The Relevant Statutory Provisions
141 Section 15(1) of the VE Act provides that a veteran who is in receipt of a pension under Pt II of the VE Act in respect of the incapacity of the veteran may apply, in accordance with s 15(3), for an increase in the rate of the pension on the ground that the incapacity of the veteran has increased since the rate of pension was assessed or last assessed. There is no doubt that the appellant's March 2009 application for an increase in his pension was made pursuant to s 15(1).
142 Subsections (3) and (4) of s 15 provide:
(3) An application under subsection (1) or (2):
(a) shall be in writing and in accordance with a form approved by the Commission;
(b) shall be accompanied by such evidence available to the applicant as the applicant considers may be relevant to the application; and
(c) is to be lodged at an office of the Department in Australia in accordance with section 5T and is taken to have been made on a day determined under that section.
(4) Subsection (3) shall not be taken to impose any onus of proof on an applicant or to prevent an applicant from submitting evidence in support of the application subsequently to the making, but before the determination, of the application.
143 Where a claim for an increased pension is made under s 15(1) of the VE Act, the Secretary of the Department of Veterans' Affairs is obliged to cause an investigation to be made into the matters to which the claim or application relates (s 17(1)). When the investigation is complete, the Secretary must cause the application to be submitted to the respondent for its consideration and determination (s 17(2)). The application must be accompanied by the evidence and documents relied upon by the veteran in support of his or her application.
144 Section 18 provides:
18 Duties of Commission in relation to pensions
(1) It is the duty of the Commission in considering a claim or application submitted to it, to satisfy itself with respect to, or to determine, as the case requires, all matters relevant to the determination of the claim or application.
(2) Where the Board, the Administrative Appeals Tribunal or a court makes a decision remitting to the Commission a matter, being:
(a) the assessment of the rate, or increased rate, at which a pension is to be payable under this Part; or
(b) the fixing of the date as from which a decision of the Board, the Administrative Appeals Tribunal or the court is to operate;
it is the duty of the Commission to determine that matter having regard to the provisions of this Act and the reasons of the Board, the Administrative Appeals Tribunal or the court, as the case may be, for that decision.
145 Section 19 provides:
19 Determination of claims and applications
(1) Where a claim or application is submitted to the Commission in accordance with subsection 17(2), the Commission shall:
(a) consider all matters that, in the Commission's opinion, are relevant to the claim or application; and
(b) subject to this section, determine the claim as provided by subsection (3); and
(c) subject to this section, determine an application under subsection 15(1) under subsection (5D); and
(d) subject to this section, determine an application under subsection 15(2) as provided by subsection (5).
(2) Without limiting the generality of paragraph (1)(a), the matters that the Commission may consider include:
(a) the evidence and documents that were submitted with the claim or application in accordance with subsection 17(3);
(b) any evidence subsequently submitted to the Commission in relation to the claim or application; and
(c) any evidence, documents or other material furnished to the Commission under section 32.
(3) The Commission shall determine a claim for a pension as follows:
(a) first, the Commission shall determine whether the claimant is entitled to be granted a pension in respect of:
(i) the incapacity of a veteran from war-caused injury or war-caused disease, or both; or
(ii) the death of a veteran that was war-caused;
(b) then, if the Commission determines that the claimant is so entitled, the Commission shall proceed as set out in subsections (5A), (5B), (5C) and (5D).
146 In the present case, the respondent was obliged to deal with the appellant's application in accordance with subs (5A), (5B) and (5C) of s 19 (see s 19(3)(b) and s 19(4A)) and to determine that application under subs (5D) of s 19 (see s 19(1)(c) and s 19(3)(b)).
147 Subsections (5A), (5B), (5C) and (5D) of s 19 are in the following terms:
(5A) If:
(a) paragraph (3)(b) applies in respect of a claim; or
(b) subsection (4A) applies in respect of an application under subsection 15(1); or
(c) paragraph (5)(b) applies in respect of an application under subsection 15(2);
the Commission must assess the matters set out in subsection (5C).
(5B) The Commission must assess the matters set out in subsection (5C) in accordance with whichever of sections 22, 23, 24, 25, 27 and 30 are applicable in the particular case.
