Edington v Board of Trustees of the State Public Sector Superannuation Scheme [2016] QCA 247
SUPREME COURT OF QUEENSLAND
CITATION: Edington v Board of Trustees of the State Public Sector
Superannuation Scheme [2016] QCA 247
PARTIES: JOSEPH DAVID EDINGTON
(appellant)
v
BOARD OF TRUSTEES OF THE STATE PUBLIC
SECTOR SUPERANNUATION SCHEME
(respondent)
FILE NO/S: Appeal No 9344 of 2015
Appeal No 12164 of 2015
SC No 8074 of 2011
DIVISION: Court of Appeal
PROCEEDING: General Civil Appeal
ORIGINATING
COURT: Supreme Court at Brisbane – [2015] QSC 245
DELIVERED ON: 30 September 2016
DELIVERED AT: Brisbane
HEARING DATE: 27 July 2016
JUDGES: Gotterson JA and Dalton and Burns JJ
Separate reasons for judgment of each member of the Court,
each concurring as to the orders made
ORDERS: 1. Appeal dismissed.
2. The appellant is to pay the respondent’s costs of the
appeal on the standard basis.
CATCHWORDS: EQUITY – TRUSTS AND TRUSTEES – PROCEEDINGS
BETWEEN TRUSTEE AND BENEFICIARIES OR THIRD
PARTIES – where the appellant was a member of the
superannuation scheme administered by the respondent – where
the appellant suffered total permanent disablement (“TPD”) –
where the appellant’s claim for a TPD benefit under the
superannuation scheme was rejected because the Board was
satisfied that the disablement was related to a pre-existing
medical condition which was not disclosed prior to becoming an
insured member or upon increasing his units under the scheme –
where a judge of the trial division refused to set aside the decision
made by the Board – where the appellant alleges that the Board
fell into error in evaluating the ‘competing’ medical opinions for
the purpose of making the decisions – where the appellant alleges
that the Board breached its duty to accord him natural justice by
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failing to notify and give him an opportunity to make submissions
on material adverse to his claim – whether the judge of the trial
division erred in refusing to set aside the decision of the Board
CONTRACT – INTENTION TO CREATE CONTRACTUAL
RELATIONS – where the appellant was a member of the
superannuation scheme administered by the respondent – where
the appellant suffered TPD – where the appellant’s claim for a
TPD benefit under the superannuation scheme was rejected
because the Board was satisfied that the disablement was related
to a pre-existing medical condition which was not disclosed prior
to becoming an insured member or upon increasing his units
under the scheme – where a judge of the trial division refused to
set aside the decision made by the Board – where the appellant
alleges that the judge of the trial division erred in deciding that the
appellant failed to establish the requisite intention to create
contractual relations on the part of the appellant and the Board –
where there was no expression of intention to create contractual
relations – where there is an already existing trustee-beneficiary
relationship – whether an intention to enter into a contractual
relationship, which would co-exist with a trust relationship, ought
to be implied
Superannuation (State Public Sector) Act 1990 (Qld), s 12
Superannuation (State Public Sector) Deed 1990 (Qld), s 4,
s 77, s 84, s 86, s 88
Alcoa of Australia Retirement Plan Pty Ltd v Frost (2012)
36 VR 618; [2012] VSCA 238, considered
Chapman v United Super Pty Ltd [2013] NSWSC 592, cited
Edington v Board of Trustees of the State Public Sector
Superannuation Scheme [2015] QSC 245, approved
Ermogenous v Greek Orthodox Community of SA Inc (2002)
209 CLR 95; [2002] HCA 8, cited
Finch v Telstra Super Pty Ltd (2010) 242 CLR 254; [2010]
HCA 36, considered
Taylor v Johnson (1983) 151 CLR 422; [1983] HCA 5, cited
COUNSEL: P W Hackett, with A Katsikalis, for the appellant
S E Brown QC, with G J Handran, for the respondent
SOLICITORS: Black & Co Lawyers for the appellant
Crown Law for the respondent
[1] GOTTERSON JA: The appellant, Joseph David Edington, commenced employment
with the Department of Primary Industries on or about 10 September 2001. He was
employed as a Field Assistant in the Department’s Fire Ant Eradication Program.
He became a member of the State Public Sector Superannuation Scheme, known as
“QSuper”, upon commencement of his employment. The respondent, Board of
Trustees of the State Public Sector Superannuation Scheme (“the Board”), a
statutory body corporate administers QSuper.
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The QSuper Deed and insurance terms
[2] QSuper is established by a Deed entered into on 14 June 1990. The Deed is
subordinate legislation.1 Under the terms of the Deed, the Board must provide
insurance against death or total and permanent disablement (“TPD”) to members of
QSuper.2 The expression “total and permanent disability” is defined in the Deed to mean:
“disablement of a degree which, in the opinion of the board after
obtaining the advice of not fewer than 2 medical practitioners, is
such as to render the member unlikely ever to be able to work again
in a job for which the member is reasonably qualified by education,
training or experience.”3
The Board must also decide the terms on which the death or TPD insurance is
offered to members.4
[3] There are corresponding provisions in the Deed with respect to the provision of
income protection insurance to members.5 The Board must keep an Accumulation
Account for each member.6
[4] The Board published the terms on which it had decided that death or TPD insurance
would be offered to members.7 One term, clause 3.2, provided for automatic
membership, as an insured member, of the Accumulation Account death and TPD
insurance arrangements, at a particular rate, for new employed members, that is to
say, persons who became State public sector employees after 1 May 2000. The rate
was measured by “units” held. Another term, clause 10, permitted the member to
increase voluntarily the amount of cover by the acquisition of more units.
[5] It was common ground that under clause 3.2, the appellant acquired four units of
cover effective from 10 September 2001. On 10 December 2001, he voluntarily
increased the amount of cover by acquiring an additional 17 units. The amount of
death and TPD insurance benefits applicable to 21 units of insurance cover was $991,200.
[6] Certain other terms denied an entitlement to be paid a benefit for this type of
insurance in certain circumstances. Relevant for present purposes are clauses 6.2(c)
and 6.5(c). The former of these, which related to the date when the member became
an insured member, provided:
“No insurance benefit will be paid for a claim unless:
(i) the member has been an insured member for fewer than
10 continuous years; and
(ii) the member did not lodge a personal medical statement
at or about the date on which the member became an
insured member; and
1 Superannuation (State Public Sector) Act 1990 (Qld) s 12(2). Consistently with that, the Deed’s provisions
are denoted as “sections”.
2 Section 84.
3 Section 4.
4 Section 86.
5 Section 88.
6 Section 77.
7 Terms for arrangements which commenced on 1 May 2000; Affidavit E M Fletcher sworn 23 May
2012 Exhibit “EMF-8”: AB701-714.
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(iii) it is established to the satisfaction of the board that
the total and permanent disablement or death or
temporary disablement was not related to a condition
that ought reasonably to have been disclosed had a
personal medical statement been submitted at or
about the date on which the member became an insured
member.” (emphasis supplied)
[7] Clause 6.5(c) was in analogous terms but related to the circumstance where the
number of units had been increased. Thus, items (ii) and (iii) thereof were
referenced to the date of the increase in the number of units.
[8] The appellant did not lodge a personal medical statement either at the date when he
became an insured member of QSuper or, subsequently, at the date when he
increased his units. He did not then disclose the fact that he had a pre-existing
medical condition, namely, schizophrenia.
The claim and events which preceded it
[9] In reasons published on 21 August 2015, the learned primary judge outlined events
which preceded the lodgement of a claim for insurance cover. His Honour said:
“[66] On 2 January 2002, whilst hurriedly trying to exit a domestic
property to escape two Rottweilers when carrying out a fire ant
inspection, the [appellant] injured his right ankle. It transpired
that the [appellant] had not in fact been at risk of being hurt by
the dogs because there had been another fence between them
and the [appellant].
