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[2002] FCA 1541
mixed. Application amended to substitute Olive Mildred Fogarty as applicant; Tribunal decision of 24 August 2000 set aside insofar as it determined IHD was not war-caused and remitted to the Tribunal for...
Fogarty sought veteran entitlements for IHD and GAD claimed to be war-caused. The Tribunal rejected both. The Commission conceded the Tribunal had erred on IHD by failing to follow the required Deledio procedure and by making a factual finding at the wrong stage; the Court set aside that part of the decision and sent it back for rehearing. On GAD the Court found the Tribunal had made procedural errors (failing to do a preliminary diagnostic finding), but the Tribunal's factual conclusion that the veteran did not show clinically significant impairment was open on the evidence and the error was not material; the Tribunal's decision on GAD was therefore affirmed. The judgment reiterates the mandatory sequencing when SoPs apply and the separate standards for diagnosis (s 120(4)) and causation (s 120(1)).
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William Francis Fogarty, a World War II veteran, claimed pension entitlements under the Veterans' Entitlement Act 1986 for ischaemic heart disease (IHD) and generalised anxiety disorder (GAD) as war-caused conditions. His service (Royal Australian Navy, 1940–1946) was accepted to be operational service (see [2]). The Veterans' Review Board denied the claims; the Administrative Appeals Tribunal (the Tribunal) affirmed that decision on 24 August 2000. Fogarty appealed to the Federal Court. While the appeal was pending Fogarty died and his widow, Olive Mildred Fogarty, was substituted as applicant under s 126 of the Act (see [1]).
The Repatriation Commission conceded the Federal Court appeal should succeed in respect of the IHD claim because the Tribunal had failed to apply the Full Court's Deledio methodology and had made a factual finding at the wrong stage of the statutory enquiry (see [3]). The Commission did not concede the GAD claim. The Tribunal had concluded the material "points to" hypotheses connecting the claimed disabilities with service but that those hypotheses were not reasonable because they did not satisfy the relevant SoP template (SoP No 48 of 1994 for the GAD component), particularly the SoP requirement for "clinically significant distress or impairment" (see [4], [8], [63], [66]–[67]).
Justice Ryan accepted that the Tribunal erred in its treatment of IHD, set aside that part of the decision, and remitted it for rehearing in accordance with law. He also found that, although the Tribunal had erred procedurally in not conducting a clear preliminary diagnostic inquiry in respect of GAD, that error was not material because the Tribunal's factual conclusion that the veteran did not display the required clinically significant impairment was open on the evidence. Consequently the Tribunal's decision on GAD was affirmed (orders and [30]).
Two core legal structures determine outcome in veterans' entitlements cases involving Statements of Principles (SoPs):
The Deledio sequence: where an SoP applies, the tribunal must take, in order, the four steps set out in Repatriation Commission v Deledio (the Deledio methodology): (1) consider whether the material points to a hypothesis connecting the disease with service; (2) identify whether an SoP is in force; (3) determine whether the hypothesis is reasonable by testing it against the SoP 'template' (it must contain the essential elements prescribed by the SoP); (4) if so, undertake the s 120(1) enquiry of whether, beyond reasonable doubt, there is no sufficient ground to determine the disease was war-caused (see the full quote at [17]). Ryan J emphasised this ordering and that fact-finding belongs to the final stage (step 4) ([17]).
The preliminary diagnostic inquiry: where the very existence of a disease is contested, the tribunal must first, to its reasonable satisfaction under s 120(4), determine what collection of symptoms (if any) the veteran exhibits before turning to Deledio (see [14]–[16]). The Court relied on earlier authorities (Cooke, Budworth, Benjamin) that distinguish the diagnostic standard (reasonable satisfaction under s 120(4)) from the causation standard under s 120(1) (see [14]–[16]).
Application to the facts:
Ryan J therefore framed the outcome to remedy the material error (IHD) and leave intact the part of the decision that was supported on the evidence (GAD).
Before Fogarty the controlling authorities included:
Fogarty reinforces and clarifies two points:
After Fogarty:
Paragraph [17] (Deledio four-step process):
Paragraph [14]–[16] (preliminary diagnostic inquiry and standard of proof distinction):
Paragraph [28] (finding of procedural error):
Paragraph [29] (desirability that Tribunal make explicit diagnostic findings):
This judgment is directly relevant in two fact patterns:
Cases where an SoP is in play and the tribunal has to apply the Deledio methodology. Where the tribunal fails to observe Deledio sequencing or improperly conducts fact-finding at stage 3, Fogarty shows the error is a ground for remittal (see [3], [17]).
Cases where the existence of a disease is itself contested. Fogarty stresses that tribunals must first identify the veteran's collection of symptoms to their reasonable satisfaction before applying SoPs. If a tribunal skips this diagnostic step and proceeds to apply SoP templates, that procedural error can be remediable, unless it is shown to be immaterial to the outcome (see [14]–[16], [28]–[29]).
