AustLII Home | Databases | WorldLII | Search | Feedback

Administrative Appeals Tribunal of Australia
You are here:  AustLII >> Databases >> Administrative Appeals Tribunal of Australia >> 2019 >> [2019] AATA 2314

Database Search | Name Search | Recent Decisions | Noteup | LawCite | Download | Context | No Context | Help

 Brideson  by guardian Lynette  Brideson  and Australian Capital Territory (Compensation) [2019] AATA 2314 (31 July 2019)

Last Updated: 1 August 2019

 Brideson  by guardian Lynette  Brideson  and Australian Capital Territory (Compensation) [2019] AATA 2314 (31 July 2019)

Division: GENERAL DIVISION

File Number(s): 2016/6726

Re: Michael  Brideson  by guardian Lynette  Brideson 

APPLICANT

And Australian Capital Territory

RESPONDENT

DECISION

Tribunal: Deputy President Gary Humphries AO

Date: 31 July 2019

Place: Canberra

The Tribunal affirms the reviewable decision dated 24 November 2016.

............................................................

Deputy President Gary Humphries AO

Catchwords

WORKER’S COMPENSATION – accepted condition of post-traumatic stress disorder – whether a psychiatric assistance dog is a form of medical treatment or an aid for the purposes of the Act – whether the psychiatric assistance dog obtained at the direction of a legally qualified medical practitioner – whether the psychiatric assistance dog is reasonable to obtain – where Tribunal faced with uncertain and vague evidence as to the

medical effects of the psychiatric assistance dog – psychiatric assistance dog is not medical treatment for purposes of the Act – whether psychiatric assistance dog is an aid under the Act – statutory construction – decision under review affirmed

Legislation

Compensation (Commonwealth Government Employees) Act 1971, s 37

Disability Discrimination Act 1992, s 9

Safety, Rehabilitation and Compensation Act 1988 ss 4, 14, 16, 39

Cases

Alamos and Comcare [2014] AATA 629

Beezley v Repatriation Commission [2015] FCAFC 165

Capital Territory Health Commission v Cavanagh [1978] FCA 5

Comcare v Watson [1997] FCA 149; (1997) 73 FCR 273

Durham and Comcare [2014] AATA 753

Jorgensen and Commonwealth [1990] AATA 129; (1990) 23 ALD 321

Ondrich v Kookaburra Park Eco-Village [2009] FMCA 260; (2009) 227 FLR 83

Pethes and Comcare [2018] AATA 483

Popovic and Comcare [2000] AATA 264

Queensland v Forest [2008] FCAFC 96; (2008) 168 FCR 532

Rope and Comcare [2018] AATA 42

Smith and Comcare [2018] AATA 2901

Thiele v Commonwealth [1990] FCA 123; (1990) 22 FCR 342

Topping and Comcare [2015] AATA 525

WBJM and Comcare [2015] AATA 143

Secondary Materials

Commonwealth, Parliamentary Debates, House of Representatives, 22 April 1971, 1893-1898 (William Charles Wentworth, Minister for Social Services).

Explanatory Memorandum, Compensation (Commonwealth Employees) Bill 1971.

Dr Gwendolyn Cazander et al, “Maggot excretions affect the human complement system” 20(6) Wound Repair and Regeneration – the International Journal of Tissue Repair and Regeneration (November-December 2012).

Marguerite O'Haire and Kerri Rodriguez, “Preliminary Efficacy of Service Dogs as a Complimentary Treatment for Posttraumatic Stress Disorder in Military Members and Veterans” (2018) 86(2) Journal of Consulting and Clinical Psychology pp 179-188.

Dr Ronald Sherman, “Maggot Therapy for Treating Diabetic Foot Ulcers Unresponsive to Conventional Therapy” (2003) 26(2) Diabetes Care – American Diabetes Association.

REASONS FOR DECISION


Deputy President Gary Humphries AO

31 July 2019

INTRODUCTION

  1. Mr Michael  Brideson  had been a long-serving member of the ACT Fire Brigade when, in September 2011, he and his crew attended a large factory fire in Mitchell, ACT. As a result of that attendance he suffered a psychiatric condition (PTSD). Comcare, as the Australian Capital Territory Government’s then insurer, accepted this condition as an injury pursuant to s 14 of under the Safety, Rehabilitation and Compensation Act 1988 (the Act). It is also accepted a secondary injury of bruxism, with a date of injury of 19 July 2013.
  2. Mr  Brideson  has a dog, Ted. On 30 July 2016 he made a claim for the care, upkeep and training of Ted on the basis that Ted is a psychiatric assistance dog[1] (or mind dog). However, on 2 August 2016 Comcare made a determination rejecting his claim stating that the claimed costs did not satisfy the relevant criteria in s 16(1) of the Act for medical treatment. Specifically, it was asserted that Ted:
  3. The determination went on to say:
There are no other areas of the SRC Act that could conceivably apply to the acquisition and upkeep of a mind dog.
  1. On 10 August 2016 Mr  Brideson ’s wife, Lynette, sought reconsideration of this determination, claiming that costs associated with the acquisition, upkeep and training of Ted were compensable under either ss 16 or 39 of the Act. However, on 24 November 2016 Comcare affirmed its earlier determination. In relation to s 39, Comcare’s delegate considered that an aid must be something artificial in nature, not a dog or other animal. Mrs  Brideson , as Mr  Brideson ’s litigation guardian, sought merits review of this determination by the Tribunal on 28 November 2016.
  2. On 1 March 2019 the Australian Capital Territory (ACT or the Territory) became a licensee under the Act, and thus the respondent in these proceedings.

RELEVANT LEGISLATION

  1. An injured worker with an accepted condition is entitled to compensation, relevantly, under two provisions of the Act. The cost of medical treatment can be recovered pursuant to s 16:
(1) Where an employee suffers an injury, Comcare is liable to pay, in respect of the cost of medical treatment obtained in relation to the injury (being treatment that it was reasonable for the employee to obtain in the circumstances), compensation of such amount as Comcare determines is appropriate to that medical treatment.
  1. The Act defines medical treatment in s 4 as follows:
  2. Alternatively, the cost of an aid or appliance, reasonably required by the worker, can be recovered pursuant to s 39:
(1) Where:
(a) an employee suffers an injury resulting in an impairment; and
(b) the employee is undertaking, or has completed, a rehabilitation program or has been assessed as not capable of undertaking such a program;
the relevant authority is liable to pay compensation of such amount as is reasonable in respect of the costs, payable by the employee, of:
(c) any alteration of the employee's place of residence or place of work;
(d) any modifications of a vehicle or article used by the employee; or
(e) any aids or appliances for the use of the employee, or the repair or replacement of such aids or appliances;
being alterations, modifications or aids or appliances reasonably required by the employee, having regard to the nature of the employee's impairment and, where appropriate, the requirements of the rehabilitation program.