[67] After that incident the following work-related incidents
occurred to the [appellant]:
(a) on 19 January 2002 he aggravated his right foot injury
whilst walking;
(b) on 7 February 2002 he hurt his right foot walking up a
driveway;
(c) on 29 February 2002 he suffered injury to his right foot
when he fell after being chased off a property by dogs;
(d) on 31 May 2002 he lost his footing when his right foot
gave way while he was climbing through a fence;
(e) on 8 July 2002 he suffered further aggravation of the
injury to his right foot walking on uneven or rough ground.
[68] Following the incident on 8 July 2002 the [appellant] visited
his doctor who recommended that he take sick leave. After the
[appellant] explained to that doctor his symptoms of tiredness
and other vague symptoms of back pain, anxiety and stress
‘which had appeared after the initial dog incident of 2 January
2002, and the fear and anxiety that the further dog incident on
29 February 2002 had aroused in me’, the doctor suggested to
the [appellant] that apart from the foot injury, the [appellant]
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may also have been ‘suffering from the effects of post-
traumatic syndrome’.8
[69] The [appellant’s] last day of work was 8 July 2002.”9
[10] The appellant made a claim for income protection and was paid those benefits from
26 July 2002 to 23 June 2003. He also lodged a claim for a TPD benefit. He did so
on 12 February 2003.
Rejection of the TPD claim
[11] On 26 August 2004, the respondent Board decided to reject the claim for a TPD
benefit (2004 decision).10 The Board determined that the appellant had suffered
TPD. The basis of the rejection was that the Board was satisfied that this
disablement was related to a pre-existing medical condition which was not
disclosed, but, consistently with the terms of insurance, should reasonably have
been disclosed by the appellant. Thus, in the Board’s opinion, clause 6.2(c) applied
to disentitle the appellant to TPD insurance cover in respect of the initial units and
clause 6.5(c) so applied in respect of the after-acquired units.
[12] The 2004 decision was litigated. The history of that litigation was summarised
briefly by the learned primary judge as follows:
“(a) On 5 November 2004 the [appellant] sought a review of the
Board’s decision by the Superannuation Complaints Tribunal
(“the Tribunal”) pursuant to the Superannuation (Resolution of
Complaints) Act 1993 (Cth). On such a review the Tribunal
undertakes a hearing de novo for the purpose of determining
for itself whether or not the decision of a trustee of a
superannuation fund was, in its operation in relation to a
complaint, fair and reasonable.
(b) On 2 October 2006, the Tribunal affirmed the decision of the
Board. The [appellant’s] appeal to the Federal Court was
dismissed on 14 December 2007. However on 15 May 2008 an
appeal from that decision to [a full court of the Federal Court]
was allowed by consent, previous orders set aside and the
matter remitted to the Board to decide the matter, informed by
a further medical report favourable to the [appellant] which
had not been before the Board when it decided to reject the
claim.”11
[13] On 25 September 2008, the Board decided for a second time to reject the appellant’s
claim for a TPD benefit (“2008 decision”). Whilst it determined that the appellant
had suffered TPD, the Board also was satisfied that the disablement was related to
a pre-existing medical condition which should reasonably have been disclosed. The
8 His Honour noted that these quotes are from the appellant’s letter to the Board dated 2 August 2004,
which was before the Board at the time of the impugned decision (and also the 2004 decision) to
which reference is made later in these reasons.
9 AB1329-1330.
10 This decision was, in fact, a decision to affirm the decision of a duly-appointed delegate to decline
the TPD claim made on 23 May 2003. The decision was made upon a review requested by the
appellant.
11 Reasons [6]. The summary was drawn from the interlocutory decision of Mullins J in Edington v Board of
Trustees of the State Public Sector Superannuation Scheme [2012] QSC 211 at [17]-[47].
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Board resolved to affirm its previous decision that the appellant was not entitled to
a TPD benefit.
[14] This decision, too, was the subject of litigation which the learned primary judge also
summarised. His Honour noted:
“(d) On 15 January 2009 the [appellant] again sought a review of
the Board’s decision by the Tribunal.
(e) On 11 September 2009, the Tribunal affirmed the decision of
the Board. On 21 May 2010, the [appellant’s] appeal to the
Federal Court was successful, Reeves J determining that the
Tribunal had misdirected itself about the nature of its powers
of review. On 1 February 2011, the Board’s appeal to [a full
court of the Federal Court] was allowed, with the consequence
that the Tribunal’s decision affirming the Board’s decision of
25 September 2008 was reinstated.”12
[15] In the wake of his unsuccessful review challenging the 2008 decision, the appellant
commenced proceedings in the trial division of the Supreme Court on 12 September
2011 with the objective of having the rejection decision reversed. These
proceedings sought both relief under s 8 of the Trusts Act 1973 (Qld) and contract-
based remedies.
The making of the 2008 decision
[16] The Board made its 2008 decision in circumstances where it had first been briefed
with a number of documents. The learned primary judge listed those documents as
follows:
“(a) A submission to the Board for the purposes of its decision
which was made by ‘QSuper’ and signed by QSuper’s
‘Manager Legal Review’;
(b) The equivalent submission by QSuper which had been placed
before the Board at its meeting on 26 August 2004 together
[with] a multiplicity of medical and other reports which were
marked as appendices “A” to “R”;
(c) A report by a Dr De Leacy Psychiatrist dated 22 October 2005;
(d) A report by Dr Reddan Psychiatrist dated 9 March 2006;
(e) The determination and reasons of the Tribunal in relation to
the hearing it conducted in respect of the Board’s 2004
decision;
(f) The decision of Justice Collier of the Federal Court on appeal
from the Tribunal;
(g) The decision of the Full Federal Court on appeal from Justice
Collier;
(h) A further report of Dr Reddan Psychiatrist dated 15 July 2008;
(i) Three submission[s] by the [appellant’s] solicitors dated
respectively 4 August 2008, 18 August 2008 and 11
September 2008;
12 AB1312.
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(j) A memorandum of advice from Mr McLeod, Barrister dated
22 August 2008;
(k) Two letters from Q-Super’s case manager dated 26 May 2003,
one to DPI and one the [appellant].”13
[17] It is convenient, at this point, to set out a number of preliminary observations made
by his Honour with respect to certain of those documents. The observations provide
a substantive and chronological context to the issues in dispute in this appeal. They are:
“[78] As to the two QSuper submissions:
(a) As I have mentioned, the Board’s 2004 decision was an
appeal from a decision of a delegate pursuant to s 30 of
the Deed.
(b) The Board’s 2008 decision was not an appeal from a
decision of a delegate but was occasioned by virtue of
the matter having been remitted back to the Board by the
Full Federal Court.
(c) Neither of the QSuper submissions were “decisions” of
delegates of the Board.
(d) The 2004 QSuper submission was a report which I infer
was prepared by a person appointed for that purpose
pursuant to the power so to do which was conferred on
the Board by s 7 of the Act (which permitted the Board
to employ staff ‘engage consultants; and do anything
else necessary or convenient to be done for, or in
connection with, the performance of its functions’). It
seems to be common ground that the author was a staff
member of a wholly owned subsidiary of the Board,
namely QSuper Limited.
(e) The 2008 QSuper submission was a similar report which
I infer was prepared by a person appointed either
pursuant to s 7 or part 3A of the Act (which had been
introduced in 2007). Part 3A of the Act created a
mechanism by which a particular ‘government
superannuation officer’ could be appointed such that the
officer could be directed to prepare such reports or could
take steps to ensure that particular public service
employees were assigned to that task.
[79] As to the reports of Drs De Leacy and Reddan:
(a) A report of Dr Reddan had been before the Board on the
occasion of its 2004 determination and was adverse to
the [appellant]. It formed one of the appendices to the
2004 QSuper submission.
(b) The report of Dr De Leacy was a report favourable to
the [appellant] which had not been before the Board on
the occasion of its 2004 determination. It concluded that
13 Reasons [76]. These documents, at AB195-379, are part of Exhibit 1.
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the post-traumatic stress disorder (“PTSD”) which had
been caused by a work-related dog incident had
rendered the [appellant] TPD within the meaning of the
insurance terms. It was critical of the report of Dr
Reddan.
