[2025] UKUT 033 (AAC)

The appellant is still serving in the RAF and accordingly there was no dispute that his case had to be considered under Article 8 (set out above) only and not also under Article 9 (injury made worse by service) as Article 9 only applies to former members of the forces.

The appellant’s case was that he developed myofascial/atypical facial pain as a result of dental treatment that he was obliged by his commanding officer to have against his wishes, and that the pain was also in part caused by work-related stress. His case was thus put on the basis that both the treatment and the exacerbation of the pain by stress were ‘caused by service’ so that, taken together, his injury was ‘predominantly’ caused by service.

The Tribunal directed itself by reference to the decision of the three-judge panel of the Upper Tribunal in JM v Secretary of State for Defence (AFCS) [2015] UKUT 332 (AAC), [2016] AACR 3 to apply a four-stage test of: (i) identify all potential causes; (ii) discount causes that are too remote or uncertain; (iii) categorise remaining causes as Service and non-Service; (iv) if not all remaining causes are Service-related, apply the predominance test. It reminded itself of the guidance in that case at [86] that breach of duty and fault are not relevant to the AFCS scheme, only the question of whether the injury is caused by service.

Regarding the dental treatment, the Tribunal concluded this was not caused by service as follows:-

42.

The medical evidence demonstrates that the appellant consented to both

procedures. We find no compulsion of service made the appellant undertake

the dental treatment. The consent obtained for the two procedures was in line with civilian dental procedure.

43.

The documentary evidence does not support a finding that the appellant was ordered to undertake the treatment.

44.

We considered the appellant’s perception that he had to have the treatment to remain dentally fit. The appellant’s evidence was that he had lived with the chipped filling for 3-4 years and had remained fit for work. We find that although the appellant was required to attend an appointment, he was under no compulsion to have the treatment. Using the expertise available to it we found that if the appellant had not consented to the treatment and he remained fit for work then no action would have been taken.

45.

We therefore found that a) the filling repair was not a service related cause.

Regarding the stress, the Tribunal concluded that although part of the injury was caused by stress, the appellant’s stress was not caused by service:

46.

We find that the medical evidence refers to stress being related to the

condition. At page 127 in the letter which found that the pain was partly due to stress, the consultant stated that the appellant was not under undue stress at work but has had a very difficult year with facial pain and also some personal relations issues which are now better. He has been having CBT therapy at his base and this has been helpful. There is no evidence that any stress which contributed to the facial pain is service related.

The Tribunal thus concluded that as none of the causes of the injury were service-related, the appellant’s claim must fail.