Typical features that will engage Fogarty:
The text before this Court does not itself record or rely upon any later appellate treatment of Fogarty. Fogarty sits in the established line applying Deledio and the diagnostic/cause separation in Cooke, Benjamin, Budworth and Hill. In this judgment Ryan J applies and clarifies those pre-existing authorities rather than introducing novel doctrinal shifts (see [14]–[17], [28]–[29]). Any authoritative account of subsequent judicial treatment of Fogarty would require review of later decisions, which are outside the source material analysed here.
However, Fogarty’s clarifications are likely to be cited in subsequent cases for two propositions: (a) the necessity of performing the preliminary diagnostic inquiry where disease existence is contested, and (b) the prohibition on making primary fact-findings at Deledio step 3. These points are expressly stated and grounded in prior authorities in Fogarty (see [17], [28], [29]).
Fogarty clarifies crucial procedural obligations but leaves some practical and doctrinal questions with residual uncertainty:
Materiality threshold for remedial relief: Fogarty applies a pragmatic approach, errors in process that are not material to outcome do not inevitably require remediable relief. The boundary between material and immaterial error remains case-specific: courts will need to assess whether the Tribunal's correct outcome was one that could reliably have been reached despite the legal error (see [28]–[30]). Practitioners will need to argue forcefully on materiality facts.
Degree of specificity required in diagnostic findings: Fogarty urges tribunals to make specific diagnostic findings when disease existence is in issue (see [29]). It does not prescribe the precise form or depth of reasoning required. How detailed must tribunal findings be to satisfy review courts remains an operational question.
Handling multiple potentially applicable SoPs: Fogarty reiterates the principle that tribunals should consider SoPs not raised by an applicant, but on appeal the applicant must identify more beneficial SoPs to obtain relief ([29]). The procedural allocation of responsibility between applicant and tribunal, and the evidential consequence when tribunals fail to canvass an arguably more favourable SoP, remains a practical source of litigation argument.
Interaction with s 119(1)(h): Fogarty notes the tribunal's broad informatory powers and the need to consider evidentiary difficulties arising from the passage of time (see [11]). How s 119(1)(h) interacts, in practice, with the strictures of Deledio and s 120 standards requires careful balancing in later cases, especially where primary documentation is absent or witnesses are unavailable.
Remedial scope where discrete parts of tribunal reasoning are defective: Fogarty remitted only the IHD issue, affirming the GAD decision. Practical issues remain about whether remittal should be broader where procedural missteps affect the tribunal's general approach, even if particular findings seem open on the evidence.
Conclusion: Fogarty is a practical, precedent-grounded reminder that tribunals must observe the ordered diagnostic-and-Deledio sequence, avoid premature fact-finding, and explain diagnostic conclusions where disease existence is contested. It also demonstrates that appellate courts will balance procedural correctness with material outcome: not every procedural error automatically upsets the tribunal’s decision.
REASONS FOR JUDGMENT 1 This is an application by way of appeal from a decision of the Administrative Appeals Tribunal ("the Tribunal") affirming a decision of the Veterans' Review Board that the conditions of ischaemic heart disease ("IHD") and generalised anxiety disorder ("GAD") suffered by William Francis Fogarty ("the veteran") had not been war-caused. The decision of the Tribunal was made on 24 August 2000 when the veteran was still living and he lodged the present appeal. However, while the appeal was pending, the veteran died on 13 July 2001 and the present applicant, his widow, Olive Mildred Fogarty, was approved by the Repatriation Commission as the person to continue the appeal pursuant to s 126 of the Veterans' Entitlement Act 1986 ("the Act"). Accordingly, I shall order that the application to this Court be amended by substituting the said Olive Mildred Fogarty as the applicant. 2 The veteran was born on 1 June 1922 and served in the Royal Australian Navy from 30 September 1940 to 4 January 1946. That period of service is accepted on both sides as "eligible war service" as defined in the Act. Because that service was rendered on Royal Australian Navy ships in South-Western Pacific waters, it is also common ground that the whole of the veteran's service was "operational service" as defined in the Act. 3 The respondent Commission has conceded that the appeal should succeed in respect of the condition IHD and that such part of the Tribunal's decision as is related to IHD should be set aside and the matter the subject of that part of the decision be remitted to the Tribunal to be heard and determined according to law. The error of law which is accepted as infecting the IHD part of the Tribunal's decision is its failure to apply to the principles enunciated by a Full Court of this Court in Repatriation Commission v Deledio (1998) 83 FCR 82 ("Deledio") and by its making of a finding of fact at the third stage when it said it preferred the evidence of Dr Kenny to that of Dr Cole; see McKenna v Repatriation Commission (1996) 86 FCR 144. 