ADMINISTRATIVE APPEALS CHAMBER
On appeal from First-tier Tribunal (War Pensions and Armed Forces Compensation Chamber)
B e f o r e :
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MA |
Appellant |
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The Secretary of State for Defence |
Respondent |
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Scarlett Milligan and Chiara Cordone, both of counsel, instructed by Kara Young of GLD for the respondent
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Crown Copyright ©
The decision of the Upper Tribunal is to dismiss the appeal.
Introduction
Reasons for decision in summary
The FTT's decision
Events after the FTT's decision
"1. I give permission to appeal because it is arguable with a realistic prospect of success that the First-tier Tribunal erred materially in law in coming to its decision of 16 September 2022, for the reasons set out in the ground of appeal. In addition, the correct legal construction of article 47(1) of the 2011 Order merits further consideration by the Upper Tribunal, and a definitive ruling by the Upper Tribunal on its construction might be welcomed.
2. If the ground of appeal relying on the construction of article 47(1) adopted by the [other] First-tier Tribunal…is correct, it would appear from [the FTT's] view when refusing permission to appeal that the [FTT in this appeal] may have directed itself incorrectly that article 47(1)(a) and (d) were not mutually exclusive. As a result, [and] in any event, it is arguable the First-tier Tribunal failed to consider whether on the evidence before it [the appellant's] neck and back pain was (instead) an 'illness' under article 47(1)."
"2. The Secretary of State's submission does not address the legal issue about the correct construction of article 47(1) of the 2011 Order. He argues, instead, that the appeal should be withdrawn, struck out or dismissed as it has become academic. The appeal is said to be academic because the Secretary of State has, subsequent to the First-tier Tribunal's decision, made an award to [the appellant] under the 2011 Order for the claimed condition of back and neck pain. It is argued, therefore, that any success [the appellant] may have on this appeal could not lead to any more beneficial result for him and so, in that sense, the appeal is academic. It is also pointed out that the latest quinquennial review has recommended that all time limits (such as in article 47(1)) should be removed. It appears to be suggested by the Secretary of State that it is by this means that any future issues of principle concerning time limits should be addressed.
3. The appellant does not consent to his appeal being withdrawn. Only he can do so: see rule 17 of the Tribunal Procedure (Upper Tribunal) Rules 2008 ("the UT Rules"). (Nor is it apparent on what basis this appeal could be struck out under rule 8 of the UT Rules.) The appellant argues that the appeal is not academic because the Upper Tribunal can still give a binding decision on the correct construction of rule 47(1). Moreover, that binding decision is likely to affect other current cases more readily than any future response to the quinquennial review's recommendations. He also seeks an oral hearing of the appeal.
4. At present I incline more to the appellant's case on this issue than that of the Secretary of State, and at least sufficiently to direct an oral of the appeal to hear argument both on the 'academic' nature of this appeal and on the correct construction of article 47(1) of the 2011 Order.
5. It is trite law that not all academic appeals should be dismissed: see R v Secretary of State for the Home Department ex parte Salem [1991] AC 491 (HL), and paragraph [20] of VS and RS v Hampshire CC [2021] UKUT 187 (AAC), and see further paragraphs [8]-[16] of DD v Sussex Partnership NHS Foundation Trust and Secretary of State for Justice, MIND intervening [2022] UKUT 166 (AAC). I am inclined at present to the view that the Upper Tribunal ruling on the correct construction of article 47(1), on which the specialist First-tier Tribunal Chamber has disagreed, and in a context where no other case is yet at Upper Tribunal appellate level on this issue and where both parties are represented, is an appropriate use of the Upper Tribunal's jurisdiction even where the point in issue may no longer have any practical effect for [the appellant]
6. On this very last point, however, I feel I should indicate my concern as to the proper lawful basis for the Secretary of State making an award under the 2011 Order to [the appellant] for the claimed condition of back pain in circumstances where, at present and as between the parties, the First-tier Tribunal's decision is very arguably to the effect that there was no in-time (and thus lawful) claim by [the appellant] for that condition. What as a matter of law allows the Secretary of State to ignore or reconsider the First-tier Tribunal's decision in [the appellant's case]? In other benefit schemes in the UK the law provides (limited) grounds on which a First-tier Tribunal's decision may be altered by the Secretary of State even though he is a party to the independent tribunal's decision and otherwise bound by it: see for example sections 10 and 17 of the Social Security Act 1998 and the regulations on 'supersession' made under that Act. What are the provisions in play in this case that allowed the Secretary of State to make the award under the 2011 Order to [the appellant] for the claimed condition of back and neck pain notwithstanding the First-tier Tribunal's decision that [the appellant] had not made a lawful (i.e. in-time) claim under the 2011 Order for that condition? These considerations may be relevant to whether the appeal is academic.