(c) The report of Dr Reddan dated 9 March 2006 was a terse
responsive report which indicated that she did not
change her view. The report dated 15 July 2008 was a
longer report. It developed her reasons for not changing her
views and specifically referred to the report of Dr De
Leacy, including by articulating flaws therein.
[80] As to the submissions by the [appellant’s] solicitors dated
respectively 4 August 2008, 18 August 2008 and 11
September 2008:
(a) By letter dated 4 August 2008, the [appellant’s]
solicitors contended that the consequence of the Full
Court decision in relation to the Tribunal was that Dr
Reddan’s report of 15 July 2008 was objectionable and
should not be considered by the Board. The letter stated that
in light of that submission, the [appellant] did not propose
to obtain any further medical evidence and asked that
the Board consider the matter.
(b) By letter of 18 August 2008, the [appellant’s] solicitors -
(i) reiterated their submissions that it was not
contemplated that fresh evidence would be
generated for the consideration of the Board;
(ii) contended that the Board’s duty as a trustee acting
in good faith such that it should not ‘now seek to
overcome what it might perceive to be
deficiencies in the case against Mr Edington by
obtaining fresh customised evidence from Dr
Reddan’;
(iii) submitted that the Tribunal found that the
operative condition was PTSD or anxiety
disorder; and
(iv) concluded with the proposition that the Board
should make its deliberation and that the report of
Dr Reddan dated 15 July 2008 would not be
placed before it for consideration.
(c) By letter dated 11 September 2008, the [appellant’s]
solicitors -
(i) noted that the Board had advised the [appellant]
that its legal advice was that it was necessary to
obtain a further report from Dr Reddan and that
the [appellant] had been invited to make further
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submissions in light of the use that would be made
of the report;
(ii) reiterated the points that had been made in the
previous letter, including that the Tribunal had
found that the operative condition was PTSD or
anxiety disorder;
(iii) made submissions and criticisms concerning the
substance of Dr Reddan’s report of 15 July 2008,
including by the following (emphasis added):
(i) There is simply no empirical evidence which
would point to a change in Mr Edington’s
mental state when it comes to his
schizophrenia. All the evidence points to
Post Traumatic Stress Disorder.
(ii) There is no evidence that but for the dog
attack and its traumatic psychological
effects that Mr Edington would not have
continued to work with the Fire Ant
Authority. The various matters reported by
him as having occurred in the work place
did not necessarily point to a steady decline
in his capacity to do the work. These
complaints may have been most reasonable
and his recording of them as he was obliged
to do may well have been simply a
manifestation of concrete thinking
attributable to his stable residual
schizophrenia. That is there is no
evidence that Mr Edington could not have
continued to work in the absence of the
major stressor event in the dog attack.
In conclusion, Mr Edington has been left with a
chronic Post Traumatic Stress Disorder because
instead of assisting in treating the problem QSuper
decided to have him retired.
(d) The upshot of the foregoing was that by the time the
matter came before the Board in 2008, it was both accurate
and fair for the Board to regard the [appellant’s] position
as contending for the proposition that the [appellant’s]
TPD was due to a PTSD or anxiety disorder which had
been caused by the work-related dog incident referred to
in Dr De Leacy’s report.”
[18] I would add that the 2008 QSuper submission document concluded by offering two
options for the Board’s consideration.14 Option A was that on further review of the
evidence, the Board determines that the appellant has a TPD; that his TPD was
related to his schizophrenia which should reasonably have been disclosed had
14 AB204-207.
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personal medical statements been submitted when he became an insured member
and when he increased the cover; and that, accordingly, the Board affirms its
decision that the appellant was not entitled to the insurance benefit claimed. Material
findings for Option A were set out.15 Option B was that on review of the evidence,
the Board determines that the appellant’s symptoms of stress, which were due to his
reaction to the dog incident in 2002, have caused his TPD and that he was entitled
to the benefit claimed.
[19] The Board’s minutes of its meeting on 25 September 200816 are dated 23 October
2008. The minutes record the determinations and resolutions to which I have
referred. They also set out the Board’s material findings. Those findings were
repeated in a Statement of Reasons for the decision.17 In that document, the issue
for the Board to resolve was stated to have been whether the appellant’s TPD
related to a pre-existing condition pursuant to QSuper’s insurance terms.
[20] The material findings are these:
“1. Mr Edington was employed as a Field Assistant, Fire Ant
Control by the Department of Primary Industries. Mr
Edington entered the QSuper Accumulation Account on 10
September 2001, with 4 insurance units effective from 10
September 2001 and 17 insurance units effective from 10
December 2001.
2. On 2 January 2002, Mr Edington sustained an injury to his
right foot whilst inspecting a domestic property for fire ants.
The injury was sustained as Mr Edington had to hurriedly exit
the property because of a challenge by two Rottweiler dogs.
3. Mr Edington was retired from the Department of Primary
Industries on 23 June 2003 and his income protection was paid
for his foot injury under the Insurance Terms up to this date.
4. Mr Edington has been examined by various medical
practitioners and the following diagnoses and comments have
been made:
(a) Dr Butler, Treating Psychiatrist, in his report dated
13 January 2003 diagnosed schizophrenia paranoid sub
type with ongoing residual negative symptoms and an
anxiety disorder. Dr Butler stated that the schizophrenia
was first diagnosed in 1996.
(b) Dr Olsen, Consultant Physician in Occupational and
Environmental Medicine, in his report dated 2 April
2003 made a primary diagnosis of an injury to Mr
Edington’s right foot as well as his back and neck, and a
secondary diagnosis of schizophrenia (which he noted as
being first diagnosed in 1996).
15 These are the findings subsequently set out in the minutes and the Statement of Reasons to which I refer.
16 AB380-382 in Exhibit 1.
17 AB383-394 in Exhibit 1.
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(c) Dr Reddan, Consultant Psychiatrist, in her report dated
3 May 2003 diagnosed schizophrenia. Dr Reddan stated
that the schizophrenia was first diagnosed in the mid-1990s.
(d) Dr Jamieson, Consultant Orthopaedic Surgeon, in his
report dated 9 May 2003 made a primary diagnosis of
right heel pain.
(e) Dr De Leacy, Consultant Psychiatrist, in his report dated
22 October 2005 diagnosed schizophrenia, paranoid
type, chronic, and post-traumatic stress disorder,
chronic.
5. Dr Butler, Consultant Psychiatrist, stated in his report dated
13 January 2003 that since the diagnosis of schizophrenia,
Mr Edington’s work options have been drastically reduced and
that his illness limits his capacity to learn new skills, sustain
attention, maintain concentration and process information.
Dr Butler stated that the sort of job that could be suitable for
Mr Edington would probably be part time and involving
predominantly manual duties.
6. Ms Jooste, Treating Psychologist, stated in her report dated
11 March 2003 that with suitable counselling and therapy,
Mr Edington should make a full recovery from the traumatic
effects of the Rottweiler incident, and that his original
condition of schizophrenia would continue as before.
7. Dr Olsen, Consultant Physician in Occupational and
Environmental Medicine, stated in his report dated 2 April
2003 that as Mr Edington is struggling with his psychiatric
illness, he cannot predict the short term progress and that Mr
Edington would qualify for total and permanent disability.
8. Dr Olsen also stated in his report dated 2 April 2003 that
Mr Edington only requires ongoing treatment for his
schizophrenia, and that it was remarkable that he was working
in the fire ant eradication program and his illness is
moderating his ability to apply himself in the way that would
be necessary for him to return to any work.
9 Dr Reddan, Consultant Psychiatrist stated in her report dated
3 May 2003 that:
(a) Mr Edington will be permanently unable to perform the
duties of his position as a field assistant and that the
most significant issue which prevents him from
returning to that position is the residual symptoms of
schizophrenia.