4 It is common ground that the Statement of Principle ("SoP") applicable to the veteran's claim in respect to the remaining condition of GAD was No 48 of 1994 which recites; "1. Being of the view that there is sound medical-scientific evidence that indicates that generalised anxiety disorder and death from generalised anxiety disorder can be related to operational service rendered by veterans, peacekeeping service rendered by members of Peacekeeping forces and hazardous service rendered by members of the Forces, the Repatriation Medical Authority hereby determines, under subsection 196B(2) of the Veterans' Entitlements Act 1986, that the factors that must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting generalised anxiety disorder or death from generalised anxiety disorder, with the circumstances of that service, are: (a) having been a prisoner of war; or (b) experiencing a stressful event not more than two years before the clinical onset of generalised anxiety disorder; or (c) experiencing a stressful event not more than two years before the clinical worsening of generalised anxiety disorder; or (d) inability to obtain appropriate clinical management for generalised anxiety disorder. 2. Subject to clause 3 (below) at least one of the factors set out in paragraphs 1(a) to 1(d) must be related to any service rendered by a person. 3. The factors set out in paragraphs 1(c) and 1(d) apply only where: (a) the person's generalised anxiety disorder was suffered prior to a period, or part of a period, of service to which the factor is related; and (b) the relationship suggested between the generalised anxiety disorder and the particular service of a person is a relationship set out in paragraph 8(1)(e), 9(1)(e), 70(5)(d), or 70(5)(A)(d) of the Act. 4. For the purposes of this Statement of Principles: "generalised anxiety disorder" means a psychiatric disorder that is a generalised anxiety disorder attracting ICD code 300.02, and which meets the following description (derived from DSM-IV): (a) excessive anxiety and worry (apprehensive expectation) occurring more days than not for at least six months, about a number of events or activities (such as work or study), which: (i) the person finds difficult to control; and (ii) which is associated with three or more of the following six symptoms, at least some of which are present for more days than not for the previous six months: (A) restlessness or feeling keyed up or on edge; (B) being easily fatigued; (C) concentration difficulties or mind going blank; (D) irritability; (E) muscle tension; (F) sleep disturbance (difficulty falling or staying asleep, or restless unsatisfying sleep); and (iii) the focus of which is not confined to features of an Axis 1 disorder, for example, it is not about: (A) having a Panic Attack (as in Panic Disorder); or (B) being embarrassed in public (as a Social Phobia); or (C) being contaminated (as in Obsessive-Compulsive Disorder); or (D) being away from home or close relatives (as in Separation Anxiety Disorder); or (E) gaining weight (as in Anorexia Nervosa); or (F) having multiple physical complaints (as in Somatization Disorder); or (G) having a serious illness (as in Hypochondriasis); and (iv) it does not occur exclusively during Post-Traumatic Stress Disorder; and (v) either the anxiety or worry, or physical symptoms, cause clinically significant distress or impairment in social, occupational, or other important areas of functioning; and (b) which is not due to the direct physiological effects of: (i) a drug of abuse; or (ii) a medication; or (iii) a general medical condition (such as hyperthyroidism); and (c) which does not occur exclusively during a Mood Disorder, a Psychotic Disorder, or a Pervasive Development Disorder. "DSM-IV" means the fourth edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders; "stressful event" means an occurrence which evokes feelings of anxiety or stress." 5 The Tribunal noted that the veteran had not consumed alcohol at all before he joined the Navy. Its findings in respect of the veteran's consumption of alcohol and his claim to suffer from GAD were as follows; "32. As he recorded in his written statements, Mr Fogarty asserted that he first started consuming alcohol after joining the Navy. He was then 18 years of age and continued to drink throughout his naval service. Again as recorded in his written statements, Mr Fogarty's evidence was that he drank alcohol whenever he went ashore, to relieve stress and tension, and "to be one of the boys". While serving in VICTORIA, his level of consumption routinely averaged "about 8 beers approximately every second day". 33. Again, as recorded in his statement dated 6 August 1999, it was Mr Fogarty's assertion that after discharge he continued to drink, meeting with friends at a hotel every Friday evening after work. He stated that on these occasions he would drink eight or more glasses of beer. He would also drink on other social occasions. 