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2.1.7 Some Claims must be made on a particular form

The following claims must be on a form approved for that purpose by the MRCC:

  • acceptance of liability for a service injury sustained by a person or a service disease contracted by a person (Form D2051); and

  • acceptance of liability for the service death of a person (Form D2053).

     

    The MRCC has approved the Claim for Liability and/or Reassessment of Compensation (D2051) form for, acceptance of liability for injury or disease arising from service on or after 1 July 2004 and, reassessment of compensation payable under the MRCA.

     

    2.1.7.1 Claims lodged under one Act incorrectly and subsequently determined under another Act

    Claims made for conditions related to VEA, SRCA or MRCA service are occasionally lodged on claim forms intended for another of these Acts.

    The Claim for Liability and/or Reassessment of Compensation (D2051) form has been updated. The latest version of the form provides a Cross-Act Authority which enables delegates to make investigations under all three Acts, without seeking further approval to do so from the client.

    Previous versions of the claim form required the delegate to contact the client and request a new completed claim form under the correct Act or a completed Release Authority Form.

    It is important to identify which version of a claim form has been used to determine whether you need to obtain a completed Release Authority from the client or whether the latest version of the form has been used and so sufficient consent has been provided.

    The checklist below will assist you to identify which version of the claim form has been used:

    Latest D2051 MRCA form:

  • contains a DVA Rehabilitation and Compensation Claim Checklist at the beginning of the form. Please see 2.1.7.7 for further information;
  • contains an Injury or disease details sheet at the end of the form; and
  • provides a combined Authorisations and Declarations at Part H on page 10 of 11.

Previous D2051 MRCA form:

  • does not include a DVA Rehabilitation and Compensation Claim Checklist;
  • does not include an Injury or disease details sheet; and
  • provides the Authorisation at Part H on page 7 of 8 and the Declaration at Part I on page 8 of 8.

Once you have identified which form the claimant has lodged, go to the following section to determine what actions need to be taken next:

2.1.7.2 – Cross-Act Authority Form

2.1.7.3 – Use of old versions of MRCA, VEA, and SRCA claim forms

 

2.1.7.2 Cross-Act Authority Form

The latest form allows the client to give their consent for the delegate to consider their claim under one or more of the Acts. For example, where the client has submitted a D2051 MRCA claim for compensation, using the Cross-Act Authority form, but the injury or disease should be determined under the VEA or SRCA, than the claim can be accepted under the VEA or SRCA. 

 

Please note that if a claim is submitted on the incorrect claim form and not enough information has been supplied to make a full assessment, then you should investigate and obtain the required information from the client.

 

A Release Authority form is not required where a claim is lodged on the latest version of a claim form.

 

A Release Authority form is not sufficient in cases where an old version of the MRCA or a SRCA claim form has been lodged for a VEA condition, that claim can be accepted as an informal claim under the VEA.  However, a formal VEA claim on a D2582 must be lodged subsequently.

 

The below rules in 2.1.7.3 are not applicable when the client has lodged the latest version of a claim form which provides the Cross-Act Authority, but be aware the rules applicable to denying the claim lodged under the incorrect Act still apply.

2.1.7.3 Use of old versions of MRCA, VEA, and SRCA claim forms

Where the client has submitted a claim using the old version claim form and the conditions are to be considered under one or more of the Acts, then the below steps must be followed:

  • If lodged on an old version MRCA form:

    • SRCA - accept the claim and obtain a completed Release Authority form,

    • VEA - accept the claim as an informal claim under the VEA, but a formal VEA claim will still need to be lodged;

  • If lodged on an old version VEA form:

    • MRCA - accept the claim and obtain a completed Release Authority form,

    • SRCA - accept the claim and obtain a completed Release Authority form;

       

  • If lodged on an old version SRCA form:

    • MRCA - accept the claim and obtain a completed Release Authority form,

    • VEA - accept the claim as an informal claim under the VEA, but a formal VEA claim will still need to be lodged.

       

      2.1.7.4    Release Authority Form

      Where a Release Authority Form is required, the claimant should be asked to sign the form.

      A returned Release Authority Form acknowledges that the claimant knows that the information provided will be used for assessing eligibility under the MRCA or SRCA.

      Should a person lodge an old version MRCA or a SRCA claim form for a VEA condition, that claim can be accepted as an informal claim under the VEA.  However, a formal VEA claim on a D2582 form must be lodged subsequently.

      Claims must be lodged at a place, or with an employee of DVA, approved by the MRCC.  DVA State Offices, National Office and Veterans’ Affairs Networks in Darwin and Townsville are approved offices.  DVA officers at the following levels are approved employees for this purpose:

      Executive Level 2 (DVA Band 4);

      Executive Level 1 (DVA Band 3);

      APS Level 6 (DVA Band 3);

      APS Level 5 (DVA Band 2);

      APS Level 4 (DVA Band 2); and

      APS Level 3 (DVA Band 2).

      Claims lodged via MyAccount, specific facsimile numbers or specific email addresses as detailed in the Military Rehabilitation and Compensation *Electronic Lodgement Approval) Instrument 2016 are also taken to have been lodged with an Office of DVA.