(2) The matters to which the relevant authority shall have regard in determining the amount of compensation payable in a particular case under subsection (1) include such of the following matters as are relevant in that case:
(a) the likely period during which the alteration, modification, aid or appliance will be required;
(b) any difficulties faced by the employee in gaining access to, or enjoying reasonable freedom of movement in, his or her place of residence or work;
(c) any difficulties faced by the employee in gaining access to, driving or enjoying freedom and safety of movement in, a vehicle used by the employee;
(d) any alternative means of transport available to the employee;
(e) whether arrangements can be made for hiring the relevant aid or appliance;
(f) when the employee has previously received compensation under this section in respect of an alteration of his or her place of residence or a modification of a vehicle and has later disposed of that place of residence or vehicle--whether the value of that place of residence or vehicle was increased as a result of the alteration or modification.

ISSUES TO BE DETERMINED

  1. Mr  Brideson ’s claim for the costs associated with Ted can be considered under either s 16 or s 39. Under the former, to satisfy the section it must be established that:
  2. In the alternative, to satisfy s 39 it must be established that:
  3. The ACT’s contentions were cast more broadly than asserting that Ted does not satisfy either section. Its contention was that no psychiatric assistance dog can fall within the ambit of either section. The Tribunal was advised that there have been no previous decisions by Australian courts or tribunals on the question of whether a psychiatric assistance dog can constitute medical treatment or an aid or appliance.

EVIDENCE ON BEHALF OF MR  BRIDESON 

  1. Mr  Brideson ’s wife gave evidence to the Tribunal. Mrs  Brideson  said that Ted had been acquired as her pet originally, but soon became very attached to Mr  Brideson . Over time she noticed that Ted would become agitated and attempt to be with Mr  Brideson  when he, Mr  Brideson , was upset or anxious. She noticed that he would become calmer and more relaxed when Ted was with him. This phenomenon occurred frequently. After Ted had been trained as a mind dog, Mr  Brideson  was able to go to public places with him that he had previously avoided, because doing so previously had brought on a panic attack or further stress. Whereas previously Mr  Brideson  rarely went out of his home, after Ted’s training he and Ted would go out almost every day.
  2. A list of expenses claimed in relation to Ted was tendered. The expenses included insurance premiums, animal registration, Dog training, dietary food, grooming, veterinary costs, desexing and vaccination.
  3. It appears that Ted was acquired in 2014. An application for a Psychiatric Service Dog directed to mindDog, an organisation which provides services in relation to psychiatric service dogs, was signed by Mr  Brideson  and dated 3 February 2016. Ms Keli Wainwright, Mr  Brideson ’s treating psychologist between 2012 and 2016, describes in a letter dated 5 April 2017 various incidents between April and June 2016 where it had been reported to her that Mr  Brideson  obtained benefits from his use of Ted.
  4. A psychiatrist who treated Mr  Brideson , Dr Son Nguyen, completed a part of Mr  Brideson ’s application to mindDog set aside to be filled in by a medical practitioner. That section of the form is dated 14 January 2016. In it, Dr Nguyen certifies that Mr  Brideson  meets the definition of disability as defined in the Australian Disability Discrimination Act 1992. In answering the question How do you expect a mindDog to assist your patient, Dr Nguyen notes It would be helpful with PTSD related hyperarousal in shopping centres and crowds of people. The purpose of this section of the form, however, is not otherwise specified.

EVIDENCE REGARDING TED’S TRAINING

  1. A letter dated 23 March 2017 from Ms Cath Phillips and Ms Gayl O’Grady, Chairman and Head Assessor respectively of mindDog, was tendered. In the letter they say:
    1. Under the Commonwealth Disability Discrimination Act 1992, a psychiatric assistance dog is one that has been trained to alleviate the effects of its hander’s disability...
    2. We first visited Michael on Wednesday November 30, 2016. We are not medical practitioners so our observations are those of lay people. Michael appeared to have a flat affect and we found it difficult to engage him. His conversation was desultory. Ted was trying to get his attention.
    3. Our second visit was on Wednesday, February 8, 2017. Michael’s demeanour was much improved. He appeared happy, willing to engage, and gave Ted much more attention...

Every handler/mindDog relationship is unique. The handler’s condition is unique to him and his dog’s response to it is unique...

However, in general our dogs assist clients with Michael’s diagnoses by:

barking when the handler is in flashback or a fugue state.

waking the handler from when breathing stops.

waking the handler from night terrors [sic]...

through distraction, bringing the handler back to the moment when in a state of acute anxiety [sic]...

alleviating the handler’s depression by the need for regular physical exercise and play.

These are some of the assistance behaviours mindDogs provide. Ted will develop his own repetoire of skills while he works with Michael [sic].

  1. A report dated 11 May 2019 from Dr John Ayerbe, veterinary surgeon and consultant to Animal Expert Witness Service Ltd, was also tendered. In it he makes the following comments:
I have been supplied with information regarding the required competencies of a “psychiatric dog”. It would appear that an animal must have “basic training” first, before commencing training to become a “Minddog”.
“Basic training” involved training an animal to respond to stimuli or signals as a result of a positive experience.
I believe that it would be extremely difficult to demonstrate that an animal can be trained to perform the tasks required of a “Minddog”.
There is evidence that dogs may have a relaxing or calming effect on their owners...
2. Can a dog be trained to “sense” whether a person is “nervous”, such that the dog decides to distract or otherwise assist a person?
There is anecdotal evidence that animals (dogs in particular) may be able to sense whether an owner is nervous.
It may be that a human emits some form of chemical or smell when nervous. This odour would not be detected by humans but may be able to be detected by some dogs. It also may be that a dog is able to interpret body language signals of an owner who is nervous.
However, my belief is that while some dogs may have this as an innate competency this ability cannot be “taught” to the animal.
If an animal does have an innate ability to detect nervousness then it may be able to have the skill “enhanced” by some form of positive reinforcement training...
3. Can a dog be trained to “alert family members in advance” when a person is experiencing suicidal thoughts, depression, hypervigilance and anxiety?
I don’t believe that an animal could sense that a person would be having suicidal thoughts and as such would not be able to warn family members in advance of such an occurrence. I don’t believe that a dog can read a human’s mind...
5. Can a dog be trained to bark when its handler is in “flashback or a fugue state”?
I find it difficult to understand how a dog could recognise when an owner would be suffering from either of these conditions, unless there is a patterned reaction to these states by the handler. If this was the case then it may be possible to train an animal to bark in response to this behaviour...
11. Can a dog be trained to assist a person to alleviate the effects of post-traumatic stress disorder in contradistinction to mere obedience training?
The methodology involved in training an animal relies upon the process of positive reinforcement of an animal for a patterned experience. The method would be the same for “assisting the effects of post-traumatic stress disorder” as it would be for “mere obedience training”...

