[2006] UKSSCSC CAF_3326_2005 (03 October 2006)
DECISION OF THE PENSIONS APPEAL COMMISSIONER
The factual background
"I am having increased problems with my back which has lead to problems with my right hip. I have had xrays on my hips. The lumbosacral spine shows early degeneration of lumbosacral facet joints. I am now limited in how long I am able to stand. My hip is a consequential disability from my accepted condition."
The appeal to the PAT
The appeal to the Commissioner
"The Appellant's claim has been rejected under the label `Soft Tissue Injury Low Back (Post Service)'; the Tribunal upheld this rejection and dismissed this part of the Appeal. [The claimant] `does not dispute the decision' (see letter 15/8/05). However, this part of the Appellant's claim had originally been made for `hip problems' as a consequence of the accepted condition of Service Back Injury (1964-74). The issue was canvassed at our Appeal hearing as to whether this was in reality an assessment issue arising from the accepted injury, or a new entitlement claim. This would have required a change of `label' by us. In the event we found the existing label was appropriate (see paragraph 5 of our Decision).It is at least arguable that this finding is open to challenge."
"a. There was a dispute between the parties as to whether the Appellant's condition was appropriately described by the label used by the Secretary of State, or whether the label `hip problem' should have been substituted. The Pensions Appeal Tribunal adopted the label given by the Secretary of State, but gave no reasons for this in the decision given.b. The Pensions Appeal Tribunal failed to give adequate reasons to explain its decision that the Appellant's post service soft tissue injury was not attributable to the Appellant's military service."
Did the PAT of 8 June 2005 err in law?
(a) Decisions of the nominated judges
"the doctrine of stare decisis [ie that a legal principle necessary to the decision in a case must be applied in later cases by a court at the same level] does not apply in its full rigour to this branch of the law. The decisions of the Superior Courts (The High Court in England, the Court of Session in Scotland and the Supreme Court in Northern Ireland) are binding on the Pensions Appeal Tribunals. They are not absolutely binding on the Superior Court itself or on the courts of co-ordinate jurisdiction but will be followed in the absence of strong reason to the contrary."
"[A] single Commissioner follows a decision of a Tribunal of Commissioners unless there are compelling reasons why he should not, as, for instance, a decision of superior Courts affecting the legal principles involved. A single Commissioner in the interests of comity and to secure certainty and avoid confusion on questions of legal principle normally follows the decisions of other single Commissioners (see Decisions R(G) 3/62 and R(I) 23/63). It is recognised that a slavish adherence to this could lead to the perpetuation of error and he is not bound to do so."
There is practical guidance in Chief Commissioner's Practice Memorandum No 2 (31 December 2004). For the avoidance of any possible doubt, decisions of the nominated judges remain binding on PATs, as will be decisions of the Pensions Appeal Commissioners.
(b) The overall structure of entitlement under the Service Pensions Order
"(1) Where, after the expiration of the period of 7 years beginning with the termination of the service of a member of the armed forces, a claim is made in respect of a disablement of that member, or in respect of the death of that member (being a death occurring after the expiration of the said period), such disablement or death, as the case may be, shall be accepted as due to service for the purposes of this Order provided it is certified that--(a) the disablement is due to an injury which--
(i) is attributable to service after 2nd September 1939; or
(ii) existed before or arose during such service and has been and remains aggravated thereby; or
(b) the death was due to or substantially hastened by--
(i) an injury which was attributable to service; or
(ii) the aggravation by service of an injury which existed before or arose during service.
(4) Where, upon reliable evidence, a reasonable doubt exists whether the conditions set out in paragraph (1) are fulfilled, the benefit of that reasonable doubt shall be given to the claimant."
Article 3 makes it a condition of any award under the Service Pensions Order that the disablement or death was due to service (now confined to service before 6 April 2005).
"Physical or mental injury or damage, or loss of physical or mental capacity"
Injury is defined to include "wound or disease".
"(1) Where any claim in respect of the disablement of any person made under any such Royal Warrant, Order in Council or Order of His Majesty as is administered by the Minister or under a scheme made under section 1 of the Polish Resettlement Act 1947 is rejected by the Minister on the ground that the injury on which the claim is based--(a) is not attributable to any relevant service; and
(b) does not fulfil the following conditions, namely, that it existed before or arose during any relevant service and has been and remains aggravated thereby;
the Minister shall notify the claimant of his decision, specifying that it is made on that ground, and thereupon an appeal shall lie to a Pensions Appeal Tribunal constituted under this Act (hereafter in this Act referred to as "the Tribunal") on the issue whether the claim was rightly rejected on that ground."
