RESERVED DECISION OF THE WAR PENSIONS AND ARMED FORCES COMPENSATION CHAMBER ENT 41 Appellant Tribunal sitting in:

John Ramon CAMMISH Birmingham Tribunal ref: ENT/00317/2010 Date: 29 March and 15 April 2011

1. The decision of the Tribunal is to allow the Appeal. 2. This is an Appeal under Section 1 of the Pensions Appeal Tribunals Act 1943 (the Act) against a Decision of the Secretary of State (the Decision) rejecting a claim for entitlement to disablement under the War Pensions Scheme, treated by the Decision under the following medical label:

Cancer of the Larynx

3. The Appellant appeared at the hearing. 4. The Appellant was represented at the hearing by Group Captain Andrew Ades Rtd. 5. The Secretary of State was represented by Mr Andrew Frith, Presenting Officer. 6. The Tribunal considered the Response, evidence given by the appellant, Mr Colin Duncan, Dr Chris Busby and proceedings at the hearings. 7. The Tribunal considered other evidence produced at the hearing on 15 April 2011 namely a) a kim wipe and for comparison a piece of paper kitchen towel b) a response dated 8 April 2010 (in fact 2011) from the Ministry of Defence to a Freedom of Information Act request made by Mr Duncan. c) Mr Cammishs supplementary witness statement.

Reasons for Decision 8. Article 41 of the Naval, Military and Air Forces (Disablement and Death) Service Pensions Order 2006 (the Order) applies to and governs this Appeal. The effect of that Article in the Order is to place the burden of proof on the appellant at least to the extent of requiring him to raise a reasonable doubt in his favour based on reliable evidence. Having assessed all the evidence the Tribunals findings of facts material to the appeal are: 9. Mr Cammish served in the Royal Air Force from 10 January 1950 to 1 June 1975. 10. He qualified as a Chief Technician in March 1965. In order to qualify as a Victor Crew Chief he attended Training Courses in Airframes, Electrical and Instruments. He attended the Victor Aircraft Servicing Chief Training Course from November 1966 to March 1967. He passed that course and on 29 March 1967.joined 543 Squadron which was based at RAF Wyton. It operated Victor Mark 2 aircraft.

Continued on page 2:

11. In March 1971 Mr Cammish successfully completed a course on Radiation Safety Practice for category C Competent Persons at the Institute of Naval Medicine, Alverstoke, Hampshire. 12. He remained with 543 Squadron until it disbanded in 1975 when he applied for discharge. 13. 543 Squadron was responsible for providing detachments of Victor aircraft to obtain samples of atmospheric debris produced by the Chinese and French nuclear tests in the Pacific. This involved deliberately searching out fallout clouds, flying through them and collecting samples of the fallout clouds in removable scoops that were fitted in specially modified ducts which were attached to the airframe. Such samples included highly radioactive particles. The samples were then sent by accompanying AWE personnel back to Aldermaston for detailed analysis. The aircraft were subjected to high levels of radioactive contamination when their missions were successful. 14. Mr Cammish served as a Crew Chief on the following detachments (1) Operation Wig, based in Guam during September and October 1969, monitoring Chinese tests (2) Operation Alchemist, based at Jorge Chavez International Airport Lima Peru from May to August 1970, monitoring French tests (3) Operation Attune based at Jorge Chavez International Airport Lima Peru from 24 May to 23 July 1971, monitoring French tests at the Pacific testing ground at Mururoa Island. (4) Operation Radius 2, based at USAF Base McClellan California from 16 to 30 November 1971, monitoring Chinese tests (5) Operation Radius 3, based at the US Naval Station Midway Island from 29 February to 20 March 1972, monitoring Chinese tests (6) Operation Aroma 1, based at US Naval Station Midway Island from 9 December 1972 to 17 January 1973, monitoring Chinese tests. (7) Operation Aroma 3, based at US Naval Station Midway Island from 11 June to 13 July 1973, monitoring Chinese tests. (8) Operation Vellum, based at Jorge Chavez International Airport Lima Peru, from 9 June to 26 September 1974, monitoring French tests at the Pacific testing ground at Mururoa Island. 15. Mr Cammishs primary responsibility as a Crew Chief and a Chief Technician during the detachments was, with a team of technicians, to ensure that the aircraft in the detachment remained airworthy and had the necessary servicing done between sampling and other flights including the return flight to the UK. 16. When a plane returned from a sampling flight we find (1) The Crew Chief on duty was responsible for marshalling in the aircraft when taxiing in and supervising the ground crew putting wheel chocks in place. After the aircrew had closed down the engines he would place steps for aircrew to exit the aircraft. (2) He opened the hatch for the aircrew to exit the aircraft and afterwards closed it. This involved physically touching the aircraft with bare hands. No gloves were worn. (3) He helped the crew exit and to unload navigation bags and ration boxes. Each of the five members of the aircrew had a bag. This involved touching those items with bare hands and potential contact with crew overalls. (4) The aircrew then went through radiation and contamination checks before entering the debriefing area. The Crew Chief debriefed with the Aircrew about issues relating to the serviceability of the aircraft. (5) In the meantime AWRE personnel wearing protective suits, respirators and lead-lined gloves would remove the collected radioactive samples, process them and place them in lead lined pots for delivery to Aldermaston. 2