(5C) The matters that the Commission must assess are:
(a) the rate or rates at which the pension would have been payable from time to time during the assessment period; and
(b) subject to subsection (6), the rate at which the pension is payable.
(5D) After making an assessment under subsection (5C), the Commission must determine that pension is payable at the rate assessed.
148 In the case of an application made under s 15(1), a pension is payable from the date of effect of the determination made by the respondent under s 19(5D) (see s 19(5E)(iii)). Such a determination takes effect from the date upon which the determination is made or on such later or earlier date as is specified in the determination (see s 19(5F)(c)).
149 Section 19(6) provides that, where the respondent has, pursuant to s 19(5C), assessed that a pension at the intermediate or special rate is payable at some time during the assessment period, then the rate at which the pension is payable shall not be lower than the applicable rate provided by s 23 or s 24 (whichever is the applicable section).
150 Subsection (9) of s 19 is in the following terms:
(9) In this section:
application means an application made in accordance with section 15.
application day, in relation to a person who has made a claim or application or on whose behalf a claim or application has been made, means:
(a) the day on which the claim or application was received at an office of the Department in Australia; or
(b) if subsection 20(2), 20(2B) or 21(2) applies to the person - the day on which the claim or application referred to in paragraph 20(2)(a), 20(2B)(a) or 21(2)(a) was so received.
assessment period, in relation to a claim or application relating to a pension, means the period starting on the application day and ending when the claim or application is determined.
claim means a claim made in accordance with section 14.
relevant documentary medical evidence, in relation to a claim or application referred to in subsection (8), means certificates, reports or other documents from a medical practitioner, or from a hospital or similar institution in which the veteran or deceased veteran in respect of whom the claim is made had received medical treatment, in support of the claim or application, being certificates, reports or documents reasonably used:
(a) in support of the claim or application; or
(b) if a part only of the claim or application was granted - in support of that part of the claim or application.
151 Section 21(1) provides that the respondent may specify as the date that a determination of s 15(2) application takes effect, the date when that application was received by the Department.
152 Section 21A(1) and (2) provide that the respondent is to determine the veteran's degree of incapacity from war-caused injury or war-caused disease, or both, and determine that degree of incapacity as 10% or a multiple of 10% up to 100%.
153 Section 22 deals with the general rate at which a pension is payable to a veteran and the extreme disablement adjustment. Section 23 provides for the intermediate rate of pension. Its structure is similar to that of s 24.
154 Section 24 provides for the special rate of pension. Section 24(1) and (2) are in the following terms:
24 Special rate of pension
(1) This section applies to a veteran if:
(aa) the veteran has made a claim under section 14 for a pension, or an application under section 15 for an increase in the rate of the pension that he or she is receiving; and
(aab) the veteran had not yet turned 65 when the claim or application was made; and
(a) either:
(i) the degree of incapacity of the veteran from war-caused injury or war-caused disease, or both, is determined under section 21A to be at least 70% or has been so determined by a determination that is in force; or
(ii) the veteran is, because he or she has suffered or is suffering from pulmonary tuberculosis, receiving or entitled to receive a pension at the general rate; and
(b) the veteran is totally and permanently incapacitated, that is to say, the veteran's incapacity from war-caused injury or war-caused disease, or both, is of such a nature as, of itself alone, to render the veteran incapable of undertaking remunerative work for periods aggregating more than 8 hours per week; and
(c) the veteran is, by reason of incapacity from that war-caused injury or war-caused disease, or both, alone, prevented from continuing to undertake remunerative work that the veteran was undertaking and is, by reason thereof, suffering a loss of salary or wages, or of earnings on his or her own account, that the veteran would not be suffering if the veteran were free of that incapacity; and
(d) section 25 does not apply to the veteran.
