THE DECISION
4 The sole issue before the Tribunal for its determination was the date on which Ms Hutchinson, who was at all material times employed by the respondent, Comcare, first sustained either of her compensable mental injuries. Liability had been accepted by Comcare pursuant to s 14(1) of the Safety, Rehabilitation and Compensation Act 1988 (Cth) (SRC Act) to pay compensation to the applicant in respect of 'a major depressive disorder - single episode' and 'post-traumatic stress disorder'. It had become common ground that the former compensable injury should be described as 'major depressive disorder'. The Tribunal accepted that each of those mental injuries was a disease as defined in s 5B(1) of the SRC Act. The question for Tribunal, pursuant to s 7(4) of the SRC Act was the date on which, for the purposes of SRC Act, Ms Hutchinson 'shall be taken to have sustained [each] injury'. Pursuant to that subsection, it was to be the date on which (relevantly):
(a) Ms Hutchinson first sought medical treatment for the disease; or
(b) the disease first resulted in incapacity for work or impairment of Ms Hutchinson.
5 The decision of the Tribunal examined at length the evidence in relation to claims made by Ms Hutchinson concerning her conditions and the treatment of those claims by medical experts, predominately psychiatrists, but also two psychologists.
6 Having set out Ms Hutchinson's claims and a great deal of the medical evidence in relation to her claims over some 70 pages, the Tribunal reached the conclusion (at [43]) that she:
… "first sought medical treatment for" a relevant mental ailment (being a "disease" as defined in s 5A(1) of the SRC Act), within the meaning of s 7(4)(a) of the SRC Act on 31 January 2011.
7 At [44]-[46] the Tribunal noted:
44. For the purposes of the application of para (b) of s 7(4) of the SRC Act, the following questions arise:
• did either or both of the relevant diseases (namely, major depressive disorder and post-traumatic stress disorder) "result in the incapacity for work, or impairment of the [applicant]" before 31 January 2011? and, if so
• on which date did either of those relevant diseases "first result in the incapacity for work, or impairment of the [applicant]"?
45. The applicant's case rested entirely on her submission that she suffered post-traumatic stress disorder on 5 March 2010 by reason of the Director [X], who was sitting next to her at a training workshop, leaning towards her and quietly saying to her "I'm going to fucking kill you" ("the perceived death threat incident"), and that she immediately suffered mental impairment as a result, and, in support of that submission, she primarily relied on the medical reports of Dr Dellar dated 31 January 2013 (T38) and 28 May 2013 (Exhibit R2) (set out in paragraphs 33 and 34 above).
46. Although there is a considerable number of expert psychiatric and psychological reports in evidence, unfortunately none of them directly addresses the question as to when the applicant first suffered a mental ailment and mental impairment as a result of the perceived death threat incident. Each of those reports, however, does contain an expression of opinion regarding the diagnosis or nature of the mental ailment suffered by the applicant at the time of the clinical examination of the applicant on which the relevant report was based.
(emphasis added)
8 The Tribunal (at [48]-[50]) compared the available evidence as follows:
48. The Tribunal notes that all of the psychiatrists who examined the applicant in the period from March 2011 (when she was first referred for psychiatric assessment) to November 2012 - namely, Dr Spence, Dr Felman, Dr Spear and Dr Edwards-Smith - made a diagnosis of major depressive disorder in the applicant's case, and none of them made a diagnosis of post-traumatic stress disorder in her case. The latter diagnosis was first made by Dr Brendan Dellar, Specialist Clinical Psychologist. The Tribunal notes that, in the evidence before it, the first reference to the applicant's suffering from post-traumatic stress disorder is made in Dr Dellar's report of 31 January 2013 (T38) but the Tribunal is unable to determine when Dr Dellar first made that diagnosis in the period from February 2012 when he commenced treating the applicant. The Tribunal notes, furthermore, that Dr Lawrence Blumberg, Consultant Psychiatrist, also made a diagnosis of chronic post-traumatic stress disorder in the applicant's case upon his examination of her on 21 June 2013, as stated in his report of 25 June 2013 (T46).
49. Neither Dr Blumberg nor Dr Dellar, in their abovementioned reports, specifically addressed the timing of the applicant's developing or contracting post-traumatic stress disorder. Certain passages in Dr Dellar's report of 28 May 2013 (Exhibit R2) may, however, be indicative of the view that the applicant contracted or developed post-traumatic stress disorder immediately or shortly after the perceived death threat incident of 5 March 2010 - in particular, the following passages:
"… I consider Posttraumatic Stress Disorder to be the original injury, and that the Major Depressive Disorder is secondary …
… The injury was the death threat incident which directly led to anxious-arousal, avoidance and re-experiencing symptoms. The prolonged anxiety and lack of control in my opinion led to the secondary development of Major Depressive Disorder.