34. Mr Fogarty's evidence was that by 1957 he was drinking four glasses of beer per day, sometimes from six to eight glasses per day, even more at weekends. As he recorded in his statement dated 6 August 1999, this pattern continued until 1988, when he said he started to "ease down" because he was experiencing major health problems. He more or less ceased drinking in 1994. ... … … 37. Mr Fogarty stated in cross-examination that he finally ceased consuming alcohol in the early 1990's. 38. It was Mr Fogarty's evidence that he has never been diagnosed with psychiatric condition (including GAD), although he has been told by two GP's that they considered he had a GAD. 39. When asked what were the main occasions when he drank alcohol, Mr Fogarty stated: "As I said before Friday would be the, when my dad was alive, would be the main night. But then there would be reunions and things like that, there'd be main days. You'd have more than your six glasses on those occasions and you'd catch a cab home, or be driven home." (Transcript p. 26) When further asked whether this was because he was aware that it could be dangerous to drive after consuming that amount of alcohol, Mr Fogarty responded by stating: "Well you thought you knew when you'd had enough. But history has proven you didn't know." (Transcript p. 26) 40. In re-examination Mr Fogarty stated that he now realizes that he had driven "many many" times when on "today's situation" he should not have been driving." 6 The Tribunal then referred to a statement by the substituted applicant, Mrs Fogarty, about her husband's consumption of alcohol and made this reference to evidence given by Dr Cole, a consultant psychiatrist: "46. Mr Cole examined Mr Fogarty on 5 November 1999 but did not question him concerning his earlier smoking or drinking history. However, after reading the statements provided by Mr Fogarty and his wife, the doctor stated in his report dated 3 March 2000: "It is apparent that the veteran suffered from alcohol abuse until he ceased drinking in 1988 and that his drinking was related to his war service. His chronic generalised anxiety disorder would also have had the effect of causing him to drink more than he might otherwise have done." 47. It was Dr Cole's opinion that Mr Fogarty is suffering from a chronic GAD which was in evidence when he was discharged from the Navy and that the condition is attributable to his war-service: "In my opinion, he meets the requirements of the Statement of Principles for such a diagnosis. There was no suggestion that he might be exaggerating his symptoms, and, on the contrary, I think he is inclined to deny to himself the full extent of his anxieties. His nervous disorder is mild, does not call for psychiatric treatment and appears to have stabilised." (Exhibit A5) The doctor explained that he formed this view after having regard for the history provided by Mr Fogarty. 48. It was Dr Cole's further view that Mr Fogarty satisfied the criteria relevant to the definition of GAD contained in SoP No. 48 of 1994." 7 The veteran had also been examined by another consultant psychiatrist, Dr B Kenny, whose evidence was summarised by the Tribunal in these terms; "51. Dr Kenny saw Mr Fogarty on 21 July 1999. He then provided a report for the purposes of these proceedings, dated 22 July 1999 (Exhibit R2) 52. During his oral evidence Dr Kenny confirmed that he asked Mr Fogarty concerning his consumption of alcohol: "Yes. He said that he learned to drink, in the Navy, and he - the phrase he used was "used to give alcohol a bit of a nudge" - was the phrase he used - "for awhile there afterwards". But he said that it was never a problem to him. He'd never had any drink driving, no drunk and disorderly incidence, no broken relationships, no loss of jobs because of drinking and no illnesses because of drinking." (Transcript p. 43) 53. Dr Kenny explained that, because at the time he saw him Mr Fogarty gave him the impression alcohol had never been a problem for him, he did not estimate the actual amount that Mr Fogarty consumed: "... but I looked at whether it appeared to have had any effect on his life, and it didn't, so my impression of him was that he did not suffer from alcohol abuse or psychoactive substance abuse." (Transcript p. 45) 54. It was Dr Kenny's view that Mr Fogarty does not have a psychiatric disturbance of any kind. Indeed, he viewed Mr Fogarty as a reasonably active and confident man for his age. 55. When asked during cross-examination whether, because he did not have an accurate assessment of Mr Fogarty's alcohol consumption level, he was not able to address SoP No. 5 of 1994 (Psychoactive Substance Abuse or Dependence) in detail, the doctor confirmed that this was so. 56. It will be noted that during his evidence Mr Fogarty made reference to medication ("little pills") having been prescribed by his local GP in respect of "some sort of anxiety condition". When questioned concerning the nature of the treatment Mr Fogarty replied: "Only the little pills. And after 50 years I wouldn't know what they were. But I've heard certain names that rang a bell but I wouldn't put it on record in case it's wrong." (Transcript p. 27) 57. It was Dr Kenny's evidence that Mr Fogarty had informed him he "thought he had nerve tablets in the late 1950's". 58. When asked what effect the tablets would have on Mr Fogarty's nervous condition if they were Valium, Dr Kenny said: "Well, Valium is usually, of course, as a minor tranquilliser for anxiety and it would suggest that at that particular time he may well have been a somewhat anxious restless sort of person and one would expect that they might take the edge of that." (Transcript p. 49) The doctor then went on to state that, if Mr Fogarty continued to be an anxious type of person, he would not necessarily have had to remain on Valium mediation: "I mean, Valium is an elective medication. I mean, you prescribe it for a patient if on balance you and the patient think it is worthwhile to deal with the person's anxiety. If on the other hand the individual takes it and doesn't feel much better, doesn't like the idea of taking tablets, then one would not be putting pressure on him to keep taking them. So there would be a great degree of variation in whether the individual would need to keep taking them, but on the