(2) For the purpose of paragraph (1)(c):
(a) a veteran who is incapacitated from war-caused injury or war-caused disease, or both, shall not be taken to be suffering a loss of salary or wages, or of earnings on his or her own account, by reason of that incapacity if:
(i) the veteran has ceased to engage in remunerative work for reasons other than his or her incapacity from that war-caused injury or war-caused disease, or both; or
(ii) the veteran is incapacitated, or prevented, from engaging in remunerative work for some other reason; and
(b) where a veteran, not being a veteran who has attained the age of 65 years, who has not been engaged in remunerative work satisfies the Commission that he or she has been genuinely seeking to engage in remunerative work, that he or she would, but for that incapacity, be continuing so to seek to engage in remunerative work and that that incapacity is the substantial cause of his or her inability to obtain remunerative work in which to engage, the veteran shall be treated as having been prevented by reason of that incapacity from continuing to undertake remunerative work that the veteran was undertaking.
155 Subsections (2A) and (2B) of s 24 govern a claim and an application by a veteran who has turned 65 before the claim or application was made. Because the appellant had not turned 65 by the time that he made his application, subs (2A) and subs (2B) are not relevant in the present case. Nor is subs (3) which provides that s 24 applies to a veteran who has been blinded in both eyes as a result of war-caused injury or war-caused disease or both.
156 Subsections (4), (5) and (6) of s 24 deal with the rate at which pension is payable to a veteran under s 24.
157 Section 24A provides for the continuation of payment of pension at the intermediate or special rate (as the case may be) once the Commonwealth becomes liable to pay a veteran at one or other of those rates unless the decision to pay at the higher rate was induced by a false statement or misrepresentation or unless the veteran's degree of incapacity changes to the extent relevantly specified in s 24A.
158 Section 25 provides for the payment of the special rate on a temporary basis.
159 Section 28 provides:
28 Capacity to undertake remunerative work
In determining, for the purposes of paragraph 23(1)(b) or 24(1)(b), whether a veteran who is incapacitated from war caused injury or war caused disease, or both, is incapable of undertaking remunerative work, and in determining for the purposes of section 24A whether a veteran who is so incapacitated is capable of undertaking remunerative work, the Commission shall have regard to the following matters only:
(a) the vocational, trade and professional skills, qualifications and experience of the veteran;
(b) the kinds of remunerative work which a person with the skills, qualifications and experience referred to in paragraph (a) might reasonably undertake; and
(c) the degree to which the physical or mental impairment of the veteran as a result of the injury or disease, or both, has reduced his or her capacity to undertake the kinds of remunerative work referred to in paragraph (b).
160 Section 29 authorises the preparation and use of an approved Assessment Guide. Decision-makers are required to act in accordance with any such guide once it is approved by the relevant Minister.
161 The respondent and the other decision-makers in the present case were required to determine the appellant's application for an increase in his pension to their reasonable satisfaction (see s 120(5) of the VE Act). Neither the appellant nor the respondent bore any onus of proving any matter relevant to the determination of that application (see s 120(6) of the VE Act).
162 In order to qualify for a pension payable at the special rate (ie the s 24 rate), a veteran who has not turned 65 when his claim or application for such a pension is made, must satisfy each of the requirements set out in subs (1)(aa) to (d) of s 24 of the VE Act.
163 The requirement in subs (1)(b) is that the veteran must be "… totally and permanently incapacitated …". That expression is defined in the subsection itself as meaning that the war-caused incapacity identified pursuant to subs (1)(a)(i) of s 24 is of such a nature, of itself alone, to render the veteran incapable of undertaking remunerative work for periods aggregating more than 8 hours per week. In s 24(1)(b), "remunerative work" must mean paid work of any kind. The focus of this subsection is upon the impact of the war-caused condition upon the health and wellbeing of the veteran and thus upon his or her capacity to perform paid work.
164 Section 24(1)(c) addresses other matters.
165 First, for that subsection to be engaged, it must be established that the veteran is prevented from continuing to undertake particular remunerative work by reason of the incapacity contemplated by and described in s 24(1)(b) alone.
166 Second, the remunerative work referred to in the subsection must be remunerative work that the veteran was undertaking. I agree with the Tribunal's opinion expressed at [19]-[20] of its Reasons that the remunerative work referred to in s 24(1)(c) is remunerative work undertaken by the veteran before he or she was prevented from continuing to undertake that work and is the type of work which the veteran previously undertook but which, because of war-caused incapacity alone, he or she can no longer undertake. It means any substantive work that the veteran has ever undertaken.