THE MEDICAL EVIDENCE

  1. Dr Nguyen authored a letter to Comcare dated 26 October 2016, following a relapse in Mr  Brideson ’s PTSD and depression which led to a hospital admission, in which he answered a question relating to the strategies put in place to assist Mr  Brideson  to self-manage his condition. He made no reference in the letter to Ted, other than to note that Mr  Brideson ’s claim for the dog had been declined by Comcare.
  2. Psychiatrist Dr Brian White’s report, dated 2 April 2017, in relation to Mr  Brideson  was tendered. In it he said:
The use of an assistance dog is becoming more widespread in recent years as it has been an effective way of improving the self-confidence of patients with chronic psychiatric conditions, including chronic Post-traumatic Stress Disorder. When accompanied by an assistance dog most patients feel less anxious in dealing with the outside world and they have increased self-confidence.
My experience has been that an assistance dog has facilitated cognitive behavioural therapies including exposure therapies for patients with agoraphobia and social phobia. This has enabled a wider range of social outings. In addition, having such a dog often assists the patient in undertaking more regular exercise.
  1. Dr White diagnosed Mr  Brideson  with PTSD, anxiety disorder and depressive disorder, all chronic.
  2. Dr John Saboisky, psychiatrist, evaluated Mr  Brideson  for Comcare in July 2017. He produced a report dated 19 July 2017, which was tendered. In it he diagnosed chronic PTSD and major depressive disorder. In relation to the assistance Mr  Brideson  might obtain from Ted, Dr Saboisky made the following observations:
    1. Are assistance animals accepted by the medical profession as treatment for a condition such as Mr  Brideson ’s claimed condition?

I am not aware that the medical profession as a group view assistance animals as a treatment for PTSD and depression. That is not to say that it has not become a popular adjunct to psychiatric treatment...

  1. Does Mr  Brideson  require an assistance dog in relation to any employment related condition/s? Please provide reasons for your opinion and the recommended frequency, if required.

I do not believe so, on the basis that while he has a good relationship with this dog there is no evidence especially over the last six months of any sustained reduction of his depression.

  1. Do you consider an assistance dog will lead to an improvement in any employment related condition/s suffered by Mr  Brideson ?

There is no evidence of any improvement over the last six months although Mr  Brideson  clearly has an affectionate, caring and supportive relationship with the dog.

  1. What benefits, if any, does Mr  Brideson  obtain from an assistance dog with respect to any employment related condition?

He claims the dog keeps him calm if distressed and helps with social engagement.

  1. To what extent does the assistance dog:
    1. empower Mr  Brideson  to independently self-manage his compensable condition?

Ultimately he may be able to venture further afield particularly to supermarkets and independently shop.

  1. allow him to live a functional and productive life while self-managing symptoms if they arise?

There is no evidence to date that the three years he has had the dog has led him to a more functional and productive life.

  1. Drs White and Saboisky gave concurrent evidence to the Tribunal. Dr White considered that Ted did constitute therapeutic treatment for Mr  Brideson ’s PTSD, on the basis that:
...the role of the assistance dog in therapy is to facilitate or assist the process of therapy which is already being... given to a patient so that they can carry on that therapy themselves.

He said that an assistance dog can assist with conditions such as social anxiety or agoraphobia. The animal is thus not a companion animal, but can assist in cognitive behavioural processes. He conceded that most of the literature around this question at this stage is anecdotal, not based on formalised research. He said there was some suggestion in the literature that exposure therapy – facilitating a sufferer’s gradual exposure to the things he fears most – is sometimes beneficial and can be facilitated by an assistance dog. He described the research on animals as therapy as evenly balanced, sometimes supporting and sometimes offering no evidence of their value in this context. It was a work in progress. He observed that there was a general dearth of good research on the efficacy of a range of strategies deployed in relation to conditions such as PTSD, for example physical exercise.

  1. Dr White added that much depends on the individual; some respond to certain treatments, others do not. In Mr  Brideson ’s case, he considered that Ted had allowed him to apply some of the cognitive behavioural therapies he was using. He explained this by saying that Ted gave him the confidence to go out into public places that he had previously feared visiting. He became to some extent desensitised to situations which previously had made him socially anxious. He thought that Mr  Brideson  had become more active around the house and was able to get out into the community more. This had improved his quality of life. He was substantially better than when he first saw him, and he attributed at least part of this improvement to Ted.
  2. Dr Saboisky doubted that an animal could ever constitute treatment in the sense contemplated in the Act. He agreed with Dr White on the inconclusive nature of the research on the question of whether animals can constitute an aid to therapy. He referred to some of the studies suffering from having too many variables, or relying too heavily on self-reporting.[3] The highest the research reaches is that service dogs may confer a benefit. He said:
There’s certain lifestyle benefits, but no resolution of the illness, no serious amelioration of the symptomatology.
  1. Dr Saboisky doubted that Ted had led to any significant improvement in Mr  Brideson ’s psychological well-being or his capacity to function at home or in the community, though he conceded that he had only had one opportunity to examine him whereas Dr White had been involved in his ongoing treatment. He noted that whatever benefit he was obtaining from his good relationship with Ted, it was not translating into clinically meaningful improvement. He also noted that there was a range of medications and clinical treatments that Mr  Brideson  had not attempted but which might improve his condition. In response, Dr White opined that some medications and treatments would not be suitable for Mr  Brideson  or would have unacceptable side effects.
  2. On the question of whether Mr  Brideson , in the context of his impairment from injury, might reasonably require Ted pursuant to s 39, the doctors commented on the risk of self harm by Mr  Brideson  in the event of Ted’s death. Both doctors acknowledged the plausibility of this scenario, though Dr White considered that Ted may provide a means of building resilience in Mr  Brideson  over time such that this outcome was less likely.
  3. Dr Saboisky emphasised that no one treatment works for everybody. He added that what works for some patients may not be considered therapy in the legal sense at all – surfing or travelling, for example. He said that in some cases alcohol, or the services of a comfort woman, confers a benefit to a patient, but you can’t scientifically say they are required.
  4. In a letter dated 5 April 2017 Ms Wainwright, Mr  Brideson ’s erstwhile treating psychologist, expressed the opinion that a psychiatric assistance dog would complement Mr  Brideson ’s evidence-based treatment for symptoms of his condition. This would allow him to undertake CBT [cognitive behaviour therapy] graded exposure tasks that aim to reduce avoidance and improved functioning. In a later letter, dated 19 February 2019, Ms Wainwright notes that she ceased to treat Mr  Brideson  in November 2016 and that she never used Ted as part of her treatment regime. In a supplementary report dated 19 April 2019 she provided evidence of what she described as a literature review examining the benefits of psychiatric service dogs. She concluded that this showed evidence of improved mental health for military members and veterans with PTSD who used such animals. However, she said that research into the effectiveness of using a psychiatric service dog is a complimentary treatment is in its early stages.