(6) The AWRE personnel wearing protective clothing (as above) would check radiation levels. If radiation levels were above what were considered then to be safe working levels (known as Hot) the aircraft would be locked and guarded and would on occasion need to be parked at a remote part of the airfield until they were no longer considered hot. Radiation checks would then be performed about every 12 hours until AWRE considered that a safe level of radiation had been reached. Mr Cammish told us that he used to assist with radiation readings. When AWRE considered the planes were safe to clean they had no further involvement in checking radiation levels on the plane which was done by ground crew including Crew Chiefs. AWRE were, however, responsible for putting new filters in and taking out old filters in the scoops for gathering irradiated material. (7) After AWRE considered radiation levels were at a safe level the Chief Technician would return to the aircraft with his servicing team. The first job was to clean external panels around engine and undercarriage and intakes to remove dust before gaining access to the interior where servicing and any other work was required. The dust often adhered to oils and greases on the parts of the aircraft which needed cleaning or were touched in the process of cleaning. The cleaning materials used were kimwipes and swarfega handcleaning gel. No protective gloves or masks were issued. Standard UK-type denim overalls and cloth cap or beret were worn. This work would take two to three hours. (8) Thereafter the Crew Chief could gain access to the interior of the aircraft to carry out standard maintenance consisting of after flight checks, replenishments and pre-flight checks. Such checks included crawling into the engine nacelles and some delicate manual work to ensure that all consumables were filled and that there were no leaks or other dangers. (9) The Crew Chief did a complete external check of the aircraft in order to sign the aircraft safe to fly. He was also responsible for supervising refuelling. 17. We make the following additional findings about the work described above. a) The crews coveralls, navigation bags and ration boxes had been at risk of contamination because the cabin pressurisation system used air from outside the aircraft which was tapped off from the engines and fed under pressure into the cabin without removing contaminants. Evidence of the risk of contamination to flying clothing can be seen in paragraph 4 of Terence Rogans statement on page 435, paragraph 6 of the Operation Median Report on page 475 (although Mr Cammish did not participate in Operation Median) and in paragraph 10 on the reverse of page 537 (Operation Vellum) b) AWRE were well aware at the time of all the detachments that ground staff assisting aircrew to exit from cloud sampling aircraft were at great risk of exposure to ionising radiation. This is clear from the extract of the AE Oldbury Report dated June 1963 on Operation Dominic on page 334. No platform or full protective clothing of the kind described was provided. The extract refers to personal flying equipment becoming contaminated. The danger referred to is accidental contact with the outer surface of the aircraft. Crew chiefs had no choice but to touch the outside deliberately when opening the door to enable the crew to exit and closing it afterwards. c) Group Captain Rexford-Welch was in Guam for Operation Wig (see page 435) and in Lima for Operation Vellum (see page 536 and 543). He was described by Mr Rogan as the RAFs expert on radiation safety. We note that in Operation Vellum (page 543) he was described as Medical under the heading AWRE. It seems very likely that he was aware of the concerns expressed in the AE Oldbury Report. d) Fluids including fuel and grease from the radiated aircraft dropped onto the tarmac. e) The ground crew including Crew Chiefs physically touched the aircraft when cleaning away dust. f) The planes remained contaminated after cleaning because the only parts that were cleaned were those parts where servicing work needed to be done. g) Minor cuts and grazes to hands are a common hazard of cleaning aircraft by hand and aircraft maintenance work. 3