(b) Mr Edington’s anxiety around dogs would not prevent
him from returning to some form of work.
(c) The negative features of Mr Edington’s schizophrenia
on its own have been and are of sufficient severity to
impair Mr Edington’s capacity for sustained work.
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10. The Board notes that Mr Edington was extremely defensive
about his schizophrenia to Dr Reddan and apart from admitting
that he may have been hospitalised, once or twice, he refused
to provide any details.
11. Dr Reddan, Consultant Psychiatrist further stated in her report
dated 3 May 2003 that Mr Edington had told her that his
psychiatric history was of absolutely no relevance and that he
had only come to Dr Reddan’s evaluation to discuss his work
related injuries.
12. Dr De Leacy, Consultant Psychiatrist, stated in his report dated
22 October 2005 that although Mr Edington’s anxiety symptoms
may result from him being more susceptible as a result of his
schizophrenia, his current symptoms of stress which had been
discussed in this report were not due to schizophrenia but due
to a severe stress reaction from the dog incident in 2002.
13. The Board notes that when Mr Edington was seeking
reemployment, Dr Butler, Psychiatrist, in his report dated 17
July 2003 stated that Mr Edington recently described a
considerable improvement in his physical symptomatology
and that he no longer had the marked anxiety associated with
exposure to dogs.
14. The Board notes that when Mr Edington was appealing to the
Superannuation Complaints Tribunal, he was examined by
Dr De Leacy, Psychiatrist, who stated in his report dated
22 October 2005 that Mr Edington reported an extreme fear of
dogs and that he had a range of symptoms that fulfilled the
DSMIV criteria for post-traumatic stress disorder by having
the requisite number of symptoms from each category of
intrusive symptoms, avoidance symptoms and hyperarousal
symptoms.
15. Dr Reddan, Consultant Psychiatrist, stated in her report dated
15 July 2008 that the dog incident in 2002 was not a severely
traumatic event for a diagnosis of post-traumatic stress
disorder. Further, Dr Reddan stated that it was the
schizophrenia which prevented Mr Edington from successfully
maintaining a longitudinal work history.
16. The Board prefers the reasoning outlined in the medical
reports by Dr Reddan, Consultant Psychiatrist because of the
different medical histories given by Mr Edington to Dr Butler
and Dr De Leacy.
17. The Board believes that Mr Edington’s current disablement
was related to his schizophrenia which was diagnosed before
he took out his 21 units of insurance and which should
reasonably have been disclosed had a personal medical
statement been submitted by him around the dates he received
his insurance units in September 2001 and December 2001.
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18. With respect to Mr Edington’s disablement, the Board is
satisfied after having considered all the evidence that it
rendered him unlikely ever to be able to work again in a full-
time job for which he is reasonably qualified by education,
training and experience.
19. The Board notes that Mr Edington was retired on ill health
grounds upon the decision of the Department of Primary
Industries, and not QSuper.”18
The questions determined by the learned primary judge
[21] The proceeding commenced in September 2011 progressed by way of pleadings.
An amended claim was filed by leave on 4 July 2014.19 In a further amended
statement of claim filed on 15 April 2015,20 the appellant pleaded in paragraph 41(f)
that the decision of the Board that it was not satisfied that the TPD was not related
to the pre-existing schizophrenia was not properly formed in accordance with the
Board’s obligations to the appellant either as a trustee or an insurer. Paragraph 42A
pleaded a contract between the appellant and the Board for payment of an insurance
benefit to him. Paragraph 43 was critical to the pleading. It alleged that the Board
failed to exercise its duties as trustee and its obligations under the contract as insurer
in ways that were particularised in paragraphs 44 to 47E.21 Paragraph 50 alleged
that having regard to what had been pleaded, the only opinion reasonably open to a
trustee or an insurer in the position of the Board acting reasonably, in good faith and
fairly, was that the appellant’s TPD was not related to the pre-existing
schizophrenia condition. All these pleaded allegations were put in issue in an
amended defence also filed on 15 April 2015.22
[22] At the request of the parties, the learned trial judge set down some five questions for
separate determination. After a hearing in April 2015 and receipt of further written
submissions in July 2015, his Honour made an order on 21 August 2015 which answered
those questions. The questions and the respective answers to them were as follows:
“Question
1:
Should the decision made by the Board as trustee
on 25 September 2008 be set aside on the grounds
set out in paragraphs 41(f), 44-47E and 50 of the
Further Amended Statement of Claim?
Answer: No
Question 2: If yes to question 1, should the Plaintiff’s TPD
claim be remitted back to the Board for
reconsideration, or determined by the Court?
Answer: In view of the answer to question 1, it is
unnecessary to answer this question.
Question 3: Was there a contract in existence between the
Plaintiff and the Board for the provision of
insurance benefit?
18 AB391-394.
19 AB1019-1021.
20 AB1022-1062.
21 The paragraph in fact referred to paragraphs 44 to 47C but was evidently meant to be read as
referring also to paragraphs 47D and 47E which had been added by amendment.
22 AB1063-1111.
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14
Answer: No
Question 4: If yes to question 3, in forming the opinion that the
total and permanent disablement of the Plaintiff was
related to schizophrenia, did the Board breach the
terms of an insurance contract on the grounds
contained in paragraphs 41(f), 44-47E and 50 of the
Further Amended Statement of Claim?
Answer: In view of the answer to question 3, it is
unnecessary to answer this question.
Question 5: If yes to question 4, is the opinion required of the
insurer one which becomes a matter for
determination by the Court?
Answer: In view of the answer to questions 3 and 4, it is
unnecessary to answer this question.” 23
[23] Later, on 3 November 2015, his Honour made further substantive orders dismissing
the appellant’s amended claim and ordering the appellant to pay the Board’s costs
of the proceeding to be assessed on the standard basis.24
The appeals
[24] On 18 September 2015, the appellant filed a notice of appeal against the order made
on 21 August 2015.25 Later, on 1 December 2015, the appellant filed a separate
notice of appeal against the orders made on 3 November 2015.26
[25] The grounds of appeal in the notice of appeal filed on 18 September 2015 are set out
in some 34 paragraphs. Those grounds are adopted by the notice of appeal filed on
1 December 2015. There are no substantive additional grounds of appeal in it.
[26] The 34 paragraphs to which I have referred challenge the findings made by the
learned primary judge in certain of the paragraphs in the reasons for judgment
published on 31 August 2015. They did so by criticising one by one each of the
paragraphs in the reasons where a challenged finding was expressed. The
appellant’s outline of argument of some 221 paragraphs followed the same pattern.
[27] There was a very considerable degree of repetition in both documents arising from
two circumstances. One was that, in a number of instances, the same substantive
finding was expressed in more than one of the criticised paragraphs in the reasons.
The other was that there were themes which were common to many of the
criticisms. In implicit recognition of this, counsel for the appellant identified three
issues for address in oral submissions. He informed the Court that those issues
embraced the appellant’s principal points. He accepted that they were extracted
from, and summarised, the important points in his client’s appeal.27
[28] It is appropriate in these circumstances to adopt the issues addressed in oral
submissions as the framework for analysis of the appellant’s appeal. As a prelude
23 AB1305-1306.
24 AB1359.
25 AB1366-1374.
26 AB1375-1378.
27 Appeal Transcript 1-21 ll5-31; 1-26 ll15-29.
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15
to that, I note that the appellant does not contend that the learned primary judge
misapprehended any of the legal principles to be applied.
Issue 1
[29] This issue involved an attack upon the Board’s decision concerning a relationship
between the appellant’s TPD and his pre-existing schizophrenia. The Board had
fallen into error, the appellant alleged, in evaluating the “competing” medical
opinions for the purpose of making the decision. The learned primary judge had
erred in failing to find error on the Board’s part in this regard.28
[30] In developing this issue, the appellant submitted that there are a number of respects
in which the Board erred. It is convenient to consider them individually.
