s157(2) allows the Commission to utilise another period it considers reasonable if the two weeks prior to discharge would not fairly represent the daily rate. Hence I provided a broad "range" of weeks to fairly represent that some weeks were higher and lower, and given this was casual employment on top of another full time job the ongoing involvement decreased. Therefore I submit the 12 week average figure of $212.41 per week fairly represents the amount paid before ceasing to be a member of the Defence Force.
This earnings should definitely be included in the ongoing … calculations.
(Emphasis added. Errors in original.)
19 On 22 May 2023, a Claims Support Officer from the DVA advised Mr Davis by email that his email was "currently in [the] delegates' inbox for … review". On 26 May 2023, the delegate responded to Mr Davis' email of 17 May 2023, stating, relevantly:
In relation to the matter concerning the calculations of your Normal Earning, the Veteran Review Board has previously re-assessed your entitlement and any further reviews needs to be undertaken through the Appeals process for external review.
Please set out your reasons in writing and email … or post … You can go to www.dva.gov.au/app=alS for details.
(Emphasis added. Errors in original.)
20 On the same day, Mr Davis responded by stating that "[t]he matter of Home Affairs [had] never been raised until now, as no one told [him] at the time it was eligible to be assessed".
21 On 5 June 2023, the delegate again advised Mr Davis that any further reviews had to be undertaken externally, and that, alternatively, he "may be able to appeal with" the Administrative Appeals Tribunal (AAT) (emphasis added).