other hand people often have periods of anxiety in their life for whatever reason which with a bit of treatment in terms of medication or support may settle down and then resolved in which case the individual may not need to continue to take any medication of any kind." (Transcript p. 49) 59. When asked how a drug such as Valium would react with alcohol, Dr Kenny stated: "Well, any of these psychoactive drugs are inclined to react with alcohol so that you get - sometimes you get a summation of effects so that the Valium - it will, as it were, sometimes give the patient a start in terms of his drinking. It means, it is as though he has an extra three or four glasses or standard drinks in him before he starts drinking alcohol. So that is a well recognised sort of phenomenon." (Transcript p 49) 8 The Tribunal in its reasons quoted an extensive extract from Deledio (at 97) which, it noted, ordained the method to be followed by tribunals required to apply SoPs. It then concluded, after an examination of the evidence before it, that it "points to" hypotheses connecting the claimed disabilities of IHD and GAD with the veteran's war service. It identified some eight facts which were said to have that indicative effect and then proceeded to consider whether the hypotheses advanced were reasonable. Its observations under that heading in relation to GAD were; "63. In our opinion that the hypotheses pointed to by the material before us are not reasonable. That is to say the hypotheses, which are in respect of IHD and GAD, do not contain one or more of the factors determined by the RMA in the relevant SoPs, to be the minimum which must exist, and be related to the person's service. This includes the factors upon which Mr Fogarty relies. In other words, the hypotheses fail to fit within the "template", to be found in the relevant SoP's, and thus the claims must fail. ... … … 66. Finally, as we have recorded Mr Fogarty relies upon factor 1(b) of SoP No. 48 of 1994 in respect of his claim for GAD, that is to say experiencing a stressful event not more than two years before the clinical onset of GAD. 67. While we accept that Mr Fogarty experienced stressful service in the Navy, we have, however, formed the opinion that he never developed a GAD as a result of any aspect of his service. Indeed, his own evidence makes it very clear that since his naval service, Mr Fogarty has enjoyed not only a long and happy family life but also a most successful and rewarding working life, particularly while at the Trades Hall and then later in politics." 9 Mr De Marchi who appeared as solicitor for the applicant referred to sub-ss 120(1) and (3) of the Act which provide; "(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." 10 For the purpose of deciding, pursuant to s 120(3), whether the material before it raises a reasonable hypothesis, the Commission is required to have regard to an applicable SoP determined under s 196B. That requirement is imposed by s 120A(3) which provides; "(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 (b) a determination of the Commission under subsection 180A(2); that upholds the hypothesis." 11 It was submitted on behalf of the applicant that s 119(1)(h) should be applied "to ameliorate any difficulty that lies in the way of ascertaining the existence of any fact, matter, cause or circumstances in making the enquiry." Section 119(1) provides, so far as is relevant; "(1) In considering, hearing or determining, and in making a decision in relation to: (a) a claim or application; ... … … the Commission: (f) is not bound to act in a formal manner and is not bound by any rules of evidence, but may inform itself on any matter in such manner as it thinks just; (g) shall act according to substantial justice and the substantial merits of the case, without regard to legal form and technicalities; and (h) without limiting the generality of the foregoing, shall take into account any difficulties that, for any reason, lie in the way of ascertaining the existence of any fact, matter, cause or circumstance, including any reason attributable to: (i) the effects of the passage of time, including the effect of the passage of time on the availability of witnesses; and (ii) the absence of, or a deficiency in, relevant official records, including an absence or deficiency resulting from the fact that an occurrence that happened during the service of a veteran, or a member of the Defence Force or of a Peacekeeping Force, as defined by subsection 68(1), was not reported to the appropriate authorities." 12 It was next contended that the Tribunal had correctly accepted that a hypothesis had been indicated connecting the veteran's claimed GAD with his war service and had identified the relevant SoP in accordance with the method enunciated in Deledio. However, it was urged that the Tribunal had erred in law when it concluded at [63] of its reasons quoted at [8] above that "the hypotheses pointed to by the material before us are not reasonable." The Tribunal explained that by saying that the hypothesis in respect of GAD did not contain one or more of the factors determined in the relevant SoP to be the minimum which must exist and be related to the veteran's service. The Tribunal further explained its conclusion by saying; "In other words, the hypotheses fail to fit within the "template" to be found in the relevant SoPs and thus the claims must fail." 13 In relation to GAD the Tribunal noted that the veteran had relied upon factor 1(b) of SoP No. 48 of 1994, ie "experiencing a stressful event not more than two years before the clinical onset of GAD."