[31] Categorisation of medical reports: At paragraph 108 of the reasons for judgment,
the learned primary judge categorised the medical evidence before the Board into
three groups, namely:
“(a) the medical opinion which supported the hypothesis of PTSD
due to a work-related dog incident, namely:
(i) the evidence of the registered psychologist, Mrs Jooste,
contained in her letter of 19 November 2002 (which had
been wrongly dated 2001) and her report of 11 March 2003;
and
(ii) the report of the psychiatrist, Dr De Leacy dated
22 October 2005;
(b) the views of Dr Butler, Consultant Psychiatrist, contained in
his reports of 13 January 2003, 17 July 2003, 15 July 2004
which contradicted the hypothesis of PTSD due to a work-
related dog incident;29 and
(c) the reports of Dr Reddan dated 3 May 2003, 9 March 2006 and
15 July 2008 which rejected the hypothesis of PTSD due to
a work-related dog incident and attributed causality to the negative
symptoms of schizophrenia.”
[32] The appellant submitted that his Honour’s grouping replicated an error made by the
Board by overlooking a significant point of commonality between the opinions of
Dr De Leacy and Dr Butler. It was submitted that both psychiatrists had excluded
the negative effects of the appellant’s schizophrenia as being a cause of his TPD.
That commonality ought to have been reflected by categorising the reports in which
those opinions were expressed into a fourth group. Once that group was recognised,
it was further submitted, a clear division of opinion between Dr De Leacy and Dr
Butler on the one hand and Dr Reddan on the other, would have been appreciated.
[33] It is clear that Dr De Leacy did not believe that the residual features of the
appellant’s schizophrenia had prevented him from working.30 His opinion,
therefore, was that the TPD was not related to the pre-existing schizophrenia.
28 Ibid ll35-42.
29 Dr Butler was the appellant’s treating psychiatrist at the Logan Central Adult Mental Health Service.
His three reports were Appendices “F”, “N” and “Q” to the 2004 QSuper submission to the Board.
30 Report paragraph 5: AB307.
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16
[34] However, the validity of the appellant’s submission is dependent upon Dr Butler
having expressed substantially the same opinion. It is therefore necessary to
consider his three reports to ascertain whether he did express such an opinion.
[35] In his report dated 13 January 2003, Dr Butler identified three contributors to the
appellant’s “work limitation”. He said:
“The primary psychiatric diagnosis is that of Schizophrenia paranoid
sub type with ongoing residual negative symptoms. Also Mr
Edington suffers from an anxiety disorder not otherwise specified and
orthopaedic problems referred to in the report by Dr Daunt and the
podiatrist report of 9 November 2002. Mr Edington’s schizophrenic
illness was diagnosed in 1996. At the time he was suffering from
significant symptoms which required treatment with anti psychotic
medication. Although the medication controlled his more overt
symptoms he continued to display residual symptoms of
schizophrenia which affected his motivation and social engagements.
He was first made aware of the nature of his illness in the mid 1990s.
The second diagnosis pertains to an anxiety disorder which resulted
from the unfortunate incident whilst working as a Field Officer in
Fire Ant Surveillance. Subsequent to that incident he has suffered
from some phobic anxiety with relation to exposure to dogs and has
experienced some avoidance. Also there has been an increase in his
baseline level of agitation. I have taken his history several times
regarding this matter and I do not believe that he has suffered from a
fully fledged post traumatic stress disorder, the third diagnosis also
pertains to the incident occurring whilst a Field Officer. He received
substantial damage to his leg/ankle which has significantly restricted
his mobility since. It is not my area of expertise to comment
specifically upon it and such information would be required from
other practitioners. To my knowledge neither of the last two
diagnosis were pre existing prior to 10 December 2001.
The three diagnoses all contribute to Mr Edington’s work limitation.
Additionally he has some longstanding difficulties with literacy, which,
in combination with his schizophrenic illness has greatly restricted the
nature of available employment options. Hence, it is likely that with
specific reference to the issue of ill health retirement, that the anxiety disorder
and the physical disorder are the most pertinent contributing factors.”31
[36] The next report dated 17 July 2003 was written after the appellant’s employment
had been terminated. It was written in support of his reinstatement to his previous
position. Dr Butler made the following observations:
“… I have ongoing concerns about the process of his discontinuation
of his employment. If indeed his inability to continue employment is
primarily related to his having a schizophrenic illness then it
automatically begs the question of what his work performance was
like prior to his injury and why appropriate action was not taken at
that time. I noted in my report of the 13 January 2003 that the
reasons for his being unable to work at that time were because of his
31 AB234-235.
-- 16 of 27 --
17
anxiety reaction to a feared dog attack and a physical injury he
sustained at the time. It was also noted that his schizophrenic illness
and his limited literacy skills could impair his capacity to engage in
alternative employment particularly that of a clerical nature.
Recently Mr Edington describes a considerable improvement in his
physical symptomatology and he no longer has the marked anxiety
associated with exposure to dogs. In my opinion, the most
appropriate cause(sic) of action would be for him to be reinstated in
his previous position provided that his work performance is
monitored to determine his ongoing suitability for that position. If he
was adequately able to fulfil the various job description requirements
of his occupation prior to injury then there is a reasonable chance
that he will be able to meet those obligations again. Alternatively
further consideration for other duties within the auspices of the Fire
and Surveillance Authority could be considered.”32
[37] Dr Butler’s final report dated 15 July 2004 was written for a similar purpose. He
said:
“… At the time of my original report dated 13 January 2003 I noted
the ongoing impact of his schizophrenic illness upon retraining and
employability as well as the salient effect of the emotional and
physical consequences of the dog attack upon his ability to work
specifically with the Fire Ant Surveillance Authority. Conclusions at
that time were rather open ended given my limited knowledge of his
physical morbidity and incomplete nature of his progressive
recovery. I maintain the view that I expressed at the time that the
major cause of his immediate disability was the anxiety and physical
symptoms directly related to the dog attack and that his
schizophrenic illness was a secondary issue.
Consequently, on the basis of the information supplied by Mr Edington it
appears that he has made a substantial physical recovery and no
longer has the phobic anxiety regarding dogs. It seems likely that if,
his previous position were available he would be able to fulfil the
necessary requirements.”33
A little later, he added:
“With respect to this, I believe that the disability prohibiting his
unemployment was not directly linked to a pre-existing condition
and, has subsequently proved to be a largely temporary
impairment…”34
[38] It can be seen from Dr Butler’s second and third reports that he did not accept that
the appellant had a TPD. He thought that he was capable of working in his previous
position. Dr Butler acknowledged that the appellant had a temporary period of
unemployability. He thought that the dog attack was the major cause of it but,
relying on the appellant’s own report, he concluded that, by the time that his second
report was written in July 2003, that cause had abated.
32 AB282.
33 AB286.
34 AB287.
-- 17 of 27 --
18
[39] Dr Butler did, in his latest report, state that he believed that the “disability
prohibiting” the appellant’s employment was “not directly linked” to a pre-existing
condition. However, that statement addressed the appellant’s temporary
unemployability and not a TPD. Further, it negatived a direct linkage only to that
unemployability. Dr Butler did not, at any point, express an opinion that the
appellant’s TPD was not related to the pre-existing schizophrenia.
[40] In these circumstances, I cannot accept the appellant’s attribution of error to the
Board or the learned primary judge by having misapprehended Dr Butler’s opinion
and a resultant failure to categorise his reports with that of Dr De Leacy.
[41] Material finding 16: The appellant, in oral submissions, drew attention to paragraph 16
of the Board’s material findings. At paragraph 130 of the reasons, the learned
primary judge observed that the “different medical histories” of which the Board
was speaking were the different histories given by the appellant to Dr De Leacy on
the one hand and to Dr Butler on the other.
