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War Service Disabilities - Assessment of - Report of Royal Commission, dated 22nd December, 1924


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1925.

THE PARLIAMENT OF THE COUMON,VEALTH OF AUSTRALIA.

OF THE

ROYAL COMMISSION

ON TBli:

ASSESSMENT OF WAR SERVICE DISABILITIES.

22ND DECEMBER, 1924.

Pre3ented by Command; ordered to be printed, lOth June, 1925.

[CQit oj Papet' :-Preparation, not &iven; 930 copies; approximate cost of printing and publishing, £7.]

Printed and for the GOVERNMENT of the COMMONWEALTH of AUSTRALIA by H. J. GREBN, Government Printer for the State of Victoria.. No. 5.-F.750.-PRICE 3n.

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ROYAL COMMISSION ON rrHE ASSESSMENT OF

WAR SERVICE DISABILITIES.

0

Melbourne, 22nd December, 1924.

1. To His Excellency the Right Honorable HENRY WILLIAM BARON FoRSTER, a Member of His Maiesty's Most Honorable Privy Cmtncil, Knight Grand Cross of the Most Distinguished Order of- Saint Michael and Saint George, and

of the Commonwealth of Australia.

MAY IT PLEASE YouR ExcELLENCY :

We, your Commissioners appointed by Letters Patent dated the 27th August, 1924, inquire into and report upon matters relating to the administration of the Australian Soldiers' Repatriation Act, have the honour to make our report in accordance with the following terms of reference :- . ·

" Is the .present method of 'determining whether an disability is due to or aggravated by war service adequate to decide the origin or the degree to which it is aggrav.ated, and what portion of his present incapacity can be regarded as having resulted from his war service?" -2. ThiS Report is the .result of investigations made in Melbourne.

3. It was decided at the. outset that the inquiries should be made in public, and was · the case throughout the proceedings, except where documentary e;vidence was examined. The documentary evidence i.nclgded the· numerous files referred to by witnesses and those asked for by your. Commissioners. Great care was taken in comparing the statements made in evidence with those recorded in all the departmental files, and in .each instance, all the files relating to the case were available.

4. It 'was felt that useful evidence of the practical working of the present method might be obtained from the various organizations which have been formed amongst different groups of returned soldiers since the war, and accordingly officials from each of these bodies were invited to attend and give evidence. ·

5. The Federal bodies represented were-The Returned Sailors and Soldiers' Imperial League of Australia (represented by the General Secretary). The Tubercular Sailors and Soldiers' Association of Australia (represented by the

Federal President). ·

6. The Honorary Secretary of the Commonwealth Council of the Limbless and Maimed Soldiers' Association was invited to attend, and he was represented by the Secretary of the Victorian Association, who communicated with the associations in other States before attending.

7. As. in the case of some associations there is no federal body, the representatives of the Victorian associations were.invited to appear, and opportunity was taken by-The Blinded Soldiers' Association (represented by the President). The Soldiers' Association (repres.en:ted by the Secretary).

The Returned Nurses' Association (represented by Miss Grace Wilson, R.R.C.). The Australian Imperial League of Sailors and Soldiers' Womenfolk (represented by the President). The Sailors and Soldiers' Fathers Association (represented by the President).

The nature of these ·bodies is such that a large field was covered.

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8. With a view to assisting the organizations concerned to follow the evidence, typewritten copies were supplied to them from day to . day without expense.

9. It is felt that the evidence which these organizations could, and did, bring before the Commission, was sufficiently illustrative of the administration of the Australian. Soldiers' Repatriation Act, and it was not thought necessary bring to Melbo.urne of the

various bodies from other States. Very valuable evidence was submitted by the Witnesses who appeared, and cases were cited from all parts of the Commonwealth. '

10. It was not the function ·of the Royal Commission to deal with personal cases, except insofar as they were illustrative of some particular phase of the administration, but several personal cases were considered as a result of representations by the soldier himself, or on his behalf.