18. After working on the aircraft the ground crew were screened for radioactivity by AWRE personnel or by the Duty Crew Chief. If found to be contaminated the ground crew would hand wash with soap and water until a satisfactory level was attained. Hair was not washed. It was difficult to clean thoroughly under nails. Denims and hats were left in the crew room at the end of the shift. Shoes were not changed until the return to crew accommodation and the soles of shoes were never checked. Snacks and light refreshments were available in the crew room. 19. We comment in subsequent paragraphs more specifically in relation to each detachment 20. The detachments for the Chinese atomic tests. (1) Operation Wig. a) A notable feature of Mr Cammishs accepted exposure to ionising radiation of 20 mRem is that it occurred over a short period of eight days. See Reverse page 11. b) There were two Crew Chiefs but Crew Chief Fiddler broke his wrist and therefore Mr Cammish had to stand in for him. See page 829. c) Mr Cammish told us there were two or three successful sorties. He considered the yield of the explosion relevant to his high reading. We note that Mr Terence Rogan in his statement on page 435 states that there was no exposure to radiation fallout on that detachment but that the exposure was purely due to the residues from exposure during Operation Web in 1968. We prefer Mr Cammishs evidence that there were successful sorties. However we consider that it is plausible that exposure was partly due to residue because of the comments made in paragraph 18 of Annex D of the Detachment Commanders Report for Operation Web. Aircraft XL 161 was part of both detachments. See page 456. d) There is no Detachment Commanders Report for Operation Wig which the Tribunal directed should be disclosed. We recognise that extensive efforts have been made by the SPVA to obtain the official report but note that Mr Rogan states that it is in the National Archives at Kew. e) Mr Rogan quotes from Group Captain Wrexford-Welchs letter attached to the operation report that as usual the (radiation) safety measures were inadequate: the Radiation Safety Officer, the detachment Engineering Officer, was overworked. We have no reason to doubt the accuracy of the quote from Mr Rogans statement. (2) Operation Radius 2. No samples were obtained. There are no dosimeter records. (3) Operation Radius 3. a) Although the detachment was in Midway from 29 February to 20 March 1972 it is clear from the Detachment Commanders Report on page 503 that the sampling occurred on a flight departing from Midway on 19 March at 1920 and returning on 20 March at 0605. b) Mr Cammish flew back in the Victor to RAF Wyton departing from Midway at 1100 on 20 March. The Victor XL 161 arrived back at RAF Wyton at 0930 on 22 March. See reverse of page 506 and page 507. The Victor was hot for the whole of the return journey to RAF Wyton. See paragraph 9 of the Detachment Commanders report on the reverse of page 504. All the other ground crew on the attachment returned on a Britannia which left Midway on 28 March. Thus Mr Cammish was responsible for the various safety and service checks needed to be done at USAF Base McClellan (where the plane was not adequately washed - see paragraph 9 of the Detachment Commanders report) and at Offutt. c) There are no dosimeter records. d) We find that Mr Cammish was exposed to substantial ionising radiation during the short period (46 hours) between the morning of 20 March in Midway and the morning of 22 March at RAF Wyton. (4) Operation Aroma 1. No detonation occurred. 4