      The following table summarises the action required when a claim is lodged on the incorrect claim form. Please note that the Release Authority form is not required when the latest claim form with the Cross-Act Authority has been submitted. However, be aware the rules applicable to denying the claim lodged under the incorrect Act still apply. See 2.1.7.2 for further information on the latest claim forms.

Which Act/form claimed under

Authority to accept the claimed condition under MRCA?

Authority to accept it under SRCA?

Authority to accept it under VEA?

Comments

VEA

Yes but a release form is required.

The claim will be denied under VEA and determined under MRCA.  Appeal rights will be issued under MRCA.

Yes but a release form is required. 

The claim will be denied under VEA and determined under SRCA. Appeal rights will be issued under SRCA.

Yes

MRCC has approved the use of the VEA claim form to be determined under MRCA or SRCA, if the claimant has lodged it in error, provided a release form is used to process the MRCA or SRCA claim.

SRCA

Yes but a release form is required.

The claim will be denied under SRCA and determined under MRCA.  Appeal rights will be issued under MRCA.

Yes

Yes – will accept it as an informal claim.

A formal claim will also need to be subsequently lodged.

MRCC has approved the use of the SRCA claim form to be determined under MRCA, provided a release form is used to process the MRCA claim.

Should a person lodge a SRCA claim form for a VEA condition, that claim can be accepted as an informal claim under the VEA. 

However, a formal VEA claim on a D2582 form must be lodged subsequently.

MRCA

Yes

Yes but a release form is required.

The claim will be denied under MRCA and determined under SRCA.  Appeal rights will be issued under SRCA.

Yes – will accept it as an informal claim.

A formal claim will also need to be subsequently lodged.

MRCC has approved the use of the MRCA claim form to be determined under SRCA, provided a release form is used to process the SRCA claim.

Should a person lodge a MRCA claim form for a VEA condition, that claim can be accepted as an informal claim under the VEA. 

However, a formal VEA claim on a D2582 form must be lodged subsequently.

 

2.1.7.5         Procedure on Receipt of an Unsigned Claim Form

When an unsigned claim form is received, the delegate should take a photocopy for the file, but then return the original claim form to the claimant with a covering letter asking for the claim form to be signed and returned without delay.

The delegate may in the interim begin what limited investigation of factual and medical circumstances is covered by documents accompanying the claim form.

However, the delegate should progress the matter no further and especially should not approach agencies and medical personnel for further information until the claim form is returned with the claimant’s authority to proceed.

 

2.1.7.6         Rejection and/or Correction of Incomplete Claim Forms

If the claim form is incomplete the delegate has the power to refuse to deal with the claim. Should the delegate refuse to deal with the claim than it is considered a determination and the claimant must be informed in writing.

Formal rejection on the basis of non-compliance is an extreme step. Initially incomplete claims should be returned with an explanation of what information is required and the significance of the missing information/signature. The client must be told that the claim cannot be registered until this information has been received. Only if there is a refusal to conform to this direction should the delegate refuse to deal with the claim.

For minor omissions on the claim form the claim should be registered and the investigation begun along with the request to the claimant for more information. The intent of this strategy is to minimise the delay in the processing of the claim.

 

2.1.7.7        Documents to be lodged with Claim Forms

The latest forms include a DVA Rehabilitation & Compensation Claim Checklist (D1380) attached to the front of each form. This checklist ensures that delegates receive the majority of information required to make a quicker investigation.

 

In order to process claims as quickly as possible the following documents should be lodged with the claim form:

  • Injury or disease details sheet (D2049). Note: A separate injury or disease details sheet must be completed for every injury or disease the client is claiming;

  • Proof of Identity documents (see 2.1.7.8);

  • A statement/contention describing how the condition is related to the claimant’s ADF employment;

  • Service history (PMKeyS ADO Full Service Record);

  • ADF medical treatment records since date of injury;

  • Recent SVA/ADF payslip;

  • ADF Incident Report (AC563) (if appropriate);

  • Witness statements (if appropriate);

  • Authority to participate in Civilian Sport (if appropriate); and

  • Hazardous Material Exposure Report (if appropriate).

    The claimant is often in the best position to obtain these documents. Therefore, where possible, claimants should be encouraged to obtain the documentation themselves in order for the claim to be determined as quickly as possible. However, if the claimant is not able to provide the documents, it is DVA’s responsibility to investigate all matters related to the claim.

    Medical information may also be available from the ADF health unit responsible for a serving member’s medical care. All requests made to Defence must be made through SAM using DocTracker in aDVAnce.

     

    2.1.7.8         Proof of Identity

    There are Proof of Identity (POI) requirements to be met before a claim can be finalised.

    These requirements can be found in the Compensation Support Policy and Procedures Libraries in CLIK via the following links:

  • Compensation and Support Policy on Proof of Identity

  • Compensation and Support Procedures on Proof of Identity
     

  • 2.1.7.8.1     Approved Persons for Certifying Proof of Identity Documents

Persons who can certify Proof of Identity documents are listed in the DVA Factsheet DVA06 Proof of Identity Requirements and on DVA Form D0663 Proving Your Identity to DVA.