167 Third, it must be demonstrated that, by reason of the fact that the veteran is prevented from continuing to undertake relevant remunerative work because of his or her war-caused incapacity alone, he or she is suffering a loss of salary or wages, or of earnings on his or her own account, that the veteran would not be suffering if the veteran were free of that incapacity. This requirement would generally be readily demonstrated once the requirements set out earlier in s 24(1)(c) have been shown to be satisfied.
168 These notions or ideas embodied in s 24(1)(c) have been encapsulated in the Flentjar questions. Those questions are:
(1) What was the relevant "remunerative work that the veteran was undertaking" within the meaning of s 24(1)(c)?
(2) Is the veteran, by reason of war-caused injury or war-caused disease, or both, prevented from continuing to undertake that work?
(3) If the answer to question 2 is "yes", is the war-caused injury or war-caused disease, or both, the only factor or factors preventing the veteran from continuing to undertake that work?
(4) If the answer to questions 2 and 3 are, in each case, "yes", is the veteran by reason of being prevented from continuing to undertake that work, suffering a loss of salary, wages or earnings on his own account that he would not be suffering if he were free of that incapacity?
169 The focus of s 24(1)(c) is on the financial impact of the war-caused incapacity.
170 Section 24(2) must always be addressed when the Court is called upon to determine whether, in a particular case, the requirements of s 24(1)(c) have been satisfied.
171 The subject matter of s 24(2)(a) is separate and distinct from the subject matter of s 24(2)(b).
172 Section 24(2)(a) provides that a veteran who has ceased to engage in remunerative work for reasons other than his or her war-caused incapacity or who is incapacitated, or prevented from engaging in remunerative work for some other reason, shall be deemed to be not suffering the relevant financial loss by reason of that incapacity. A veteran who is caught by s 24(2)(a) would probably not have satisfied the requirements of s 24(1)(c), properly understood, in any event. Section 24(2)(a) should be regarded as an attempt to make crystal clear that s 24(1)(c) requires that the veteran be prevented from engaging in relevant remunerative work by reason of his or her war-caused incapacity. The cessation of work and the financial loss caused by that circumstance must be the consequence of the war-caused incapacity not the result of an independent decision to stop work or the consequence of incapacity brought about by some incident or other matter which is not war-caused.
173 Section 24(2)(b) is an ameliorating provision designed to assist a veteran to comply with the particular requirement set out in s 24(1)(c) to the effect that he or she must establish that he or she has been prevented by reason of the relevant war-caused incapacity from continuing to undertake remunerative work that the veteran was undertaking, even though, absent subs (2)(b) of s 24, he or she would not be able to meet that requirement because he or she has not been engaged in any remunerative work since suffering the relevant incapacity or perhaps has not been prevented from undertaking remunerative work by that incapacity.
174 A veteran who meets the threshold requirement of not having been engaged in remunerative work and who satisfies the respondent that:
he or she has been genuinely seeking to engage in remunerative work; and
he or she would, but for that incapacity, be continuing so to seek to engage in remunerative work; and
that incapacity is the substantial cause of his or her inability to obtain remunerative work in which to engage
is entitled to the benefit of s 24(2)(b).
175 The present case raises for consideration the question of whether s 24(2)(b) has any application to a veteran who has, at some stage, engaged in remunerative work. That is, is the correct interpretation of the threshold requirement (viz "… [a veteran] who has not been engaged in remunerative work …") that the subsection only applies to a veteran who has not worked at all since suffering the war-caused injury or war-caused disease, or both, which has rendered him or her totally incapacitated within the meaning of s 24(1)(b)? I will deal with this issue in the next section of these Reasons when addressing the first of the three questions formulated by the appellant as the questions which he contends are raised by his appeal.
176 I should add that, where the requirements of s 24(1)(c) are met by a veteran according to their terms, there will be no role for s 24(2)(b) to play and no need to resort to that subsection in order to ameliorate the strict application of s 24(1)(c) in an otherwise worthy case.