11. It was unfortunate that the Commission, on occasion, was referred to in the press as the Appeal Board. This led to a misunderstanding in some quarters, particularly outside Victoria, it apparently being the impression that special appeals were being dealt with in that State.to the disadvantage of the other States.

12. After full and careful inquiry into all matters arising out of the reference, your Commissioners unanimously agree that, in the majority of cases, the present machinery for determining disability and assessing pensions is sufficient. There are, however, certain types of disabilities present in a small minority of ex-soldiers which are, for various reasons, inadequately determined. The inadequacy, to some extent, has been due to defects in the Australian Soldiers' Repatriation Act, e.g., sections 22 and 40. In some cases rulings made with the object of facilitating the grouping of cases have been· found in course of time to operate harshly in

exceptional cases, and some unavoidable delay has occurred in determining the suitable alterations or modifications required.

·13. The chief difficulty, however, has been met with in dealing with "those cases in which disabilities have manifested themselves at a much later period, after discharge, than had been anticipated by those who framed the Act, and by those interpreting its intentions. It was clearly the intention of Parliament when framing the Act to cover all disablement resulting from War Service;

14. This entails. the necessity for investigating the possible relationship to war service of illnesses appearing long after discharge. Delay is often unavoidable while efforts are being made to trace .and discover continuity tha:t will enable interpreting .the Act

to establish a relatiOnship between the illness under review and war serV!ce. In ce:rtam cases discontent has been" aroused by the applicants and their friends not appreciating the cause of the delay: ·

15. Your 9ommissioners are of opinion that the Repatriation Commission is greatly hampered. by the madequacy of the records as to the exact state of health of soldiers upon discharge from service. · ·

RECOMMENDATIONS.

. 16. due to all evidence which has been given before your Commissioners,

it has been unanrmously deCJded to recommend that- · ·

(a) An allowance in addition to the present pension be paid to blinded soldiers for an attendant ; .

(b) A pension in some degree be paid where tuberculosis has resulted from war service;

(c) In place of the e?'isting Form "K" a and more comprehensive

form be substituted and, as occasiOn offers, each pensiOner be examined and the recorded the new form. Such examinations should be repeated

periodically. (It IS thought that the new form should be on similar . lines to that for life and cover all the systems of the body. In view of

new which have been so frequently reported amongst ex-soldiers,

It IS. that ex-soldiers should be encouraged to appear for

so the1! state of hea_lth ma;y: be in the same way.

ThiS would be of particular value m relatiOn to recurring and hitherto unrecognized vene-real disease).

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. (d) Steps should be taken to ensure that ex-soldiers who have had venereal disease, especially syphilis, continue to present themselves for treatment till the medical officers are satisfied with their condition. (This is a matter as much in their own interest as in that of future generations). (e) Ruling 83 (4), which prescribes in regard to venereal disease that the Repatriation

Commission-" \Viii not accept responsibilty for treatment . . on account of any

effects of these diseases in whatever form they may appear "

be amended and full responsibility accepted for the treatment of venereal disease contracted before discharge from service ; (f) Section 40 of the Act, which prescribes that-"A pension shall not be payable in respect of the death of a person . . . . . after the expiration of seven years from the date of his discharge, except to the widow and children ofthat person and unless the person died from the result of an occurrence happening during the period he was a member of the Forces, and was at the time of his

death in receipt of a pension." ·

· be deleted as unnecessarily hampering the Repatriation administration, which can be relied upon to estimate tlie value of time in assessing these claims; (g) In view of the fact that it is rare, except in the case of a wound received in action, for the exact time of onset of a disabilitv to be determined, Section 22 of the

Act, which prescribes that-- "

"'The rate of pay of the member' means the rate of pay received by the member of the Forces as a member at the time of the occurrence of the casualty, or the contraction of the disease . . . . . . ." .

be amended to provide that pension shall be payable in accordance with the rank on discharge, and not at the time of occurrence ; (h) There be no medical representative on the Repatriation Commission or the State Board. (It is considered that the Medical Staff should be regarded as technical

advisors and referees only) ; ·

(i) The present method by which the applicant's file is discussed with him by a responsible Repatriation Officer be not altered. (Direct inspection of the file by the ex-soldier is most undesirable) ; (j) Where it ismecessary to appoint a trustee for the pension of alcoholics, it should be

a public officer rather than a wife or personal friend.