[42] I have already referred to Dr Butler’s account that, by July 2003, the appellant had
self-reported that he no longer had marked anxiety associated with exposure to
dogs. However, he told Dr De Leacy in October 2005 that he had “an intense fear
of dogs” with “recurrent and intrusive distressing recollections of the event” and of
having “recurrent distressing dreams” of the event.35
[43] The appellant’s submissions on this matter began with a reference to the decision of
Reeves J in which his Honour appears to have understood the paragraph as referring
to a medical history given by the appellant to Dr Reddan which differed from
a consistent, but different, history given by him to Drs Butler and De Leacy.36 The
appellant sought to employ that understanding to criticise the Board as having not
detailed in the finding what the inconsistencies were and for having engaged in
a “mere adoption” of the finding as it had been submitted to the Board by QSuper.
[44] In my view, the matters raised by the appellant in regard to paragraph 16 do not
bespeak error on the part of the Board or of the learned primary judge. It is
tolerably clear that paragraph 16 comprehended the differences in the accounts
respectively given by the appellant to Dr Butler in 2003 and then to Dr De Leacy
more than two years later. It is a difference which a reader of the respective reports
would have readily appreciated.
[45] Rejection of the appellant’s criticisms of Dr Reddan’s report: Dr Reddan’s
report dated 15 July 200837 was made against a background where she had provided
a report on 3 May 200338 and she had been provided with Dr De Leacy’s report and
Dr Butler’s later two reports. In her later report, Dr Reddan affirmed her previously
expressed opinion that it was the appellant’s residual symptoms of schizophrenia
that prevented him from returning to work.
[46] Dr Reddan explained her reasons for affirming her opinion. In the course of so
doing, she commenced upon some aspects of the observations made by Dr De
Leacey. Dr Reddan said:
“Dr De Leacy’s report indicates that he evaluated Mr Edington
2½ years after my evaluation, at the request of Mr Edington’s solicitors
35 AB301. The “event” to which Dr De Leacy was referring was the dog incident on 2 January 2002.
36 [2010] FCA 504 at [39].
37 AB356-358.
38 Appendix “J” to the 2004 QSuper submission to the Board: AB256-270.
-- 18 of 27 --
19
and, in the context of Mr Edington seeking a review of a decision by
QSuper. Dr De Leacy was not entirely aware of Mr Edington’s
longitudinal history of reported injuries or incidents at work and
Mr Edington’s history, in 2003, and the accompanying material
suggests that he ceased work around the middle of 2002 primarily
because of symptoms in his foot.
The longitudinal history suggests that Mr Edington struggled to
obtain but, more relevantly, maintain work as a result of his chronic
Schizophrenia. The negative symptoms of Schizophrenia are more
disabling in the long term than the positive or acute psychotic
symptoms. It would appear that Dr De Leacy may not have been
aware of Mr Edington’s occupational history and the significant
impact of his Schizophrenia on his occupational history. Mr
Edington began working in the fire ant program in approximately
September 2001 but, by 4 January 2002, he was reporting incidents
at work. There were subsequent reports of incidents occurring on 19
January 2002, 7 February 2002, 29 February 2002, 31 May 2002 and
8 July 2002. His treating psychiatrist, Dr Butler, had reported that Mr
Edington had problems being around other people and, in 2003 he
expressed considerable distrust of his work mates. These problems as
well as his negative symptoms, are likely to have significantly
affected his response to fairly minor injuries and to have made it
increasingly difficult for Mr Edington to cope at work.
The incident where Mr Edington, and a co-worker entered a yard and
heard dogs barking occurred as far as could be determined, on
29 February 2002. At interview on 29 April 2003, Mr Edington
reported that he and his co-worker heard growling from what
sounded like two large dogs but they did not actually see the dogs
nor were they chased by them. He reported that, as he tried to get
over the fence, he fell and landed on cement, causing an injury to his
right foot. The dogs were actually unable to attack [him] and his co-
worker. Mr Edington described this incident spontaneously without
distress or evidence of avoidance. By the time Mr Edington was
evaluated by Dr De Leacy 2½ years later, he reported considerably
more fear. In any event, although it would have initially been
frightening to hear the dogs growling and it would have been
appropriate for [him] and his co-worker to exit the property quickly,
this is not a severely traumatic event for an adult male and a severely
traumatic event is required for a diagnosis of PTSD. Mr Edington
described anxiety about dogs but this did not amount to a Specific
Phobia which, in any event, would not prevent Mr Edington from
returning to work. A Specific Phobia is a treatable condition if he
had sought treatment from the mental health clinic where he attends.
As previously stated, the referring letter refers to Dr Butler stating
that Mr Edington no longer had severe anxiety of dogs as early as
2003.
Symptoms of PTSD are almost always referred to 'spontaneously
and, in a medicolegal context, it is important not to ask leading
questions, as suggestibility is heightened in that context. It should be
noted that, when interviewed in 2003, Mr Edington was quite
-- 19 of 27 --
20
guarded and defensive about his Schizophrenia but not at all about
any work related injuries. Dr De Leacy’s comments about why Mr
Edington did not describe the incident or his symptoms in 2003 the
same way as he had in 2005 are personally directed and they reflect a
failure to consider other alternative explanations.
Clearly Mr Edington has wanted to work but he suffers from a major
mental illness and, as previously stated, the most disabling aspect of
Schizophrenia is the negative symptoms rather than the acute
positive psychotic symptoms. It is the Schizophrenia which
prevented Mr Edington from, as previously stated, successfully
maintaining a longitudinal work history…”39 (emphasis supplied)
[47] The learned primary judge responded to criticisms made for the appellant of
Dr Reddan’s reports at paragraph 131 of his reasons. His Honour described the
criticisms as “grossly overstated”. He then made the following observations:
“(a) The evidence before Dr Reddan was that there were two dog
incidents: one which occurred on 2 January 2002 and another
which occurred on 29 February 2002. The evidence before the
Board included the plaintiff’s own letter which referred to both
incidents being productive of stress. (footnote omitted)
(b) I agree that in a section of Dr Reddan’s third report (and to a
lesser extent the first report) she seems to have confused the
second incident with the first incident and that confusion is a
valid criticism of one aspect of her reasoning.
(c) But the confusion does not give rise to the conclusion that no
reasonable person in the Board’s position could have accepted
the reliability of Dr Reddan’s analysis.
(d) In evaluating the reliability of the reports, the inconsistency in
medical histories was far more significant and the failure of
Dr De Leacy even to advert to it was a far weightier criticism
of his reasoning than was the impugned aspect of Dr Reddan’s
reasoning.
(e) For completeness I note that the plaintiff also criticised the fact
that in evaluating whether the plaintiff was TPD Dr Reddan
assessed the impairment by reference to the position
description that the DPI had produced for the position which
the plaintiff occupied… In my view a reasonable person would
regard that as legitimate reasoning by the doctor.”
[48] On appeal, the appellant focussed upon Dr Reddan’s reference to the dog incident as
one that occurred on 29 February 2002. That, the appellant submitted, revealed a
very significant misunderstanding by Dr Reddan of the appellant’s history to a point
of ignoring, or ignorance of, the dog incident that had occurred on 2 January 2002
and, according to the appellant, was the source of his extreme stress.
[49] There were, in fact, two work-related dog incidents reported by the appellant. They
were referred to by Dr Reddan in her report dated 3 May 2003. During the
39 AB356-358.
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21
evaluation on 29 April 2003, the appellant described the incident on 2 January 2002. Dr
Reddan’s report contains the following summary of the appellant’s description of it:
“…He stated that he and his partner entered a property at Woodridge
and they were not initially aware that there were any dogs on the
property and the residence had no warning signs about dogs. He
stated that when he and his partner heard some growling from what
sounded like two large dogs, they ran off. They did not actually
observe the dogs, nor were they chased by them. He stated that as he
tried to get over the fence, he slid and crashed to the cement. He
stated that the dogs were unable to escape, as there was a gate in the
stairwell. He stated that when he fell his partner, Mark, would not
assist him. He stated that he got up with great difficulty and was then
‘wonky’ on his legs. He stated that he hobbled over to the other side
of the footpath and telephoned his team leader. He stated that his
team leader arrived and drove him back to the depot. He stated that
by that stage he was in ‘general pain all over,’ particularly in his feet
and legs. He stated that he was ‘practically crippled,’ but none of his
work mates would assist him. He stated that he was instructed to go
home and apply for WorkCover payments.”40
Later, she noted that the appellant said that, “as a result of the incident on 2 January
2002”, he developed both problems with his foot and a phobia of dogs.41
[50] There is a brief reference in Dr Reddan’s first report to the recording in an employer
incident report of a report by the appellant of another dog incident on 29 February
2002.42 The reference is in these terms:-
“…He reported that on 29 February 2002 he suffered an injury to his
right foot after being chased off a property by dogs and falling
behind a fence…”43
Dr Reddan did not refer to any oral account of that incident having been given by
the appellant during the evaluation.