What process of reasoning should the Tribunal have followed? 14 The process of reasoning which a decision-maker is obliged to follow under the Act is not without difficulty. It has been, over time, the subject of considerable legislative amendment and comment by single Judges and Full Courts of this Court. It is now settled law that the essential task is to take, in order, the four steps formulated in Deledio. However, the reasoning in Deledio starts from the premise that the veteran is suffering, or at the time of his or her death was suffering, from a disease. Where it is not common ground as to what (if any) disease is or was suffered by the veteran a first, or preliminary, question must be answered to the reasonable satisfaction of the decision-maker. That is "From what collection of symptoms is or was the veteran suffering?"; Repatriation Commission v Cooke (1998) 90 FCR 307 at 310. While considering this preliminary question, medical labels, commonly understood terms for specific conditions and the elements of any SoP are irrelevant and should be disregarded. In Repatriation Commission v Hill [2002] FCAFC 192 ("Hill"), a case concerning Post Traumatic Stress Disorder ("PTSD"), it was not in dispute that the veteran suffered from PTSD and so the only question was whether it was war-caused. However, the Court in Hill made this observation at [63] about the statutory test to be applied in resolving the preliminary question of the existence of a disease; "It should be borne in mind that the issue whether a particular disease exists is governed by s 120(4) of the Act, not ss 120(1) and (3). That is, the issue whether or not a disease exists is to be decided to the reasonable satisfaction of the Commission: see Repatriation Commission v Cooke at 20 and Gosewinckel at [49]." 15 As the Full Court observed in Benjamin v Repatriation Commission [2001] FCA 1879 ("Benjamin") at [52]-[55]; "The second question raised in the appeal concerns the standard of proof that should be adopted by the Tribunal in considering whether any psychiatric problems identified by the Tribunal constitute a war caused disease. … … … … Section 120(1) of the Act assumes the existence of a relevant injury or disease and provides a standard of proof for the determination of whether that injury or disease was war caused. When the Commission, or the Tribunal on review, is required to determine whether a veteran is suffering from a particular injury or disease, that issue must be decided to the reasonable satisfaction of the decision-maker, in accordance with s 120(4) of the Act - see Repatriation Commission v Budworth [2001] FCA 1421 paragraph [15]. The first question for the Tribunal will be how to characterise the psychiatric problems exhibited by the Veteran. If the Tribunal is satisfied that the symptoms constitute an injury or disease, the second question will be whether there is an SoP in force in respect of the disease. The diagnosis of that disease, and the determination of whether or not there is an SoP in force in respect of that kind of disease, falls for determination according to the standard of proof laid down in s 120(4). The characterisation of a disease … for the purposes of determining whether or not an SoP is in force in respect of that kind of disease … is separate from the question of whether a claim relates to the operational service rendered by a veteran within s 120(1). The standard of proof laid down by s 120(1) has no application to the former question." (emphasis added) 16 Before anything else, the Tribunal must find to its "reasonable satisfaction" that a disease exists; Budworth at [14 - 15]. It is not confined to considering only those diseases or conditions contended for by one or other party before it, and should not test the existence of a postulated disease by reference to any SoP while conducting this first inquiry; see Benjamin at [41] and [48]-[50]. At this first stage it is necessary to determine whether the veteran has a "collection of relevant symptoms", and not the "nomenclature or … traditional medical label" that may be used to describe them; Budworth at [19]. (After the symptoms from which a veteran suffers have been identified, it might be necessary to have regard, in a general and preliminary way, to various SoPs to determine into which of them the identified symptoms fit. That may occur in taking the second step described in Deledio which is discussedbelow.) 17 After the preliminary question has been resolved, the next four steps to be taken are those set out as follows by the Full Court in Deledio, at 97-98; "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). … . 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." 18 If the existence of a disease is not in dispute before the decision-maker, then only these four questions are relevant, and the preliminary question does not arise; see Hill at [61] and [63]. 19 In Hill, a Full Court of this Court, at [53] and [54], made the following observations about the process ordained by Deledio; "… … in order to satisfy ss 120(3) and 120A(3) of the Act, there must be more than a hypothesis of connection that is consistent with the relevant SoP. In order to satisfy these provisions, the material must "raise" or "point to" such a hypothesis and this hypothesis, as raised or pointed to by the material, must fit the relevant SoP. … … … If an essential element of a hypothesis is not raised (or pointed to) by the material before the decision-maker, then the hypothesis is not raised by that material: cf East [ v Repatriation Commission (1987) 16 FCR 517] at 533." 20 The Court in Hill also said at [55], which I take to be relevant to the third step; "… a hypothesis connecting a disease with war service will only be reasonable if the material that raises it includes all of the essential elements prescribed by the SoP: see Deledio v Repatriation Commission at 274-275, Repatriation Commission v Gosewinckel (1999) 59 ALD 690 at 704 per Weinberg J, and Connors v Repatriation Commission (2000) 59 ALD 61 at 68-70."