7. I therefore grant the appellant's request for an oral hearing of this appeal."
"36. The Upper Tribunal has identified that the correct construction of Article 47(1) of the 2011 Order is a point on law which could be determined as a result of the appeal being heard, notwithstanding its academic nature. However, in the Secretary of State's submission, the question which the Upper Tribunal is considering answering in the abstract is necessarily fact-dependent and specific, and is incapable of reduction to a simple legal definition or test. In those circumstances, this case does not fit the criteria set out in cases such as Salem.
37. Moreover, the Upper Tribunal is encouraged to proceed with caution in circumstances where attempting to provide further guidance and direction on this question may, in fact, only serve to confuse or misstate the law in the absence of fully argued reasoning by reference to the high number of factual permutations which could arise on any consideration of the 2011 Order.
38. An objective reading of the terms "injury", "illness" and "disorder" as used in the 2011 Order shows that the terms were not intended to be used in a mutually exclusive way. Such an approach is contraindicated by: (i) the very definition of the terms within the 2011 Order, (ii) the preceding text in Article 47(1), namely "whichever is the earlier of the following days", and (iii) the tariff tables within Schedule 3 of the 2011 Order in this case, which refer varyingly to "disorder", "injury", and "syndrome" even within tables which are labelled as pertaining to a "disorder".
39. Further, such a highly technical approach to the legislation would undermine the attempts to make the AFCS simple and accessible for all members without legal representation, and indeed for the lay administrators of AFCS. A finding that these terms were mutually exclusive would require, on every case, a medical expert to opine on whether the symptoms amounted to an injury or illness. That position would be further complicated where an injury may have led to an illness, or vice versa.
40. The plain and objective meaning of those terms, combined with the purpose of the 2011 Order, should also inform the Upper Tribunal's consideration of Article 47(1). As set out above, in providing for four different formulae for when time may start to run for the purposes of bringing an AFCS claim, Article 47 – much like the relevant provisions of the Limitation Act 1980, albeit simplified – ensures that provision is made in order to "remedy the injustice of a claimant's claim being time-barred before they knew, or could reasonably be expected to know, that they had a claim".
41. The function of Article 47(1)(d) is best illuminated by reference to facts. By way of two brief examples only, a claimant under the AFCS could:
a. sustain a minor impact injury to their abdomen in a collision for which they do not intend to make a claim, but in two years' time seek medical attention for painful abdominal symptoms, only to learn that the traumatic impact has given rise to a form of organ disease or failure;
b. injure a limb while deployed abroad, necessitating the lower half of the limb to be amputated. At some later date, the claimant could seek medical attention for painful symptoms, only to be told that infection has taken root and that the remainder of the limb will need to be amputated. Alternatively, the claimant could develop a psychiatric condition as a result of the difficulties experienced in adjusting to life without a limb.
42. Those are but two examples of a number of factual permutations in which Article 47(1)(d) has real purpose and relevance. The examples are necessarily complicated when considering the relevance of pre-existing injuries and illnesses, and the question of whether or not predominant causation, or a worsening, is made out.
43. To summarise, the fact that injuries and illness may overlap (whether in a singular condition or across multiple conditions) does not, of itself, render Article 47(1)(d) otiose. However, the application of Article 47(1)(d) as compared to the other sub-paragraphs of that Article will necessarily turn on the facts and medicine of each case, including whether or not on the facts of the case there is an illness as distinct from an injury, and whether or not it is appropriate to treat time as running from the injury or the subsequent illness. The sheer number of factual permutations and the interactions between medical conditions make this a question that cannot be resolved by high level guidance, beyond the need to consider the application of Article 47(1) on the particular facts of each case."