[51] It is evident that when she wrote her report dated 15 July 2008, Dr Reddan was
aware of the incident on 2 January 2002. Her reference in that report to the
appellant’s “longitudinal history” plainly comprehended that incident. Her
description of the incident which she went on to identify as having occurred on 29
February 2002, matched in detail her description in her first report of the appellant’s
account of the incident on 2 January 2002 given by him during the evaluation.
Moreover, it did not match her short extract of the incident reported as having occurred
on 29 February 2002.
[52] It is apparent that Dr Reddan erred in assigning the later date to the incident which
the appellant had described orally during the evaluation. Plainly, Dr Reddan was
referring to the incident on 2 January 2002. That error would have been readily
inferred by members of the Board on reading Dr Reddan’s report. It would not have
given cause to them to question the reliability of Dr Reddan’s report. His Honour
was correct to reach a conclusion to that effect.
40 AB257.
41 AB265.
42 The report is curious in that there was no day dated the 29th of February 2002.
43 AB265.
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22
[53] For completeness, I mention that in the course of argument of the appeal, the
possibility that Dr Reddan’s reference to 4 January 2002 in the list of work incidents
might have been an erroneous reference to 2 January 2002, was canvassed. It is,
I think, clear that it was not. In her first report Dr Reddan noted that the employee
incident reports recorded that on 4 January 2002 the appellant had reported that he
had developed a skin rash as a result of irritation from a chemical at work.
[54] When the error is seen as one of the incorrect assignation of the date, there is no
force in the appellant’s contention that Dr Reddan proceeded on a misunderstanding
that none of the incidents in January and February 2002 in which the appellant was
involved prior to 29 February 2002, concerned dogs.
[55] Moreover, the opinion expressed by Dr Reddan in the quoted paragraph, which
listed those and later work incidents, clearly was that problems with being around
workmates and distrust of them, as well as negative symptoms of schizophrenia,
were likely to have significantly affected the appellant’s response to fairly minor
injuries and to have made it increasingly difficult for him to cope at work. The
point being made by Dr Reddan was that the pattern revealed by those incidents
typified the longitudinal history of a struggle to obtain and to maintain work which
Dr Reddan had set out in her earlier report.44 This was particularly so with respect
to employment from 1994 when the appellant began receiving the disability support
pension.
[56] Failure to have regard to chronology: The appellant submitted that the Board’s
evaluation of the medical opinions failed to have regard to the chronological fact
that the appellant’s TPD was diagnosed after the incident on 2 January 2002. That
circumstance compelled a deduction that the TPD must have been caused by that
incident.
[57] This submission employs the assumption that because an event occurs after another,
that event must have been caused by the other. Reasoning on the basis of such an
assumption, as the appellant does here, is flawed in logic.45 The flaw is deepened
when the reasoning is sought to be used to exclude any other preceding event from
having had a causal relationship with the event which occurs later in time.
[58] Not considering physical injuries: The appellant has criticised the Board for not
having considered the impact of the work-related injury to his foot. There was an
associated criticism that the Board had approached the appellant’s position as one
staked on his TPD being solely related to the PTSD diagnosed by Dr De Leacy.
This was a shortcoming for which, it was submitted, the learned primary judge had
failed to make allowance.
[59] There are two points to be made about these criticisms. The first is that, as the respondent
has noted, in the reviewed determination dated 2 October 2006, the Tribunal, which
had before it opinions of Dr D White, Orthopaedic Surgeon, dated 27 October
200546 and 2 December 2005,47 stated that there was a consensus of medical opinion
that the appellant’s ankle injury, and his neck and back pain would not prevent him
from undertaking semi-sedentary work such as his pre-injury employment.48 The
44 AB262, 269.
45 Such reasoning is conventionally deprecated as manifesting the post hoc, ergo propter hoc fallacy.
46 AB394.4-394.6.
47 AB394.7-394.8.
48 AB327.
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23
appellant did not reignite an argument linking his TPD to those injuries when his
TPD claim was subsequently remitted to the Board.
[60] The second point is that in correspondence addressed to QSuper dated 11 September
2008,49 the appellant’s solicitors had put his position as one which attributed his
TPD to PTSD.50 This correspondence was before the Board on 25 September 2008.
[61] Having regard to these two points, I do not consider the appellant’s criticisms as
being justified.
[62] Failure by the Board to make further enquiries: The appellant submitted in
reply that, consistently with the decision of the High Court in Finch v Telstra Super Pty
Ltd51 and of the Court of Appeal of Victoria in Alcoa of Australia Retirement Plan
Pty Ltd v Frost,52 the Board should have made further enquiries of the psychiatrists
whose opinions were before it.
[63] In making this submission, the appellant did not criticise the distillation of the
propositions derived by the learned primary judge from Finch at paragraphs 46 and
48 of the reasons for the judgment or his Honour’s assessment at paragraph 49
thereof of the guidance given in Alcoa as to the implications of the high duty on the
trustee of a superannuation fund recognised in Finch.
[64] The high duty to which his Honour referred was one which he had described as
requiring the trustee “to make enquiries so as to properly inform itself of the
relevant information”. As to the content of that duty, his Honour drew upon the
reasons of Nettle JA (as his Honour then was)53 in Alcoa. He gave particular
emphasis to the following observations made by Nettle JA:
“[59] … Superannuation fund trustees are bound to give properly
informed consideration to applications for entitlements and, if
that necessitates further inquiries, then they must make them.
[60] So to say does not mean that a trustee is required to do the
impossible. Nor is it to suggest that a trustee is expected to go
on endlessly in pursuit of perfect information in order to make
a perfect decision. The reality of finite resources and the
trustee’s responsibility to preserve the fund for the benefit of
all beneficiaries according to the terms of the deed means that
there must be a limit. Like the judge below, I accept that a
trustee is not under an obligation to go on endlessly seeking
more and more information.”
[65] I now turn to the further enquiries that the appellant submitted the Board ought to
have made. During his reply, counsel for the appellant submitted there were three
steps that the Board should have taken by way of further enquiry. The first was that
clarification should have been sought from Dr Reddan as to her understanding of
the date of the first dog incident and if that revealed a misunderstanding on her part,
then she should have been asked whether, with the misunderstanding corrected, her
49 AB368-371.
50 Extracts from this correspondence as set out in paragraph 80 of the reasons for judgment which I have
quoted.
51 [2010] HCA 36; (2010) 242 CLR 254.
52 [2012] VSCA 238; (2012) 36 VR 618.
53 With whom Redlich JA and Davies AJA agreed.
-- 23 of 27 --
24
opinion with respect to schizophrenia would change. The same clarification should
have been sought from Dr De Leacy.
[66] Secondly, an agreed summary of the appellant’s longitudinal work history should
have been put to both Dr Reddan and Dr De Leacy with the question whether it
changed their opinions. Thirdly, the same question with the agreed summary should
have been put to Dr Butler.54
[67] So far as the first step is concerned, for the reasons I have given, Dr Reddan’s error
in referring to the dog incident on 2 January 2002 as having occurred on
29 February 2002 was apparent. It would have been readily inferred by the
members of the Board on reading her reports that she understood that that incident
had in fact occurred on 2 January 2002. Dr De Leacy did not make a corresponding
error in his report. In the circumstances, it was not necessary to seek clarification
from either doctor in this respect.
