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6.5 Investigating a Claim for Incapacity Payments
Section 319 prescribes that claims for compensation (in addition to claims for liability) must be in writing. This requirement may be satisfied in one of the following ways:
- A tick in one of the boxes at question 21 on the MRCA claim form D2051; or
- The claimant's signature on a needs assessment; or
- A written request for compensation.
Subsection 330(1)(b) provides the legislative authority for the delegate to require a claim for compensation to be supported by medical evidence. Incapacity payments are not payable until a claim is received by one of the above mechanisms, and accompanied by a medical evidence.
Section 324 imposes an obligation on the delegate to investigate a claim that is made in writing.
Section 328 provides a delegate with the power to require a person to undergo a medical examination for the purpose of assessing their entitlement to incapacity payments. If the person:
- refuses or fails to undergo the examinations; or
- in any way obstructs the examination;
without reasonable excuse then their entitlement to compensation (excluding treatment) may be suspended until such time as they undergo that examination.
Whenever compensation is suspended via section 329, or any of the other suspension provisions, then compensation is not payable for the period of the suspension. 6.3.34 also refers.
Section 330 provides the authority for a delegate to request information in relation to a claim for incapacity payments from the person.
The various incapacity provisions in Chapter 4 of the MRCA provide the legislative authority to obtain information from Defence in relation to:
- rank and pay level;
- pay-related allowances;
- medical documents; and
- career progression.
Subsection 335(3) provides that the reasonable satisfaction (balance of probability) standard of proof applies to determining any claim for incapacity payments. That is, the delegate needs to determine on the balance of probabilities that a person is incapacitated for service or work by virtue of their service injury or disease.
Section 333 requires the delegate to determine a claim for incapacity payments in writing. Any such determination must clearly iterate the start date and end date of a period of incapacity.