Did the Tribunal ask the right question? 21 Ms McMahon of Counsel for the respondent, submitted, first, that the veteran had failed before the Tribunal because the Tribunal was not satisfied to the standard laid down by s 120(4) that the veteran had suffered from any GAD which I take to mean any psychological condition of that kind whatever its nomenclature and not only the condition set out in SoP No 48 of 1994. Accordingly, Ms McMahon contended, the applicant had failed to establish an affirmative answer to the preliminary question. 22 In aid of this contention the respondent relied upon the judgments at first instance and on appeal in McAuliffe v The Secretary and Department of Social Security (1991) 23 ALD 284 and (1992) 28 ALD 609 where it was held that, despite any "unhappy choice of language" by a tribunal in formulating its reasons for a decision, there will not be an error of law on the basis of a failure to give reasons, if, read as a whole, and making proper inferences, the tribunal's written decision sufficiently indicates its reasoning and findings on material matters. On this basis, the respondent invited me to infer that the Tribunal had found to its reasonable satisfaction that no GAD existed. 23 Alternatively, the respondent submitted that the veteran's claim based on a GAD would inevitably have failed at the third Deledio step. That argument was advanced in this way. The SoP for a GAD has, as an essential requirement (at par 4(v), as set out at [4] above) that the GAD must manifest itself in "clinically significant distress or impairment in social, occupational, or other important areas of functioning". It was submitted that the Tribunal had taken the view that no such impairment or distress existed when it said in its reasons at [67] that the veteran's "own evidence makes it very clear that since his naval service, Mr Fogarty has enjoyed not only a long and happy family life but also a most successful and rewarding working life, particularly while at the Trades Hall and then later in politics." I was therefore invited to infer that the Tribunal had concluded that no GAD existed, which relieved it of the need to consider whether the material raised a hypothesis connecting any GAD with the veteran's operational service. 24 In relation to the first submission, the applicant's solicitor contended, with some validity, that the Tribunal had not expressed itself as understanding that it had two separate tasks: the first being to determine whether the symptoms of a GAD or like condition were present before turning to its second task of applying the four step analysis ordained by Deledio. The plain meaning of the Tribunal's words, quoted at [12] above, is that it has found that the material points to a hypothesis and it has found that the hypothesis is not reasonable. That conclusion could only properly be reached on taking the third Deledio step. Given its explicit reference to "reasonable hypothesis" it does not appear, contrary to the respondent's first contention, that the Tribunal considered the existence of a GAD as a separate, preliminary question, as the respondent contends in its first submission. In any event, even if it did address the existence of a disease as a preliminary question, its express reference to the veteran's long and happy family life and successful career in the trade union movement and politics, seems directed to the diagnostic criteria in the GAD SoP, particularly given its introductory reference at [63] to a finding that the hypothesis raised does not contain "one or more of the [minimum] factors … which must exist". 25 Except for the passing references to the veteran's own evidence quoted at [21] above, the Tribunal did not expressly analyse under either of its headings "Application of SoP's - Methodology" or "Whether Hypotheses Reasonable" the matters discussed elsewhere in its reasons for decision which were apparently relevant to those issues. There is no explicit reference, in the GAD context, to any of the medical reports expressing opinions on its applicability. It certainly did not expressly purport to take the successive steps which had been clearly identified in Deledio. Nor did it examine, in the light of the available evidence, each cumulative criterion laid down in the SoP. These omissions make the Tribunal's reasoning process largely a matter of inference. However, it is appropriate, in the light of those strictures, to recall these observations of Weinberg J in Commission v Gosewinckel (1999) 59 ALD 690 at 703/[59], another GAD case; "The tribunal's reasons for decision should not be scrutinised upon over-zealous judicial review by seeking to discern whether some inadequacy may be gleaned from the way in which the reasons are expressed: Minister for Immigration and Ethnic Affairs v Wu Shan Liang (1996) 185 CLR 259; at 272, and at 291-3; 41 ALD 1; 136 ALR 481. The tribunal's failure when dealing with the issue of diagnosis to advert, in terms, to each and every aspect of generalised anxiety disorder, as set out in cl 4 of the SoP, does not mean that it did not have regard to each of those aspects, whether positive or exclusionary in nature. Had ground (b) stood alone, the application before the court would not have succeeded. 26 Mr De Marchi for the applicant also submitted that, in taking the approach it did, the Tribunal had precluded itself from considering other SoPs that might have applied to the veteran's symptoms. He suggested that, in disregard of Gorton v Repatriation Commission (2000) 63 ALD 723, the Tribunal had failed to consider the most recent SoP for a GAD, being that set out in Instrument 1 of 2000. However, it is by no means apparent that the new SoP for "anxiety disorder" is any more advantageous to the applicant than the pre-existing SoP in that it preserves a requirement for "clinically significant distress or impairment in social, occupational, or other areas of functioning". Nothing has been put to me that suggests that the Tribunal failed to consider an applicable SoP which was more advantageous to the applicant. On the material available it appears that the former SoP for GAD, now replaced by the SoP for "anxiety disorder", was a threshold or "entry-level" SoP for mental disorders. It was therefore unlikely that a veteran would fail to satisfy the criterion for the GAD SoP and be eligible under some other, less stringent, SoP. However, this reflects only my tentative view of the statutory scheme formed without the benefit of submissions on this point. 