CONSIDERATION

  1. Mr  Brideson  did not give evidence during the hearing. Submissions were made to the Tribunal about the weight that it should give to his submissions given his failure to appear and to subject himself to cross-examination. Evidence was led on the question of whether he had the capacity to appear. Counsel for the ACT submitted that, with suitable modifications to the process normally employed to take evidence, Mr  Brideson  could have given evidence notwithstanding his accepted condition. His counsel, conversely, argued that his condition did not permit him to do so, and led medical evidence in support of that proposition.
  2. The Tribunal has not formed a concluded view about those submissions because it finds that Mr  Brideson ’s application must fail, and the reviewable decision affirmed. It reaches that finding without needing to test the submissions made on his behalf about his personal circumstances; that is, the Tribunal’s finding stands even where the contentions regarding his state of health and the benefits he perceives are conferred on his accepted condition by Ted are accepted. In those circumstances, exploring the question of his capacity to give evidence serves no useful purpose.
  3. Similarly, the Territory submitted that the evidence of Mrs  Brideson  should be discounted on the basis that she was an advocate for the applicant and that her advocacy came at the expense of the truth or at the expense of the correctness of her version of events. In aid of this proposition her evidence was contrasted with the written record. It was established, for example, that, contrary to Mrs  Brideson ’s original assertions to Comcare, Ted was acquired originally as a family pet, not as an assistance dog. In the witness box Mrs  Brideson  conceded that she had inaccurately claimed that Ted was acquired on the recommendation of Mr  Brideson ’s treating psychiatrist. Again, it is not necessary to form a view about Mrs  Brideson ’s credit as a witness since, even if everything she said to the Tribunal were accepted as the truth, Mr  Brideson ’s claim still fails.
  4. I turn now to the specific questions posed by this application. As will be seen, those questions are resolved largely as a matter of statutory construction, and on the basis of the medical evidence, rather than as a function of the facts pertaining to Mr  Brideson ’s circumstances. To the limited extent to which they do turn on the facts, those facts are not controversial.

Is Ted a form of medical treatment pursuant to section 16?

