Workers’ compensation does not cover assistance-dog expenses
In a recent Administrative Appeals Tribunal (AAT) hearing, a worker with post-traumatic stress disorder (PTSD) has been denied costs for the care and upkeep of a psychiatric assistance dog (mind dog).
The ACT Fire Brigade worker developed PTSD and bruxism after attending a large factory fire in 2011. He then claimed for the costs of a mind dog in 2016 which Comcare (the ACT Government’s insurer at the time) rejected.
Comcare determined that the dog did not qualify as medical treatment under the Commonwealth’s Safety, Rehabilitation and Compensation Act 1988 (SRC Act), nor was there any other area of the SRC Act “that could conceivably apply to the acquisition and upkeep of a mind dog”.
The worker appealed. In the AAT hearing, the worker’s wife told the tribunal that the dog had originally been acquired as a pet. When it was discovered that the dog helped the worker with his anxiety, it was later trained as a mind dog.
With the mind dog, the worker was able to regularly go to public places without suffering panic attacks or stress, which he was unable to previously.
The worker submitted that under the SRC Act, the costs associated with his mind dog were a recoverable medical treatment expense, or alternatively an aid or appliance expense. The worker’s psychiatrist noted that mind dogs were “helpful with PTSD-related hyperarousal in shopping centres and crowds of people”.
A lifestyle benefit, not medical treatment
“The evidence before the present Tribunal regarding the medical or psychiatric effectiveness of assistance dogs was inconclusive,” AAT Deputy President Gary Humphries found.
According to one doctor, the dog’s role “had not led to any significant improvement in [the worker’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 said, and although there were “certain lifestyle benefits”, there was “no resolution of the illness” and “no serious amelioration of the symptomatology”.
While another doctor who provided evidence disagreed, he did concede that the dog was not directly therapeutic to the worker, but rather helped the process of therapy which was already being implemented.
Both doctors noted the weakness in the published research regarding the therapeutic benefits of assistance dogs.
“All of this militates against the view that [the dog] was medical treatment,” Deputy President Humphries said.
“[The dog] was, at best, an adjunct to such treatment.
“Even if I were to accept the view of [the doctor] that [the dog] had conferred some practical benefits in the management of [the worker’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 [the worker] from [the dog] rise any higher than those he would obtain from a dog which had not been designated or prepared as an assistance dog.”
Dog is not an aid
Deputy President Humphries found that the term ‘aid’ under the SRC Act could only apply to inanimate objects.
“In order to accept the construction which [the worker] 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,” he said.
However, he found that only an “uncertain and vague evidential basis” had been put forward “to determine the extent to which dogs may aid people with psychiatric conditions such as PTSD”.
Also, there was no provision in the SRC Act entitling the worker to the “cost of maintaining or sustaining an aid or appliance”.
“The Tribunal notes that [the worker’s] claim is not for the cost of acquiring [the dog] but for sustaining him – special food, veterinary fees, grooming, etc.,” Deputy President Humphries said.
“Even if [the dog] were considered an aid, none of the costs related to his care or upkeep would be recoverable…
“[The SRC Act] does not contemplate the inclusion of animals as aids or appliances, since it makes no provision for their care and upkeep.”
An ‘obvious lacuna’ in the SRC Act
While Deputy President Humphries rejected the worker’s claim, he did emphasise the role dogs can play in helping injured workers.
“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,” he said.
“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.”
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