● If yes, is the Applicant entitled to compensation for medical treatment under section 16 of the Act and to compensation for incapacity under sections 19, 20, 21 or 21A of the Act?
17 The Tribunal then referred to ss 4, 14, 16, 19, 20, 21 and 21A of the Act. It quoted extensively from ss 4, 14 and 16. In particular, the Tribunal set out the definitions of disease and injury in the terms in which those definitions were expressed in s 4 of the Act at all relevant times.
18 The Tribunal then proceeded to examine the evidence before it and to make relevant findings. These findings may be summarised as follows:
(a) In 1991, the applicant had left a previous job as a Sheriff's Officer because he had suffered Post-Traumatic Stress Disorder (PTSD) as a result of an altercation with a judgment debtor in which violence was threatened. He had sought and received medical attention as a result of this incident for a period of approximately 18 months;
(b) He subsequently had several other jobs before joining Centrelink in May 2000;
(c) Between 1993 and 2000, he had had no symptoms of any mental illness and had not sought medical treatment for such illness in that period;
(d) The applicant first became stressed at Centrelink once he was "fully on the phone". This was from about September 2000;
(e) He had problems with changing policies, dealing with various team leaders, work pressures to perform and aggression from customers;
(f) In late 2001, he changed the basis of his employment from full-time to part-time because he could not cope with his workload. He worked four days a week instead of five days a week;
(g) After this period and before early 2003, the applicant sought medical attention. He was prescribed anti-depressants which he took for some months. He was given no coping strategies nor advised to discuss his concerns with his supervisors. He may have seen a doctor in relation to other matters at that time as well;
(h) On 24 March 2003, there was a verbal altercation between the applicant and a co-worker who sat nearby. For some months there had been tension between them. The applicant was very upset by this altercation. There was no sense of fear. The applicant said that he was embarrassed in front of other colleagues;
(i) As a result of this altercation, the applicant took two days off work on sick leave. He went to a doctor because he was continually crying and could not sleep;
(j) The applicant complained to his team leader about the incident. As a result, the co-worker was moved. The applicant saw this as vindication of his complaint, although he felt that management was on the side of his co-worker;
(k) The co-worker remained in the applicant's thoughts constantly for months. He was unable to relax at home and was "short" with his children. In April 2003, the applicant was referred to the Employees Assistance Program (EAP), which provides psychological counselling for workers. Over three to four sessions, he was given strategies to rid himself of the thoughts he was having about his co-worker;
(l) The applicant also said that it was the nature of Centrelink itself and the problems that it was causing people in the community which led to his emotional problems;
(m) An internal inquiry into the applicant's complaint took place in August and September 2003. The inquiry did not recommend that any action be taken;
(n) On 13 October 2003, the applicant saw his GP and said that he was feeling stressed at work. He said that this was probably because he was disappointed with the outcome of the inquiry. He was diagnosed as suffering from depression and was prescribed Mirtazapine.
(o) The applicant's medical records showed numerous attendances at his GP's surgery between March and October 2003 with no mention of any work-related stress issues. He was unable to explain this;
(p) In 2004, the applicant found himself again physically located at work quite close to the co-worker with whom he had had the altercation in March 2003. He tried to have the co-worker moved but failed. He became upset. His sleep was interrupted. He felt sick and began crying again;
(q) On 8 September 2004, the applicant made a formal complaint about the March 2003 incident. Centrelink responded by saying that the matter was closed;
(r) The applicant then saw another EAP counsellor for about six to ten sessions. He was given other counselling.
19 The Tribunal then reviewed the medical evidence.
20 Dr Butler, the applicant's treating psychiatrist, was of the opinion that the applicant had a psychological injury which was contributed to by his employment. He said that the incident with the co-worker was only one of the reasons why the applicant had become symptomatic.
21 Dr Sagar, a psychiatrist who saw the applicant and testified at the behest of the respondent, described the applicant's condition as decompensation. He said the applicant was in a melancholy depressive state. He said that the applicant had an obsessional or defensive narcissistic personality. Dr Sagar said that the incident with the co-worker was the straw that broke the camel's back. It was possible that the applicant had decompensated before joining Centrelink. The PTSD diagnosis in 1991 was significant. Persons with that disorder typically, on securing a job, quickly have interpersonal problems at work.
22 Dr Akkerman, a psychiatrist, also gave evidence on behalf of the respondent. He said that the applicant had a personality problem which was unaffected by his employment.
23 At [39]-[44] of its Reasons, the Tribunal referred to the parties' submissions. At [40], the Tribunal noted that it was submitted on behalf of the applicant that the sole contributing factor to the applicant's condition was his employment with Centrelink. There was no mention in this section of the Tribunal's Reasons of any submission directed to the concept of "aggravation of an ailment".
24 At [45]-[60], the Tribunal considered each of the issues which it had identified at [3] of its Reasons.
25 The Tribunal held that the applicant suffered from a psychological injury (Reasons at [45]-[47]). It also held that the psychological injury from which the applicant suffered resulted in impairment and incapacity for work within the meaning of s 4 of the Act in March 2003, October 2003 and May 2005.
26 The Tribunal then considered the second issue which it had identified at [3] of its Reasons under the heading: "Did the Applicant's employment with Centrelink contribute to the condition in a material degree?"
27 At [50] of its Reasons, the Tribunal described this as "the crux of this case". The Tribunal then discussed the concept of "material contribution" and the evidence relevant to that question. The Tribunal seemed to hold that the applicant already suffered from an underlying personality disorder when he commenced working for Centrelink (see [57] of the Tribunal's Reasons).
28 At [58] of its Reasons, the Tribunal said:
It does not follow, in our view, that the Applicant's work, through aggressive telephone calls and the co-worker incident, materially contributed to his condition. The co-worker incident, in our view, produced only an episodic increase in his pre-morbid stress condition.
29 The Tribunal then returned to the concept of "material contribution". At this point in its reasons, it referred to and discussed the judgment of Finn J in Comcare v Sahu-Khan (2007) 156 FCR 536.
30 The Tribunal then concluded its Reasons with the following (at [60]):
After considering all the evidence, in particular the possible factors that may have contributed to the onset or aggravation of the Applicant's psychiatric condition, we find that the circumstances of the Applicant's employment with Centrelink did not substantially contribute to his disease. Mr Nelson is not entitled to compensation pursuant to section 14 of the Act. It follows that he is not entitled to compensation in respect of medical expenses under section 16, nor is he entitled to compensation for incapacity under sections 19, 20, 21 or 21A of the Act.
31 The only places that the concept of "aggravation of an ailment" were mentioned at all in the Tribunal's Reasons was at [5] (when s 4 of the Act was extracted) and at [60].