  1. Section 16 provides for the payment of the cost of an injured worker’s medical treatment. Medical treatment is defined in s 4(1); there the term is defined exhaustively as falling within one or more of paragraphs (a)-(i). It is uncontroversial that only paragraph (b) is relevant to Mr  Brideson  circumstances:
(b) therapeutic treatment obtained at the direction of a legally qualified medical practitioner; [4]
  1. This provision was examined by the Federal Court in Comcare v Watson [1997] FCA 149; (1997) 73 FCR 273. Finn J said (at 276-277):
The formula, "at the direction of", in this setting contains an imperative element - by which I mean a doctor prescribes a specified course to be taken. That course in turn must be therapeutic treatment. In Thiele's case, above, for example, the doctor prescribed (inter alia) the construction of a swimming pool of particular specifications for the purpose of swimming exercises of a person suffering a spinal injury. And the issue was not whether a direction had been given to construct a pool, but rather whether the provision of the pool was itself therapeutic treatment. Justice Hill held it was not and, importantly, that:
"it does not become treatment merely because it is advised, prescribed or ordered by a medical practitioner": Thiele v Commonwealth of Australia, at 382.
For my own part I would be prepared to adopt the "advised, prescribed or ordered" terminology of Hill J as representing the proper meaning to be given to the "at the direction of" formula in the s4 definition - these terms having relatively well understood and not greatly dissimilar connotations in the context of doctor-patient communications as to the undertaking of treatment for an injury. In consequence I reject not only the Tribunal's apparent construction of the formula as meaning "guidance" - I also reject the applicant's submission that direction requires monitoring, control or management by a doctor.
As the observation from Hill J I have quoted indicates, the direction must be to obtain "therapeutic treatment". These words raise the second matter of construction to which I need refer. I do not consider that the construction adopted by the Tribunal was erroneous. A course of treatment designed to, or aimed at, alleviating the pain caused by an injury or disease is, in my view, properly to be regarded as therapeutic treatment.
The applicant has submitted that a treatment can only be "therapeutic" if its object is to cure a disease or injury. Though some dictionary definitions do emphasise the "healing or curative" connotation of the words "therapy" and "therapeutic": see eg Shorter OED, 3rd Ed; the latter's use in this context encompasses the alleviation of the pain of an injury. This view is consistent with the s4 definition of "therapeutic treatment" which includes "treatment given for the purpose of alleviating an injury": (emphasis added). The Shorter OED, for example, defines "alleviation" as "the action of lightening ... pain". That usage is an appropriate one to apply here given the s4 definition itself. And it permits a construction which accords with the beneficial purposes of the legislation: see Thiele's case, 380- 381.
...The only additional comments I would make on this are, first, that therapeutic treatment in this setting is a purposive activity - ie its purpose or object must be the treatment of the particular injury in question. If such is not the actual, specified purpose of the activity then notwithstanding its beneficial effects, it will not relevantly be therapeutic treatment for present purposes. Secondly, because such treatment is purposive, an indicator that a doctor-prescribed activity is intended, relevantly, to be therapeutic will commonly be the adoption of some level of monitoring of it to gauge whether it is appropriately adapted to its purpose or is effective in some degree in realising that purpose. Obviously the nature and extent of such monitoring will be affected significantly by the nature of the treatment. Some forms of treatment may require close checking; others may well be self-monitored, once prescribed. I mention this simply to caution against the view that a doctor's positive and active control and management are indispensable elements in treatment.
When one aggregates the terms of the para (b) definition, they are seen to have a dual requirement. There must be therapeutic treatment having as its purpose the treatment of the injury in question, and that treatment must be prescribed by a doctor.
  1. His Honour makes it abundantly clear that treatment need not be curative to be therapeutic. The alleviation or relief of pain – or, in the context of a mental injury, of the disabling effects of the condition – is contemplated by the phrase therapeutic treatment. The Tribunal has applied this principle in a number of decisions, for example Topping and Comcare [2015] AATA 525; Popovic and Comcare [2000] AATA 264 at [28]; Rope and Comcare [2018] AATA 42; Smith and Comcare [2018] AATA 2901 at [87]- [97].
  2. The meaning of medical treatment was considered by the Federal Court in Capital Territory Health Commission v Cavanagh [1978] FCA 5. That case considered whether moving from Canberra to a warmer climate for the winter, on advice from her doctor that this would alleviate her back condition, constituted medical treatment of an injured worker. Holding that it did not, Nimmo J said:
I think that the key word in paragraph (b) of the definition of "medical treatment" and in the definition of "therapeutic treatment" in [then] s.5(1) is the word "treatment" which seems to me to contemplate the doing of something by some one to or for the employee concerned. It goes beyond the mere acceptance of advice from a medical practitioner to move to another climate. In my opinion it requires a person to do something in the exercise of his skill which is designed to alleviate an injury.
  1. Measured against the provisions of the statute, as interpreted by the Federal Court, it is apparent that Mr  Brideson ’s claim under s 16 immediately runs into several difficulties. The first is that it is not apparent that treatment has been obtained at the direction of a legally qualified medical practitioner. Mr  Brideson  relied on that part of the mindDog form completed by Dr Nguyen on 14 January 2016 as evidence of a medical direction. However, the form is difficult to characterise in this way. Dr Nguyen certifies nothing in the form except that Mr  Brideson  suffers from a disability; the annotation that a dog would be helpful with PTSD related hyperarousal in shopping centres and crowds of people seems to fall somewhat short of the prescribing of a dog as a form of treatment. In this context the Tribunal notes that, in his letter to Comcare of 26 October 2016 describing Mr  Brideson ’s psychiatric treatment regime, Dr Nguyen makes no reference to Ted, despite him having been used by Mr  Brideson  as an assistance dog since, apparently, April that year.
  2. The various iterations of medical treatment in s 4(1) are intended to be an exhaustive list of what falls within the definition, and those provisions dealing with treatment provided by or through a medical practitioner (paragraphs (a) and (b)) contemplate the direct application of clinical judgement to a patient’s condition. In his written submissions, Mr  Brideson  described Dr Nguyen as having recommended an assistance dog; however, there is a distinction between suggesting it may be helpful and directing that it occur as part of a treatment regime. The “recommendation” regarding Ted appears to be in the same class as Ms Cavanagh’s doctor recommending that she spend the winter in a warmer climate (Cavanagh); see also Thiele v Commonwealth [1990] FCA 123; (1990) 22 FCR 342 at 348.
  3. Counsel for Mr  Brideson  pointed to Dr Nguyen’s observation, in his letter of 26 October 2016, that strategies including cognitive behaviour therapy have been put in place to self manage the PTSD, saying that the Tribunal could infer from this that Dr Nguyen was directing Ted’s use in connection with that therapy. I do not see that such an inference can be drawn. Dr Nguyen was not called to give evidence, a matter which must weigh against the construction argued for by Mr  Brideson .
  4. The second problem is that Ted clearly was not obtained at Dr Nguyen’s direction. It is common ground that Ted was acquired in 2014 as a family pet; it was only in 2016 that he began to be trained as an assistance dog (if, indeed, he was so trained, which is controversial on the facts). The definition appears to contemplate that obtaining the treatment follows from the giving of the direction for that treatment to occur. If paragraph (b) of the definition had substituted the word used or deployed for obtained, a different view might be reached, but as it stands it seems clear that Ted was not obtained at the direction of a medical practitioner.
  5. In the circumstances particular to Mr  Brideson ’s application, Ted therefore does not fall within the definition of medical treatment. However, in the Tribunal’s view there is a third barrier to this conclusion which would be applicable even if Ted had plainly been obtained at the direction of a medical practitioner. That barrier is that s 16 requires medical treatment to be reasonable for the employee to obtain in the circumstances. In the Tribunal’s view, it must be doubted that a psychiatric assistance dog could ever satisfy that provision, based on the medical evidence it received about the efficacy of such dogs as treatment for conditions such as PTSD.
  6. For treatment to be reasonable...to obtain, it must plainly be efficacious to some extent. As already noted, to be therapeutic treatment need not be curative; it may merely relieve the symptoms or effects of the condition. But inherent in the requirement that medical treatment be reasonable to obtain is the notion that the treatment actually achieves a therapeutic benefit, however defined. Treatment which purports to be procured in relation to a condition but which does not actually cure or relieve that condition cannot, in my view, be reasonably obtained as required by s 16(1). As much may be taken from Finn J’s observation in Comcare v Watson (at 277) that treatment of an injury must be appropriately adapted to its purpose or is effective in some degree in realising that purpose. The concept of treatment being effective is a requirement applied in many decisions of the Tribunal: see for example Alamos and Comcare [2014] AATA 629 at [24]; Pethes and Comcare [2018] AATA 483 at [49]- [50]; Durham and Comcare [2014] AATA 753 at [59]- [62].
  7. The evidence before the present Tribunal regarding the medical or psychiatric effectiveness of assistance dogs was inconclusive. Dr Saboisky considered that Ted’s role had not led to any significant improvement in Mr  Brideson ’s psychological well-being or his capacity to function at home or in the community. The dog was not translating into clinically meaningful improvement. He made the following observation about assistance dogs, and appeared to apply this generalisation to Mr  Brideson  in particular:
There’s certain lifestyle benefits, but no resolution of the illness, no serious amelioration of the symptomatology.
  1. Dr White disagreed, but even he conceded that Ted was not directly therapeutic to Mr  Brideson  but rather served to facilitate or assist the process of therapy which is already being implemented by Mr  Brideson . He did this, for example, by assisting Mr  Brideson  to navigate public places which he had previously been too anxious to enter. He considered that Mr  Brideson ’s well-being and functioning had improved since using Ted as an assistance dog, but conceded that other factors may account for much of this improvement.
  2. Both Dr White and Dr Saboisky noted the weakness in the published research regarding the therapeutic benefits of assistance dogs. Dr White describes the research findings as evenly balanced on the question of efficacy and a work in progress. The import of Dr Saboisky’s view was that the available research was often flawed, and at best hinted at, but did not prove, clinical benefit. Psychologist Keli Wainwright’s letter of 19 April 2019 gave a more enthusiastic overview of the therapeutic benefit of assistance dogs, but she did not give evidence. I prefer the more guarded view expressed by the psychiatrists.
  3. All of this militates against the view that Ted was medical treatment; he was, at best, an adjunct to such treatment. Even if I were to accept the view of Dr White that Ted had conferred some practical benefits in the management of Mr  Brideson ’s PTSD, it is by no means clear that those benefits have been conferred as medical treatment, as opposed to general benefits relating to well-being that accrue to many dog owners. The Tribunal takes official notice of the fact that many people derive comfort and fulfilment from their relationship with animals, dogs in particular. Such relationships can be of particular benefit to a person during periods of distress. Given the uncertain state of the clinical research on the therapeutic value of assistance dogs, real doubt must be entertained about whether the benefits to Mr  Brideson  from Ted rise any higher than those he would obtain from a dog which had not been designated or prepared as an assistance dog.
  4. It was submitted on Mr  Brideson ’s behalf that Ted:
...brings the applicant to the present time, acts as a distraction, alleviates anxiety when carrying out normal tasks, alerts the applicant’s family or help in advance, reduces anxiety levels at home and in public, motivates the applicant, comforts and assists the applicant and provides companionship.