(5) Operation Aroma 3. No samples were collected. A dosimeter was issued to Mr Cammish and is recorded as having registered 5mRem during July 1973. Since no samples were collected we have concluded that the most likely explanation is that there was residual radiation on the aircraft XL 161 which had been used in previous successful detachments. 21. The detachments for the French atomic tests. (1) General. a) The Tribunal has far more evidence about the facilities at Lima International Airport than at the various US bases referred to above. b) The facilities for washing after working on an aircraft were rudimentary. They consisted of an outdoor sink (described by Mr Duncan as dirty and smelly) with a cold water tap from a standpipe, a bar of soap and a nailbrush. c) There were no facilities for having a shower. d) Hair could only be washed on return to the hotel at the end of the 12 hour shift. e) Contaminated denims and hats were left hanging until radiation had reduced in the igloo close to where coffee and snacks were available in the rest area. f) Shoes were not changed until the return to the hotel. g) The ground crew went round to the airport canteen for meals during their 12 hour shift after working on the aircraft. h) Mr Cammish commented on how dusty conditions were at Lima but that no changes were made to protective clothing. Mr Duncan told us that the aircraft raised a lot of dust during Operation Vellum but no masks were issued.. (2) Operation Alchemist. Mr Cammish was one of two Crew Chiefs to support Victor aircraft XL 161 and XL 230. Whilst he was there he was issued with four film badges which recorded a total of 44mRem. Mr Cammish stated that conditions were very cramped and made it difficult to operate a safe environment. (3) Operation Attune. Mr Cammish was one of two Crew Chiefs to support Victor Aircraft XL 161 and XL 193 and its replacement XL 165. The operation lasted until September but Mr Cammish returned to RAF Wyton with others in July. There were two successful sorties whilst he was in Lima on 8 and 15 June. See page 494. Whilst he was there he was issued with two film badges one from 26 May to 5 July 1971 and the second from 5 July to 20 July 1971 measuring 6 and 11 mRem respectively. Radiation Annex F to the Detachment Commanders Report on page 487 records that contamination was severe at times. (4) Operation Vellum. a) Mr Cammish was one of four Crew Chiefs to support Victor Aircraft XL 193 and 165. b) There were five successful sorties, three using XL 193 on 9 and 29 July and on 16 August and two using XL 165 on 26 August and 17 September 1974. c) XL 193 became so contaminated after a successful sortie on 9 July 1974 that it was outside working limits for four days. See reverse of page 553. It was necessary to seek a dispensation from inspecting the engine turbine blades because of the high levels of radioactivity. See paragraph 21 on the reverse of page 541. d) Mr Duncan told us that the pad was still radioactive four days after the Victors had left. One of his duties was to monitor the pad. His evidence is supported by paragraph 14 on the reverse of page 537. e) There were lapses in aircraft technicians regard for health safety during the Operation see paragraph 24 on page 538. Mr Duncan told us that it was hot and humid at the airport and that ground crew undid their denims whilst working. f) Whilst Mr Cammish was in Lima he was issued with three dosimeters during the period from 2 July to 26 September 1974. They gave a total reading of 33 mRem with 23 mRem in the period between 27 August 1974 and 26 September 1974. g) Mr Cammish returned to the UK on XL165 (see the reverse of pages 543 and 549) departing from Lima on 23 September and arriving back at RAF Wyton on 26 September 5

1974.and was responsible for routine maintenance and safety checks at Homestead AFB where they stayed two nights and at Goose Bay where they stayed overnight. The second aircraft was only at Homestead for one night. For the return flight he was provided with gloves. 22. Contamination on return to RAF Wyton. a) The work done cleaning the aircraft during detachments only involved cleaning the areas needed to enable servicing of the aircraft. b) Whilst Mr Cammish was not himself involved in washing down aircraft on their return to RAF Wyton the fact that it needed doing is clear evidence of substantial contamination to the aircraft. c) All aircraft involved in sampling needed decontaminating on their return to the UK. There is substantial evidence to support this. See statements by Mr Cammish in paragraph 5.0 on page 340, paragraph 8(E) on the reverse of page 829 and his supplementary witness statement dated 6 April 2011, Michael Elliott on page 403, Ken Turnbull on page 407, paragraph 8 of Bernard Gately on page 427 and David Steel on page 429. On return the aircraft were kept separate from the other aircraft in the squadron until they had been cleaned. d) The cleaning at RAF Wyton brought radiation levels to what was regarded as a safe level. Mr Cammish told us that the aircraft were inspected by AWRE personnel who had to sign off before a major servicing could be done. e) Paragraph 5 of Mr Rogans statement on page 435 confirms that aircraft remained radiating whilst being used as routine squadron aircraft (i.e. after cleaning on return at RAF Wyton) and that ground crew would have continued to handle all such aircraft as normal and with no protective equipment or measures in place. Mr Cammish confirmed in his supplementary statement dated 6 April 2011 that he did not wear a dosimeter doing such work. 23. We make the above findings, except where indicated otherwise, based on the extensive written and oral evidence we heard from Mr Cammish and Mr Colin Duncan. Before the hearings a Direction was made that Mr Cammish should as far as possible put his evidence in writing. This was because Mr Cammish has had a laryngectomy and his ability to speak is reduced. During his evidence Mr Cammish confirmed what we stated on page 338 was correct and in particular what he had written about the clothing worn and the washing facilities. We found them to be careful and reliable witnesses. Their evidence is consistent with the extensive official reports included in the Response. Statements used in Mr Duncans appeal were also included in the Response. In each case the maker of the statement had given his consent for his statement to be used in this appeal. 24. At the start of the hearing Mr Frith drew our attention to the certificates and other documents on which the Secretary of State was relying. These included the Policy Statement on Claims for Ionising Radiation Related Conditions. 25. Annex B on page 13 of Policy Statement states that the Ministry of Defence estimated that only 10% of all participants in UK atmospheric tests were likely to have been exposed to measurable levels of ionising radiation. The relevant groups of personnel were in order of likelihood of exposure: RAF aircrews involved in sampling from airburst clouds (205 men). Mosaic, Totem, Buffalo, Antler, Grapple RAF decontamination flight crews who sluiced aircraft (129 men) 26. We find that the work which Mr Cammish did on detachment gave him significantly greater likelihood of exposure than the RAF decontamination crews who sluiced the aircraft. In making this finding we have had regard to the statements about what was involved in sluicing down aircraft see paragraph 22(c) above. We have also found that Mr Cammish flew back in contaminated aircraft at the end of Operation Radius 3 and Operation Vellum and during stops carried out safety and service checks. 6