27 An analysis of the Tribunal's reasons must start from the proposition that the Tribunal found, to its reasonable satisfaction, as a matter of fact, no collection of symptoms corresponding to clinically significant social or occupational impairment. That was a conclusion open to the Tribunal on the material before it, and the Court is not entitled to disturb that finding. I can infer, reasonably clearly, that, when the Tribunal arrived at the third step of the Deledio process there was nothing to point to an essential element of the SoP, and it could therefore not regard the hypothesis as reasonable and so it proceeded no further. It would have been of considerable assistance if the Tribunal had formulated a clear statement of what symptoms it found to be present (or not to be present) in the veteran, but that omission was not fatal to the finding of fact to which I have just adverted. 28 Nevertheless, despite the finding of fact just mentioned, I am not persuaded that the Tribunal ever took the preliminary step of identifying the collection of symptoms of a disease from which the veteran may have suffered. It appears to have treated the existence of any mental disorder as in dispute, but has not properly carried out the exercise described in Budworth and Benjamin and discussed above at [15]; that is, the Tribunal did not consider the existence of any symptoms of mental disorder and determine to its reasonable satisfaction what symptoms were actually exhibited by the veteran before taking the successive steps described in Deledio. Rather, it went straight to the Deledio process with the exclusionary criteria of the GAD SoP in mind. That was clearly an error of law, but the question remains whether it materially affected the result at which the Tribunal arrived. 29 As a general proposition, it is desirable, where the existence of any disease at all is in issue, for the Tribunal to make a specific finding on that issue so that it can then proceed to examine the disease or collection of symptoms (if any) which it has found against every available SoP and not merely those relied on by the applicant. Neither before the original decision-maker, the Veterans Review Board, nor the Tribunal, is the applicant obliged to raise every potentially applicable SoP. The decision-maker must therefore consider whether there are any other SoPs and not merely confine the decision to the case articulated by the applicant: Grant v Repatriation Commission (1999) 57 ALD 1; [1999] FCA 1629; Benjamin at [48]. However, before this Court, an applicant contending that the Tribunal has failed to consider the more beneficial of two applicable SoPs (given the reasoning in Grant) must point to that instrument and indicate how its application would have brought about a different result. No SoP more beneficial to the applicant has been indicated in the present proceedings. Mr De Marchi has confined himself to submitting that the Tribunal failed to consider the applicable SoP currently in force, although there was an accrued right to have the veteran's circumstances also considered under the terms of the SoP in force at the time of application, if that earlier SoP would have yielded a result denied by the later SoP; see Repatriation Commission v Gorton (2000) 110 FCR 321 at [65] per Allsop J with whom Emmett J agreed. Clearly, the Tribunal did not consider the SoP actually in force immediately before it published its decision. However, in the circumstances of this case, I do not see that there is a material difference between the current "anxiety disorder" SoP and the earlier GAD SoP. Therefore, although I consider that the Tribunal erred in law both in failing to have regard to the "anxiety disorder" SOP of 2000, and in failing to conduct what I have called the preliminary inquiry (as it appears that the existence of the claimed mental disorder was in issue), those errors were not material in the result.
Conclusion 30 Since the applicant has failed to demonstrate a material error in relation to any condition which could be comprehended within those categorised as GADs, it follows that the remitter to the Tribunal must be confined to a consideration of the case which the applicant seeks to make out by contending that an entitlement to an Extreme Disablement Adjustment to the pension arose by virtue of the veteran's having suffered from IHD. Because the application has been successful to that extent, I consider it an appropriate exercise of the Court's discretion to make no order as to costs. There will be orders accordingly. I certify that the preceding thirty (30) numbered paragraphs are a true copy of the Reasons for Judgment herein of the Honourable Justice Ryan.
Mr D De Marchi appeared on behalf of the applicant.
Solicitor for the Applicant: De Marchi & Associates
Solicitor for the Respondent: Australian Government Solicitor
Fogarty
Repatriation Commission
(1998) 83 FCR 82
(1996) 86 FCR 144
(1998) 90 FCR 307
(1987) 16 FCR 517
(1996) 185 CLR 259
(2000) 110 FCR 321
Application amended to substitute Olive Mildred Fogarty as applicant; Tribunal decision of 24 August 2000 set aside insofar as it determined IHD was not war-caused and remitted to the Tribunal for rehearing according to law; Tribunal decision otherwise affirmed; no order as to costs. (See Orders.)