Despite not hearing this description of Ted from Mr  Brideson  in person, the Tribunal has no reason to doubt these benefits. What the Tribunal does doubt is that these benefits constitute medical treatment. As Finn J noted in Watson, some procedures can confer beneficial effects without satisfying the test of medical treatment.

  1. The test to be applied here is not simply how Mr  Brideson  perceives the benefits derived from Ted. As Gray J said in Jorgensen and Commonwealth [1990] AATA 129; (1990) 23 ALD 321:
In my view, the question of reasonableness in the circumstances is intended to raise issues as to whether some kind of medical treatment other than that undertaken, or in some cases no medical treatment at all, would have been better for a person suffering from the particular injury. The idea of reasonableness involves objectivity. A reference to the circumstances raises subjective factors, but they are intended to be subjective factors related to the nature of the injury, and not to details of the personal life of an applicant for compensation.
  1. Nor is it necessarily sufficient, in the Tribunal’s view, if Mr  Brideson  can demonstrate that Ted actually relieves the symptoms of Mr  Brideson ’s psychiatric condition. As Dr Saboisky pithily observed, some patients can obtain relief from their symptoms from surfing, or travelling, or consuming two bottles of whisky. That such forms of relief will not in all likelihood constitute medical treatment would seem to be ensured by the Act requiring the intervention of clinical judgement (under the supervision of/at the direction of a medical practitioner) before treatment acquires that status.
  2. The ACT submitted that Ted had not been trained to alleviate the effects or symptoms of his accepted PTSD condition; no dog, it was submitted, could be trained in this way. Ted had been given obedience training designed, said the Territory, to make sure the dog behaves itself in public. Any alleviation of the effects or symptoms of the condition which might occur was the product of Ted being there, and of Mr  Brideson  having a special relationship with him. This was not, it was submitted, medical treatment.
  3. The extent to which a dog could be trained to alleviate the symptoms of a psychiatric condition is a matter left in some doubt. Dr White could not describe how Ted’s training had led him to be able to alleviate the symptoms of Mr  Brideson ’s condition, but assumed that he had been. The tendered information from mindDog about the capabilities of psychiatric service dogs gave little information about how training produced the postulated capabilities, for example barking when a handler is in a flashback or a fugue state. On the other hand, Dr Ayerbe, while generally doubtful about the claims made about service dogs, conceded that – theoretically at least – training might enhance certain innate abilities of dogs. For example, he suggested that a dog’s ability to smell what was thought by some to be a chemical or odour given off by humans when nervous might have the skill “enhanced” by some form of positive reinforcement training.
  4. At one point in the hearing it was suggested on Mr  Brideson ’s behalf that Ted could be treated as a trained assistance animal because he had been accredited by an animal training organisation (that is, mindDog) prescribed by the regulations under the Disability Discrimination Act 1992. Section 9 of that Act provides for an animal training organisation to be so prescribed. However, the argument was not pressed, in part, as I understand it, because no evidence was available that mindDog had been so prescribed under the regulations.
  5. In Ondrich v Kookaburra Park Eco-Village [2009] FMCA 260; (2009) 227 FLR 83 at [99]- [125], the Federal Magistrates Court considered the meaning of animal trained to assist [a] ... person to alleviate the effect of ... disability in s 9 of the Disability Discrimination Act. The Court noted at [111] the observations of the Full Federal Court in Queensland v Forest [2008] FCAFC 96; (2008) 168 FCR 532 at [106], where their Honours had observed:
...The question is whether (the dogs) had been trained to assist Mr Forest to alleviate effects of a disability. The question is not whether the dogs do in fact assist Mr Forest to alleviate effects of a disability but whether they were trained with that purpose or object in mind.
  1. The Court in Ondrich then found, at [121]-[124], that:
121. It may well be the fact that the presence of the dog had and has the effect of alleviating the applicant’s social anxiety and stress but that matter alone does not demonstrate the dog was trained to assist the applicant achieve that outcome. It is plain the presence of the dog alleviates the effect of the disability but otherwise the evidence does not demonstrate any nexus between the training it received and that outcome as an intended outcome from that training.
122. Other evidence was adduced by the applicant. It was not helpful. For instance her GP, Dr Scott Jenkins noted the benefits of companionship achieved by having the dog and of the dog’s significance to her psychological wellbeing. None of that is in doubt. However it does not address the issue. Indeed Dr Jenkins describes the association between the applicant and the dog as “a significant therapeutic relationship”. That is an apt description referring to the relationship between the applicant and the dog. However there is nothing remarkable about that fact. It is difficult to imagine how the circumstance of a natural canine/human relationship could be classified as training; not to mention training intended to assist an aggrieved person to alleviate the effect of a disability.
123. Likewise the evidence of Dr Cook was of no assistance on this point. He too focussed upon the remedial effect of the dog’s presence upon the plaintiff. He did not make any observations concerning the relationship between the skills the animal has been trained to perform and the alleviation of the effect of the applicant’s disability.
124. In summary while the dog Punta has undergone a form of training in the nature of obedience training I am not satisfied that the evidence demonstrates that there is any relationship between the training and the skills acquired from that training and the alleviation of the effect of the applicant’s disability.
(Footnote omitted.)
  1. The requirement in the Disability Discrimination Act for the training of an animal as a component in protecting the animal’s owner against discrimination has no equivalent in the Safety, Rehabilitation and Compensation Act. Putting aside the other barriers, already referred to, to a dog being considered medical treatment, the Tribunal is in some doubt that training should be considered a necessary ingredient in qualifying a dog as medical treatment. For something to be therapeutic it need not be processed, prepared or designed for that purpose. For example, maggots are sometimes used in the treatment of wounds or ulcers[5]; patently, maggots cannot be trained for that purpose.
  2. It would be unwise for the Tribunal to opine that a psychiatric assistance dog could never constitute medical treatment, but on the state of the evidence before it in the present proceedings the proposition is very doubtful. Of course, to find for an applicant, the Tribunal must draw some satisfaction from the sum of the evidence before it that an applicant’s claim meets the test of eligibility set out in the relevant legislation (see Beezley v Repatriation Commission [2015] FCAFC 165 at [68]); in the circumstances of this application, it is difficult to reach that level of satisfaction.