Section 5(1) and (2) provides:
"(1) Where, in the case of any such claim as is referred to in section one, section two or section three of this Act in respect of the disablement of any person, the Minister makes an interim assessment of the degree of the disablement, he shall notify the claimant thereof and an appeal shall lie to the Tribunal from the interim assessment and from any subsequent interim assessment, and the Tribunal on any such appeal may uphold the Minister's assessment or may alter the assessment in one or both of the following ways, namely--(a) by increasing or reducing the degree of disablement it specifies; and
(b) by reducing the period or which the assessment is to be in force.
In this section the expression "interim assessment" means any assessment other than such a final assessment as is referred to in the next following subsection.
(2) Where, in the case of any such claim as is referred to in section one, section two or section three of this Act in respect of the disablement of any person, it appears to the Minister that the circumstances of the case permit a final settlement of the question to what extent, if any, the said person is disabled, and accordingly--
(a) he decides that there is no disablement or that the disablement has come to an end or, in the case of any such claim as is referred to in section three of this Act, that the disablement is not or is no longer serious and prolonged; or
(b) he makes a final assessment of the degree or nature of the disablement;
he shall notify the claimant of the decision or assessment, stating that it is a final one, and thereupon an appeal shall lie to the Tribunal on the following issues, namely--
(i) whether the circumstances of the case permit of a final settlement of the question aforesaid;
(ii) whether the Minister's decision referred to in paragraph (a) hereof or, as the case may be, the final assessment of the degree or nature of the disablement was right;
and the Tribunal on any such appeal may set aside the said decision or assessment on the ground that the circumstances do not permit of such a final settlement, or may uphold that decision or assessment, or may make such final assessment of the degree or nature of the disablement as they think proper, which may be higher or lower than the Minister's assessment, if any, and if the Tribunal so set aside the Minister's decision or assessment they may, if they think fit, make such interim assessment of the degree or nature of the disablement, to be in force until such date not later than two years after the making of the Tribunal's assessment, as they think proper."
"These matters [service and disablement], if established on a balance of probabilities, shift the onus of proof in connection with attribution or causation to the Secretary of State. Since disablement is defined as `physical or mental injury or damage, or loss of physical or mental capacity' and `injury includes wound or disease', a claimant must establish an `injury'. Section 1(1) of the 1943 Act refers to this as the `injury upon which the claim is based'. Put another way it is for the claimant to establish the injurious process upon which he bases his claim. Once he has done so the issue of attribution or causation will fall to be decided in connection with the injurious process upon which he founds his claim."
For the reasons sketched in above, I am not at all sure that the inclusion of "injury" in the definition of disablement is in itself enough to require the claimant to establish the injurious process, and the causative link to disablement, on the balance of probabilities rather than by merely showing that a reasonable doubt exists in his favour. However, in paragraphs 30, 38 and 78, Newman J traced those propositions back to the famous decision of Denning J in Royston v Minister of Pensions [1948] 1 All ER 778, 3 War Pension Appeal Reports 1593.
"considered that there was onus on the applicant as regards showing that there was some injury and resulting disablement and that it was only then for the Minister to show same was not due to or aggravated by war service. The Tribunal was not satisfied with the applicant's evidence as regards the injury and disablement alleged."
Denning J said this:
"The question on which I give leave to appeal is, whether the Tribunal were right in holding that there was an onus on her to show some disablement. I am quite satisfied that there is an onus on a claimant to show a disablement. Once she shows a disablement, there is afterwards no onus on her to prove the fulfilment of the conditions under Article 4 of the Warrant, and the benefit of any reasonable doubt has got to be given to her. That is provided by Sub-section 2 of Article 4; but Sub-section 2 does not come into play until she first shows a disablement, and `disablement' is defined as `a physical or mental injury or damage or loss of physical or mental capacity'. I think the Tribunal were quite right in saying that the onus of proving a disablement was upon her and they were quite satisfied that she had not discharged that onus. Indeed, they were satisfied that there was no injury at all as she alleged. In these circumstances, the appeal is dismissed."
(c) Did the PAT err in law by failing to explain why the appeal failed in relation to soft tissue injury low back (post-service)?
(d) Did the PAT err in law by failing to explain why it did not deal with the claim in relation to hip problems?
(e) Are the appeals to be heard by a new PAT entitlement appeals or assessment appeals?
(f) What does the claimant have to prove in the two appeals to be heard by the new PAT?
Conclusion
(Signed) J Mesher
Commissioner
Date: 3 October 2006