27. On page 673, in commenting on paragraph 61 of the Redfern Report, Dr Braidwood stated Our understanding is that in circumstances where there was potential for ionising radiation exposure deleterious to health, protective clothing and equipment would be supplied. Where, as here, duties or location do not require them, none was provided. 28. We find based on paragraph 17(b) and (c) above that both AWRE and the RAF were aware of the dangers to health in the circumstances described. No protective clothing and equipment was supplied to non AWRE personnel either in the air or on the ground. 29. We find that Mr Cammish mostly worked on detachment at what were regarded at that time at safe working levels. We do not consider that it is an argument that Mr Cammish was not exposed. 30. We find that the figure of 1.19 mSV does not fully reflect the extent of Mr Cammishs exposure a) He was exposed to substantial ionising radiation on Operation Radius 3. There is no record of him having been provided with a film badge and no explanation for why not. b) He was never provided with a film badge for servicing work in the UK on aircraft which had been involved in sampling operations. There is ample evidence that such aircraft remained contaminated after being cleaned on return to RAF Wyton. c) Dosimeters do not measure alpha particles. This is accepted by the Secretary of State who contends that there would only be alpha particles if there were also beta and gamma which the Secretary of State contends were properly recorded by dosimeters. We find that Mr Cammish ingested radioactive material and was thereby internally exposed to IR including alpha particles, the means of ingestion including inhalation (of dust directly from contaminated aircraft and which had passed thence into the environment generally), orally (through eating and drinking whilst hands, other body surfaces and clothing were contaminated) and through minor cuts and abrasions on the hands. d) We consider that the position about the dangers of internal radiation through alpha and beta emitters was well described in paragraph 13 of the Further Opinion of Medical Services dated 28 July 2008 which is quoted in the Tribunals decision in the Colin Duncan appeal (page 346) Of course we acknowledge Dr Busbys core argument concerning the difference between external and internal radiation exposure Thus it is our understanding that in respect of internal radiation, alpha particles are the most damaging of those inhaled or ingested, although beta particles are also involved. It is the case that film badges in use at the time were not able to measure internal dose directly. However to receive a significant internal dose a person would also need to be exposed to high levels of external gamma radiation as indicated by the film badge (AWE report of 04.04.06). 31. On page 6 of the Response Dr Finucane stated It is also worthwhile putting an ionising radiation dose of 1.19 mSv into context all humans are constantly exposed to ionising radiation from both the natural environment and man-made products, and in the U.K. the average level of exposure to natural background radiation is about 2.2 mSv per annum

32. It is clear that Mr Cammishs exposure was not evenly spread over the year. On each of the occasions when he was issued with a film badge, and on Operation Radius 3 when he was not, he was exposed for short periods. 33. In paragraph 9.5 of his expert report Dr Busby showed what a highly radioactive environment Mr Cammish was working in by reference to limited periods of exposure and accepted dose levels. The 7

