Carrette v Superannuation Complaints Tribunal [2017] FCA 640

Carrette v Superannuation Complaints Tribunal [2017] FCA 640

The Tribunal's decision was affected by legal error because it failed to engage with essential medical material critical to the decision, namely Professor McFarlane's 2013 opinions that the applicant's current disabling psychiatric condition was complex PTSD or a separate condition independent of the earlier PTSD and MDD. The Tribunal appeared to reject or dismiss that evidence by a mechanical application of DSM-IV criteria, although Professor McFarlane accepted that complex PTSD was not included in the DSM system. Because that central material was necessary to deciding whether the applicant's total and permanent disablement was related to a pre-existing medical condition within cl...

Jurisdiction
Australia
Judgment Date
29 May 2017
Procedural Posture
Appeal on a Question of Law Under S 46 of the Superannuation (resolution of Complaints) Act 1993 (cth) From a Decision of the Superannuation Complaints Tribunal / Final Hearing and Judgment on the Appeal From the Tribunal's Decision Dated 20 September 2016
Outcome
Appeal allowed; decision of the Superannuation Complaints Tribunal set aside; matter remitted to the Tribunal for re-hearing; second respondent ordered to pay the applicant's costs.
Legal Topics
['total and Permanent Disablement Benefit' 'pre Existing Medical Conditions Exclusion' 'superannuation Complaints Tribunal Review' 'failure to Engage With Critical Medical Evidence' 'fair and Reasonable Trustee Decision']
['superannuation' 'insurance' 'administrative Law'] ['total and Permanent Disablement Benefit' 'pre Existing Medical Conditions Exclusion' 'superannuation Complaints Tribunal Review' 'failure to Engage With Critical Medical Evidence' 'fair and Reasonable Trustee Decision']

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Procedural Posture

Appeal on a Question of Law Under S 46 of the Superannuation (resolution of Complaints) Act 1993 (cth) From a Decision of the Superannuation Complaints Tribunal / Final Hearing and Judgment on the Appeal From the Tribunal's Decision Dated 20 September 2016

Legal Issues

  1. 1 ["Whether the Tribunal erred in affirming the trustee's rejection of the applicant's total and permanent disablement benefit claim under cl 6.2(b)(ii) of the insurance policy." "Whether the Tribunal failed to engage with critical medical evidence from Professor McFarlane that the applicant's later psychiatric condition was a separate condition, complex PTSD, unrelated to earlier PTSD and MDD." "Whether the Tribunal's reasoning impermissibly or inadequately disposed of Professor McFarlane's views by reference to DSM-IV or DSM-IV-TR criteria."]

Ratio Decidendi

The Tribunal's decision was affected by legal error because it failed to engage with essential medical material critical to the decision, namely Professor McFarlane's 2013 opinions that the applicant's current disabling psychiatric condition was complex PTSD or a separate condition independent of the earlier PTSD and MDD. The Tribunal appeared to reject or dismiss that evidence by a mechanical application of DSM-IV criteria, although Professor McFarlane accepted that complex PTSD was not included in the DSM system. Because that central material was necessary to deciding whether the applicant's total and permanent disablement was related to a pre-existing medical condition within cl...

Court Disposition

Appeal allowed; decision of the Superannuation Complaints Tribunal set aside; matter remitted to the Tribunal for re-hearing; second respondent ordered to pay the applicant's costs.

Orders

  • ['The decision of the Superannuation Complaints Tribunal dated 20 September 2016 be set aside.' 'The matter be remitted to the Tribunal for re-hearing.' 'The second respondent pay the costs of the applicant.']