… As mentioned above, the PTSD was the initial result of the death threat, and Major Depressive Disorder developed as the result of prolonged anxiety and ongoing deficits in perceived control. …"
However, even if it can reasonably be inferred from the abovementioned passages that Dr Dellar is of the opinion that the applicant contracted or developed post-traumatic stress disorder immediately or shortly after the perceived death threat incident of 5 March 2010, that opinion is inconsistent with the opinions expressed by the four abovementioned psychiatrists (namely, Dr Spence, Dr Felman, Dr Spear and Dr Edwards-Smith) who examined the applicant in the period from March 2011 to November 2012 and who each took a detailed history from the applicant, including the perceived death threat incident of 5 March 2010 and its impact on her. Each of those psychiatrists made a diagnosis of major depressive disorder, and none of them made a diagnosis of post-traumatic stress disorder, in the applicant's case.
50. The Tribunal attaches great weight to the opinions of those four abovementioned psychiatrists and, having regard to that evidence, the Tribunal is not satisfied that the applicant was suffering from post-traumatic stress disorder, or any impairment resulting from post-traumatic stress disorder, before March 2011 or in the period from March 2011 to November 2012. The Tribunal is, however, satisfied, on the basis of Dr Dellar's report of 31 January 2013, that the applicant was suffering from post-traumatic stress disorder as at that date.
(emphasis added)
9 On the basis of that reasoning, the Tribunal expressly concluded that it was not satisfied that Ms Hutchinson was incapacitated in the period from 5 March 2010 to 31 January 2011, as she contended.
10 The Tribunal further explained the reasons why that was so in [54]-[58] in these terms:
54. As regards "impairment" (as defined in s 4(1) of the SRC Act), the Tribunal notes the applicant's evidence that, on 5 March 2010 following the perceived death threat incident on that day, her "psychological integrity came to a crashing halt". The Tribunal also notes, in particular, the applicant's statement regarding her state of mind while on the overseas cruise on which she had embarked on 21 May 2010 and from which she was scheduled to return to Australia on 3 September 2010:
"2.50 So consumed with fear and terror at the prospect of returning, not only to the workplace but even to Australia, the Applicant seriously contemplated suicide and to that end the Applicant left the cruise and arrived back in Victoria on 15 August 2010." (part of Exhibit A1 - set out in paragraph 14 above)
There is, however, no contemporaneous medical evidence before the Tribunal regarding the applicant's mental state in the period from 5 March 2010 to 30 January 2011.
55. The question as to when "impairment" of the applicant as a result of her compensable "injury, being a disease", namely, major depressive disorder, first occurred is, in the Tribunal's opinion, primarily a medical question, which is to be determined by the Tribunal primarily on the basis of the medical evidence before it. In the absence of contemporaneous medical evidence before the Tribunal regarding the applicant's mental state in the period from 5 March 2010 to 30 January 2011, the Tribunal is not satisfied that the applicant had "impairment" (as defined in s 4(1) of the SRC Act) resulting from major depressive disorder in that period.
56. The Tribunal is, however, satisfied, on the basis of Dr Dunne's report of 23 April 2011 (T19 - set out in paragraph 23 above), that the applicant presented with symptoms of major depressive disorder on 31 January 2011 when she consulted Dr Dunne on that date and that the applicant had "impairment" resulting from major depressive disorder on and from that date.
57. Having regard to the abovementioned considerations the Tribunal is satisfied, and finds, that:
• pursuant to s 7(4) of the SRC Act, for the purposes of that Act, the applicant is "taken to have sustained an injury, being a disease", namely, major depressive disorder, on 31 January 2011;
• the applicant subsequently sustained a mental injury, being a "disease" (as defined in s 5B(1) of the SRC Act), namely, post-traumatic stress disorder.
58. Having regard to the abovementioned findings, it is unnecessary, for present purposes, for the Tribunal to determine the date (being a date after 31 January 2011) on which the applicant contracted or developed post-traumatic stress disorder. In any event, having regard to the whole of the evidence before it, the Tribunal is unable, on the basis of that evidence, to make findings, for the purpose of the application of s 7(4) of the SRC Act, as to the precise date on which:
• the applicant first sought medical treatment for post-traumatic stress disorder;
• the applicant's post-traumatic stress disorder first resulted in incapacity for work in her case; or
• the applicant's post-traumatic stress disorder first resulted in impairment in her case.
Suffice it to say that, in the Tribunal's opinion, the medical evidence before it does not, on balance, support the proposition that the applicant was suffering from post-traumatic stress disorder before March 2011 or in the period from March 2011 to November 2012. (emphasis added)