APPEALS.

17. Much of the evidence !'elated to the question of the opportunities for appeal open to the ex-soldier. On this question your Commissioners have formed the opinion that, from the appellant's point of view, the method in vogue in Australia compares favorably with that in force in other parts of the Empire, in that no final appeal board exists. This principle, it is held, should be always maintained.

18. Your Commissioners consider that, while the right of repeated appeals to the Repatriation Commission should be admitted, there should be, on the other hand, some limitation insofar that each subsequent appeal should be based on fresh evidence, such as new facts or altered physical condition of the claimant. '

19. The right of every man to appeal from a State Board to the Repatriation Commission should,_ of course, be preserved.

20. Your are of opinion it be of .that judicial

character for which Bntish tnbunals are renowned, if partisan representatives of different bodies sat upon Appeal Boards. MENTAL DISEASE. . 21. It has suggested that Commissioners offer some upon the

questiOn of responsibility of the RepatriatiOn Department m regard to mental disease appearing in The matter. ha:s been fully and your Commissioners are of

no prmCiples .can be down. Each .case be upon its

ments, weight bemg given to a variety of crrcumstances associated With the claimant's service.

22. The establishment of special mental hospitals by the Commonwealth for ex-soldier mental cases, and for them alone, is, in the opinion of your Commissioners, unnecessary and impracticable.

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ADMINISTRATION.

23. Your Commissioners made searching inquiries regarding the administration of the Act. They are fully satisfied that a sympathetic attempt has been made by the administrators und)r the Act to grant to claimants the fullest possible measure of relief that an honest interpretatio.i of the Act would allow.

24. The attitude of the officers of the Repatriation Commission, in the opinion of the Royal Commission, has been that of friendly advisors. The Commonwealth is fortunate in havicg been able to avail itself of the extremely fair-minded eminent medical authorities who constitute the Medical Advisory Committee.

25. It is desired specially to mention the satisfactory impression made by the Principal Departmental .,WCedical Officer, Dr. Charles A. Courtney. His judicial mind, combined with his intimate knowledge of the soldiers' needs, gained through his long experience in association with them both as a " combatant" and "medical" officer, specially fit him for the work he is doing.

26. During the investigation of a very large number of files of soldiers scattered throughout the States, it was possible to judge of the attitgde adopted by the administration in: each. Your Commissioners are fully satisfied that the spirit which has characterized the Repatriation Commission and the higher officers, lay and medical, at head-quarters, is fully reflected throughout the branches.

. 27. In conclusion it may be stated that the investigation revealed causes of dissatisfaction to which claimants or their agents have given expression. .

28. Much of the difficulty has arisen owing to a confusion in the lay mind (and even in the medical mind) between sympathy for the soldier and just appreciation of the cause of his disability.

29. The consideration of matters connected with the assessment of pensions is essentially medical, and it is, therefore, difficult for the lay mind to appreciate either the problems or the principles involved in their solution.

30. Confusion has often arisen where ·a discussion has taken place between medical authorities as to whether a doubt exists, the lay mind interpreting such discussion as a proofof a doubt of which the soldier should get the benefit. ·

Your Commissioners have thee honour to be,

Your Excellency's most obedient servants,

(Sgd.) C. B. BLACKBURN, Chairman,

E. SANDFORD JACKSON }. H.· S. NEWLAND M b em ers.

W. W. GIBLIN . ·

A. _v. M. ANDERSON

Printed and Published for the GoVERNMENT of the CoMMONWEALTH of AUSTRALIA by H. J. GRUN; Government Printer for the State of Victoria.