Relevant law
""illness" means a physical or mental disorder included either in the International Statistical Classification of Diseases and Related Health Problems or in the Diagnostic and Statistical Manual of Mental Disorders ;
"injury" includes illness except in relation to determining eligibility for a fast payment in article 27(1)(a);
"47.—(1) Subject to articles 48 and 49, the time specified for making a claim for injury benefit is 7 years beginning with whichever is the earlier of the following days—
(a) the day on which the injury occurs;
(b) the day an injury which is not caused by service is made worse by service;
(c) the day on which the member's service ends;
(d) the day a member first seeks medical advice in relation to an illness.
(2) Paragraph (1)(d) applies only if the claim is in respect of an illness.
(3) The time for making a claim for injury benefit is extended by 3 years from the date of diagnosis where—
(a) an illness first presents within the period specified in paragraph (1); but
(b) the diagnosis of the illness is not made until less than 1 year before the end of that period…."
"48.—(1) Article 47 does not apply where—
(a) a claim for injury benefit is made by a former member for a late onset illness and the illness has been diagnosed by an accredited medical specialist;
(b) the death of a former member—
(i) is caused by a late onset illness; or
(ii) occurs in circumstances specified in article 10(3)(c)(ii).
(2) Where paragraph (1) applies, the time specified for making a claim is 3 years beginning with the day the late onset illness was first diagnosed, or the date of death, as the case may be."
"Finality of decisions
54.—(1) Where the Secretary of State has made a final decision awarding benefit, there is to be no review of that decision except in the circumstances specified in articles 55, 56, 57, 58 and 59.
(2) Where the Secretary of State has made a final decision which makes no award of benefit, there is to be no review of that decision except in the circumstances specified in article 59.
(3) In this article, and subject to paragraph (4), a final decision is—
(a) a decision under article 51;
(b) a decision making a final award under article 52;
(c) a decision revised by the Secretary of State under article 55, 56, 57, 58 or 59;
(d) a decision made under article 55, 56, 57 or 59 which maintains the decision under review;
(e) a decision revised by the Secretary of State following a reconsideration under article 53; or
(f) a new decision which maintains the original decision following a reconsideration under article 53.
(4) The decisions referred to in sub-paragraphs (a) to (d) are final decisions where there has been no application for reconsideration under article 53, or the time for such an application has expired."
"Review - ignorance or mistake
59.—(1) Subject to paragraph (2), any decision of the Secretary of State may be reviewed at any time (including on the application of the claimant) if the Secretary of State is satisfied that the decision was given in ignorance of, or was based on, a mistake as to a material fact or of a mistake as to the law.
(2) This article only applies—
(a) if the material fact was knowable at the time the decision was made and was disclosed to the Secretary of State at that time;
(b) if the ignorance or mistake was the ignorance or mistake of the Secretary of State;
(c) where the ignorance or mistake relates to the diagnosis of an injury, where the correct diagnosis was knowable given the state of medical knowledge existing at the time the diagnosis was made.
(3) On a review under this article, the Secretary of State may—
(a) make a new decision which maintains the decision under review ("the original decision"); or
(b) revise that decision by—
(i) awarding benefit where no award of benefit was made in the original decision;
(ii) changing the descriptor awarded so as to maintain, increase or decrease the amount awarded in the original decision;
(iii) increasing or decreasing the amount awarded in the original decision or so as to cancel an award of benefit;
(iv) changing the date on which an award of benefit becomes payable.
(4) The decision of the Secretary of State on a review under this article and the reasons for the decision must—
(a) be in writing;
(b) be given or sent to the claimant; and
(c) inform the applicant of any right the claimant may have—
(i) to a reconsideration of the decision under article 53; and
(ii) to appeal to the appropriate tribunal under section 5A(1) of the Pensions Appeal Tribunals Act 1943."
Discussion and conclusion
Approved for issue by Stewart Wright
Judge of the Upper Tribunal
On 18 April 2024