[68] With regard to the second step, the longitudinal work history to which Dr Reddan
referred was the appellant’s history in the workforce, not merely his employment at
the Department of Primary Industries. There is no evidence to suggest that
Dr Reddan misapprehended the appellant’s work history. The point she made in her
third report was that Dr De Leacy may not have been aware of that history, not that he
misunderstood it. In short, there was no reason for the Board to believe that either
psychiatrist had formed their opinion upon an inaccurate picture of the appellant’s
longitudinal work history. In these circumstances, the occasion for preparation of
an agreed longitudinal work history in which prior inaccuracies were corrected, did
not arise.
[69] As to the third step, Dr Butler was of the view that the appellant did not have a
TPD. There would have been no point in making any enquiry of him which asked
him to hypothesise that the appellant did have a TPD and then to express an opinion
as to its cause or causes.
[70] In light of these considerations, I am unpersuaded that the enquiries proposed by the
appellant were ones that the Board was required to make consistently with its duty
to properly inform itself of relevant information. I would add that the Board had
before it a very substantial amount of information. There was a clear difference of
opinion between Dr Reddan and Dr De Leacy as to whether there was a relationship
between the appellant’s TPD and his pre-existing schizophrenia. The Board made a
reasoned choice as to which opinion it preferred. The position the Board was in is
analogous with that of the trustee in Chapman v United Super Pty Ltd55 whose
decision to reject a TPD claim on the basis of a choice made between competing
medical opinions was unsuccessfully challenged in the Supreme Court of New
South Wales.
[71] To summarise, the appellant has alleged that the Board erred in a number of
respects in its decision-making process. For the reasons I have given, in my view,
none of the errors raised under Issue 1 has been made out.
Issue 2
54 Appeal Transcript 1-51 ll12-26.
55 [2013] NSWSC 592.
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[72] The second issue, which is allied to the first, builds upon the recognition by the
learned primary judge that the trustee of a superannuation fund has a duty to give
real and genuine consideration to the material before it in making a decision on a
claim. That duty, his Honour observed, may require the trustee to give attention to
the requirements of natural justice and to give the claimant a chance to address
adverse information.56
[73] It will be recalled that Dr Reddan’s third report, which was adverse to the
appellant’s claim, was given to him. His solicitors made submissions with respect
to it and those submissions were before the Board.
[74] In oral submissions, the appellant’s counsel contended that the 2008 QSuper
submission itself should have been given to the appellant.57 Two aspects to that
submission were cited as canvassing matters of which the appellant ought to be
have been notified and given the opportunity to make submissions.
[75] The first aspect concerned a matter which had been raised before the learned
primary judge with respect to the formulation of Option B in the submission.58 The
complaint made by the appellant was that the option was not cast as the obverse of
Option A; that is to say, cast as the Board being satisfied that the appellant’s TPD
was not related to his pre-existing schizophrenia. Cast as it was, the option implied
an onus on the appellant to prove that his dog incident-related stress symptoms were
the cause of his TPD, it was submitted. The second aspect was the possibility that
the Board might adopt the different medical histories given by the appellant to Dr Butler
and Dr De Leacy as justifying a preference for Dr Reddan’s opinion as was
envisaged by paragraph 16 of the material findings.
[76] As to the first aspect, the options as presented reflected the material before the
Board. Specifically, Option B reflected the submission made by the appellant’s
solicitors largely in reliance upon Dr De Leacy’s opinion. To have cast Option B
merely as the obverse to Option A would have left unmentioned the appellant’s
principal contention concerning the responsibility of a PTSD for his TPD. For it to
have been mentioned was beneficial to the appellant. In my view, Option B was not
cast in a way that was adverse to the appellant. It was not incumbent upon the
Board to have referred it to him for comment on that account.
[77] I hold a similar view with respect to the different medical histories. As I have
explained, paragraph 16 of the material facts did not misapprehend the different
medical histories given by the appellant to Dr Butler and to Dr De Leacy
respectively, as reported by them. Those histories differed markedly with respect to
any continuing stress symptoms suffered by the appellant arising from the dog
incident on 2 January 2002. The Board was entitled to accept each psychiatrist’s
account of what the appellant had told him in that regard. The Board was not
obliged to assume a possibility that either psychiatrist may have been mistaken as to
the account given to him and, on the basis of such an assumption, offer the appellant
an opportunity to correct any mistake.
[78] For these reasons, the appellant has failed to establish a breach of duty on the part of
the board in failing to accord him natural justice.
56 Reasons [57].
57 Appeal Transcript 1-22 ll5-13.
58 Reasons [137].
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Issue 3
[79] The third issue arises out of the answer given by learned primary judge to
Question 3. His Honour found that the appellant had failed to establish the requisite
intention to create contractual relations on the part of the appellant and the Board.59
[80] Intention is a necessary element of a contract.60 The relevant intention may be
express or implied.61 Whether there is such an intention in particular circumstances
is to be determined objectively from the “outward manifestations” of the parties’
intentions.62
[81] Here, there was no expression of intention to create contractual relations. Ought
such an intention be implied? That question needs to be answered in the context of
the evident trustee-beneficiary relationship that did exist between the appellant and
the Board, and, it may be noted, had existed between the respective trustees and
claimants in Finch and Alcoa. So seen, the question can be modified to one of
whether an intention to enter into a contractual relationship which would co-exist
with the trust relationship, ought to be implied.
[82] It is highly relevant to answering the question to inquire whether there is a basis for
concluding that the parties intended their relationship to include any substantive
right or obligation which was outside those rights and obligations which were
incidents of the trustee-beneficiary relationship and which, it might be thought, the
parties intended would be enforced on the basis of contract only. The appellant did not
identify any such right or obligation. That, to my mind, is all but fatal to his
contention that a shared intention to create contractual relations ought to be inferred. It
strongly suggests that the question should be answered in the negative. I agree with
his Honour’s conclusion against a concurrent contractual relationship and with his
reasons for it.
[83] I would add that even if the question were answered in the affirmative, such an
answer would not assist the appellant in a material way. In oral submissions, his
counsel informed the Court that the appellant would rely on the same matters to
prove a breach or breaches of contract as he had relied on to prove a breach or
breaches of trust.63 To put it another way, if the appellant failed to prove any breach
of trust, he would have failed also to have proved any breach of contract.
Disposition
[84] The appellant has not succeeded on any of the three issues which embrace the
principal points raised by his grounds of appeal. His appeal must therefore be dismissed.
It is appropriate that he pay the Board’s costs of the appeal on the standard basis.
Orders
59 Reasons [175].
60 Masters v Cameron [1954] HCA 72; (1954) 91 CLR 353 at 360-362 per Dixon CJ, McTiernan and Kitto JJ,
applied in Ermogenous v Greek Orthodox Community of SA Inc [2002] HCA 8; (2002) 209 CLR 95 at [25].
61 See the authorities collected in Carter on Contract at para 08-020, f 4.
62 Taylor v Johnson [1983] HCA 5; (1983) 151 CLR 422 at 428 per Mason ACJ, Murphy and Deane JJ.
See also Electricity Generation Corporation v Woodside Energy Ltd [2014] HCA 7; (2014) 251 CLR 640
at [35] per French CJ, Hayne, Crennan and Kiefel JJ.
63 Appeal Transcript 1-25 ll6-8.
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[85] I would propose the following orders:
(1) Appeal dismissed.
(2) The appellant is to pay the respondent’s costs of the appeal on the standard
basis.
[86] DALTON J: I agree with the reasons of Gotterson JA and with his proposed
orders.
[87] BURNS J: I agree with the reasons of, and the orders proposed by, Gotterson JA.
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Official source: https://www.sclqld.org.au/caselaw/QCA/2016/247