Is Ted is an aid or appliance pursuant to section 39?

  1. Mr  Brideson  submitted that Ted meets the requirements of s 39, in that he has suffered an injury resulting in an impairment; has completed a rehabilitation program; has incurred costs in relation to the use of Ted; and Ted is reasonably required by him, having regard to the nature of his impairment. The costs claimed include the cost of training Ted, his food, personal grooming and veterinary fees, and insurance premiums. A claim for desexing and vaccinations was not pressed on the basis that these things had occurred before Ted had been prepared for the role of an assistance dog.
  2. It was contended for Mr  Brideson  that Ted was an aid, not an appliance. Aid should be construed broadly and be taken to mean anything which is a source of help or assistance. Nothing in the Act indicates that a living thing cannot be an aid, it was argued.
  3. The Territory argued that both the rules of statutory interpretation and previous authorities on the meaning of aid or appliance militated against the view that an animal can be so regarded.
  4. In the Tribunal’s view, Mr  Brideson  correctly conceded that Ted could not be an appliance. The Oxford English Dictionary defines appliance to mean Something applied as a means to an end; a piece of apparatus.
  5. The same dictionary defines the noun aid to mean:
A means or source of help or assistance; anything used to assist in performing a task, esp. (in later use) a tool, device, or other object used in this way.
  1. The Territory referred to the text of s 39, and highlighted that the words aids or appliances appears accompanied by references to alterations to an employee’s place of residence or place of work and modifications of a vehicle or article used by the employee. It argued that application of the ejusdem generis rule suggests that the section is intended to refer to inanimate objects, which cannot by definition include a dog. In that respect reference was also made to the legislative history of s 39. Its predecessor, the Tribunal was told, was s 37 of the Compensation (Commonwealth Government Employees) Act 1971. In his second reading speech introducing the bill which became that Act, the minister made the following reference to what ultimately became s 37:
Payment up to a limit of $150 in any one case will be made in respect of the provision or modification of certain aids, appliances and equipment that are not included as medical treatment but are reasonably necessitated by an injury. In this category would come the provision of access ramps in the home of an employee confined to a wheel chair, safety internal or external hand rails or grips in bathroom, toilet, kitchen or bedroom, alterations of taps, catches, handles, door openings and fittings.

Similarly, the Explanatory Memorandum to the bill referred to the same clause in the following way:

A new provision in sub-clause (3) provides for payment of up to $150 in respect of the cost of an alteration to a building occupied, or a vehicle or article used, by the employee or of obtaining or repairing an aid or appliance reasonably required as a result of an injury. This provision relates to aids and appliances other than artificial limbs and aids, etc., that come within the definition of medical treatment [elsewhere]. It is intended to cover items such as the provision of a ramp (to facilitate the use of a wheel chair, that would be provided as medical treatment), an alteration to a doorway, tap, handle or light fitting, etc., or the provision of safety rails or grips, etc.
  1. By virtue of the ejusdem generis rule, again, the references to inanimate objects in the minister’s speech and the Explanatory Memorandum suggest that only such objects are intended to be included within the scope of the provision. It was submitted that the present s 39 carries forward the intent behind its predecessor provision, which is that aids and appliances are inanimate objects, and do not include animals.
  2. It appears to the Tribunal that there is some weight behind this submission. The inclusion of an assistance dog in the category aids or appliances would not seem to be consistent with either the common understanding of those terms or with the intention of Parliament, as discerned from the minister’s second reading speech and the Explanatory Memorandum.
  3. The object of s 39 and the nature of its relationship with the evidence outlined above strongly guard against a conclusion that animals fall within the ambit of the provision. The object of s 39 is to provide for compensation to be payable in respect of an injury for alterations, modifications or aids or appliances. As stated above, s 39 only makes express provision for inanimate objects. In order to accept the construction which Mr  Brideson  advances as finding that animals can be an aid, it would need to be shown on the balance of probabilities that a psychiatric assistance dog is a means or source of help or assistance. The Tribunal outlined above how an uncertain and vague evidential basis has been put forward in this case to determine the extent to which dogs may aid people with psychiatric conditions such as PTSD. Given this, it is difficult to see how Parliament could have intended animals to fall within the ambit of s 39.
  4. Mr  Brideson ’s submission regarding s 39 runs into a further difficulty. Even if it were assumed that an assistance dog could be an aid or appliance, an injured employee is only entitled in s 39(1) to recompense for the cost of:
(e) any aids or appliances for the use of the employee, or the repair or replacement of such aids or appliances;
(emphasis added)
  1. No reference is made to an employee being entitled to the cost of maintaining or sustaining an aid or appliance, suggesting that Parliament intended that an employee should recover the “capital cost” of an item or its replacement, but not its “running costs”. The Tribunal notes that Mr  Brideson ’s claim is not for the cost of acquiring Ted but for sustaining him – special food, veterinary fees, grooming, etc. Even if Ted were considered an aid, none of the costs related to his care or upkeep would be recoverable, on this view of the subsection. The better view, however, is that the subsection does not contemplate the inclusion of animals as aids or appliances, since it makes no provision for their care and upkeep.
  2. While the Tribunal’s attention was not drawn to any previous decisions relating to assistance animals in the context of s 39, its inclination referred to above about the section’s scope is buttressed by the comments of Senior Member McCabe (as he then was) in WBJM and Comcare [2015] AATA 143. That case concerned whether insurance premiums for a Segway could be considered medical treatment or an aid or appliance.
11. ... I am satisfied the Segway used by the applicant is not part of a course of medical treatment. It is not intended to make him better: it does not perform any therapeutic or curative purpose. The device is intended to help him cope with the incapacity occasioned by his work-related health condition, not provide a remedy for the condition itself. It is a classic example of an aid – in the applicant’s case, an aid to mobility – within the meaning of s 39(1)(e)...
14. That brings me back to s 39(1)(e). Comcare says an insurance policy is not itself an “aid or appliance...required by the employee” within the meaning of the legislation. That is true, as far as it goes. An insurance policy is a chose in action – a contractual right against an insurer to provide cover against identified risks. It is not the sort of thing that plays the sort of role contemplated by the expression “aid or appliance”.
15. It only makes sense to talk of insurance in this context on the basis that insurance necessarily forms part of the aid or appliance required by the incapacitated employee – that is, a part of the Segway itself. That argument might be attractive if the user of a Segway were legally obliged to hold insurance in the way that he or she is obliged to wear a safety helmet. (Recall Comcare paid for the applicant’s safety helmet even though a safety helmet is not an “aid or appliance...required by the employee” except in connection with his use of the Segway.) But there are still questions in that event. Comcare argues s 39(1)(e) does not explicitly authorise Comcare to expend money on the operating costs of aids or appliances. The applicant did not suggest Comcare should pay for the electricity used to recharge the Segway’s batteries, for example. Mr Dubé, for Comcare, suggests the sub-section focuses on Comcare’s obligation to pay for the costs of acquiring and repairing and replacing the apparatus, not operating costs.
16. The legislation does not, on its face, distinguish between the costs of operating the device and the cost of its acquisition. That distinction can probably be inferred from the fact the sub-section specifically refers to the expense of replacing or repairing the item as an example of such a cost. That reference arguably lends colour to – and limits – the word costs. The costs in question are essentially what taxpayers would refer to as capital expenses. If the legislation were intended to cover operating costs as well, Parliament would have added language like “costs incurred in the operation of...” the device.
17. As it happens, I do not need to decide whether the cost of compulsory insurance would be considered an integral part of the aid or appliance so that it might be covered under s 39(1)(e). The insurance in this case was an optional extra. It certainly does not form an integral part of the aid or apparatus...
19. The SRC Act was introduced before devices like Segways were invented. The SRC Act does not make express provision for insurance costs to be covered by Comcare under s 39. Perhaps Parliament should have done so; but that does not help the applicant in the present case under the law as it stands.
(Emphasis added)
  1. Although it determined that insurance costs were not covered under s 39 because they were not compulsory – and thus, possibly, not an integral part of the aid – the Tribunal there should be interpreted as casting serious doubt on the proposition that operating costs of an aid or appliance are compensable under that provision. The Tribunal here is similarly not persuaded that they are compensable.
  2. Accordingly, I find that Ted is neither an aid nor an appliance. Even if he were, the Act does not make provision for the costs of his care and upkeep to be recoverable by Mr  Brideson . And even if they were recoverable under s 39 in principle, I do not consider that they could be recovered in this case because Mr  Brideson  does not meet the other test in subsection (1), which is that the aid or appliance is reasonably required by the employee. This test is similar to the test in s 16, namely that medical treatment should be reasonable for the employee to obtain. For the reasons that the Tribunal has found that Ted was not reasonable for Mr  Brideson  to obtain for the purposes of medical treatment, Ted is not reasonably required as an aid either. In each instance, the lack of demonstrated efficacy of a psychiatric assistance dog must count against Mr  Brideson ’s claim. The evidence before the Tribunal is, relevantly, that Ted assists Mr  Brideson  in social contexts and offers certain lifestyle benefits. The second limb of s 39 requires that the aid be reasonably required by the employee, having regard to the nature of the employee’s impairment. The Tribunal prefers the evidence of Dr Sabiosky in determining that question; there is no evidence of any serious amelioration of Mr  Brideson ’s symptomatology nor does Mr  Brideson  have a distinguishable benefit beyond the relationship that most dog owners enjoy.
  3. This proposition is not affected by the reflection that the test is slightly different in s 39 to the test in s 16; in the former, the test is whether the aid is reasonably required having regard to the nature of the employee’s impairment. In my view, it is unlikely that an assistance dog which cannot meet the test of medical treatment can somehow still serve to minimise or relieve the effects of Mr  Brideson ’s impairment arising from the PTSD.

CONCLUSION

  1. It may seem strange that the Parliament has not seen fit to make provision, in the parts of this Act dealing with the treatment, support and rehabilitation of injured workers, for assistance animals. Notwithstanding the conclusions the Tribunal has reached here with respect to psychiatric assistance dogs, it should not be doubted that animals can and do play a relevant role in that context – a seeing-eye dog for a blinded employee is an obvious example. If, say, further research in the future polarises around the view that psychiatric assistance dogs do assist psychiatrically ill people to overcome the effects of their condition, and my interpretation of the Act as it now stands is correct, there would be an obvious lacuna in the Act’s scope.
  2. To make the observation, however, does not overcome what must be the firm conclusion of the Tribunal that Parliament has not intended to offer injured workers compensation for the costs of assistance animals. To adopt the words of Senior Member McCabe, perhaps Parliament should have done so, but noting that omission is not a licence for the Tribunal to change the intent of the law.
  3. Accordingly, the reviewable decision dated 24 November 2016 is affirmed.

I certify that the preceding 74 (seventy-four) paragraphs are a true copy of the reasons for the decision herein of Deputy President Gary Humphries AO.

........................................................................
Associate

Dated: 31 July 2019

Date(s) of hearing: 29 October 2018; 4-5 June 2019

Counsel for the Mr  Brideson : Mr Wayne Sharwood

Solicitors for Mr  Brideson : Ken Cush & Associates
Counsel for the Australian Capital Territory: Mr Peter Woulfe
Solicitors for the Australian Capital Territory: Australian Government Solicitor

[1] (Psychiatric) assistance dog, service dog and mind dog are used interchangeably in this decision.

[2] In this decision, italicised text is generally used to indicate direct quotations.

[3] He referred specifically to Marguerite O'Haire and Kerri Rodriguez, ‘Preliminary Efficacy of Service Dogs as a Complimentary Treatment for Posttraumatic Stress Disorder in Military Members and Veterans’ (2018) 86(2) Journal of Consulting and Clinical Psychology, pp 179-188, which was tendered.

[4] The Tribunal was informed that assistance dogs had not been prescribed as a form of medical treatment pursuant to paragraph (i) (any other form of treatment that is prescribed...)

[5] Dr Gwendolyn Cazander et al, “Maggot excretions affect the human complement system” 20(6) Wound Repair and Regeneration – the International Journal of Tissue Repair and Regeneration (November-December 2012); Dr Ronald Sherman, “Maggot Therapy for Treating Diabetic Foot Ulcers Unresponsive to Conventional Therapy” (2003) 26(2) Diabetes Care – American Diabetes Association.

AustLII: Copyright Policy | Disclaimers | Privacy Policy | Feedback
URL: http://www.austlii.edu.au/au/cases/cth/AATA/2019/2314.html