Secretary of State did not produce any evidence to refute this contention or the calculations which Dr Busby made. 34. During the hearing Dr. Busby was asked for his opinion on the significance of the exposure time factors in relation to the total film badge doses measured, taking for example the film badge dose of 20 mRem measured for the appellant during his 8-day deployment on Operation WIG (29 September to 6 October 1969). The appellant had previously stated that this Operation had resulted in 2-3 successful sampling sorties and that his manual post-sortie wipe-down of the relevant external aircraft surfaces would typically last around 2 hours. Dr. Busby stated that it was important to look at dose rates in such a situation and that the relevant aircraft surfaces must have been very contaminated to deliver this badge dose (which measured only the gamma component) over the period of exposure. He offered some quick rough calculations to support this: 20 mRem equals 200 millisieverts (mSv); assuming the 200 mSv was mainly received over 3x2 hour wipe-downs of contaminated aircraft, this would give a dose rate of some 33mSv per hour. This equates to around 10 megabecquerels (MBq) per square metre. For comparison, Dr Busby stated that the 30 km exclusion zone following the Chernobyl explosion had been set on the basis of a dose rate of 0.5 MBq per square metre. 35. We have concluded that the comparison with average annual dose in the U.K. is not appropriate in cases where there has been short term exposure to ionising radiation. 36. After Mr Cammish left service he worked for Shorts in Cambridge as an aircraft engineer. We find that he was not exposed to ionising radiation in his civilian job. 37. In a written statement (page 73) Mr Cammish stated that his first symptoms of his health problems developed in the mid 1990s when he started having breathing problems, a persistent cough and asthma. 38. He was not, however, diagnosed as suffering from Squamous Cell Carcinoma of the larynx until June 2005. He has had a Laryngectomy and a left hemithyroidectomy which are accepted as part and parcel conditions. It is accepted that he did not have primary Thyroid cancer. 39. Mr Cammish used to smoke. We find that he gave up about 30 years ago in the mid 1970s. Smoking is an accepted risk factor for Cancer of the Larynx. 40. We find that Mr Cammish has raised a reasonable doubt based on reliable evidence that there is a causal link between his exposure to Ionising Radiation in service which was greater than the Secretary of State accepts and Cancer of the Larynx. 41. Dr Busby referred to a number of published papers which he said were relevant to a causal link between exposure to ionising radiation and cancer of the larynx. It appears to be well established that there is a link between cancer of the larynx and radiotherapy irradiation particularly from an era when radiation doses were high. We agree that such radiation is very different from the type of radiation to which Mr Cammish was exposed. 42. We find that there are two papers which lend support to there being a causal link for lower dose exposure.

(1) 'Cancer Risk in Nuclear Workers Occupationally Exposed to Uranium- Emphasis on Internal Exposure' is co-authored by well-known experts in their field, two of whom work for the French Institute of Radioprotection and Nuclear Safety (IRSN), a French public authority under an inter-Ministerial Board of Governors.(See page 834) It is a review article of 23 studies published since 1980. On the second page, first column, the 8

last paragraph deals with laryngeal cancer in various groups of workers. Qualifications and caveats apply but this section concludes Although the evidence to support a dose response relationship is limited to one study, the results of the four studies suggest an increased risk of laryngeal cancer with exposure to internal radiation (2) 'The Mortality and Cancer Morbidity Experience of Workers at BNF 1946-1997' is published by Westlakes Scientific Consulting. This is the commercial arm of the University of Central Lancashire. The full text is available at the British Institute of Physics website in their Journal of Radiological Protection (Vol 20 No 4 December 2000). The study was commissioned by British Nuclear Fuels. It reviewed 62,141 workers which consisted of radiation and non-radiation workers. It noted the healthy worker effect overall. It includes the conclusion (see reverse of page 837) that For mortality, statistically significant associations with external whole body radiation were found for all causes of death, cancer of the larynx. Other cancers were then specified. 43. Dr Braidwood accepts in paragraph 2 on page 564 that any cancer might potentially be causally related to IR. We find that the two reports referred to above are reliable evidence and are certainly more than fanciful. 44. On page 416 there is a reference to Mr Cammish wishing to claim for skin cancer. It is unclear whether a separate claim was made, rejected and appealed. It is only in those circumstances that the Tribunal has jurisdiction. This decision does not cover any such claim.

The Tribunals reasons for deciding this Appeal, having regard to its findings of fact, to the relevant law and to the contentions put by the parties, are in summary, as follows:(1) We adopt the medical label in Paragraph 2 above as a proper interpretation of the claimed disablement. (2) The burden of proof, that under the Order lies on the Appellant, has been discharged

Signed on original copy by Judge Stubbs, Dr Anscombe and Mr Messervy-Whiting, on 31 May 2011.

ISSUED: 3 June 2011