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6.5.6 Medical Certificate/Opinion Quality Checklist

A medical opinion should never be rejected lightly.  Delegates should certainly consider seeking further or alternate information where, for instance:

  • the terms of a medical certificate are directly contradicted by documented work performance in a rehabilitation work trial, or some other documented activity (e.g. published sporting results);
  • the report or certificate is internally inconsistent (i.e. self contradictory) and/or is anomalous with respect to other medical opinions on file;
  • a medical report is written in an emotive way and discusses irrelevant matters that suggest the author has adopted an advocate's role rather than that of an objective medical assessor;
  • the report's findings on medical fact, conflicts with what the same medical assessor has written in relation to that person's case for a VEA pension;
  • the medical data and observations contained in the report conflicts markedly with what other medical assessors have found, e.g. is contrary to assessments conducted for insurance or Centrelink purposes;
  • medical opinion is not based on first hand information or on a medical examination conducted by the author; or
  • the medical report purporting to support the request for weekly payment is not current i.e. it is much older than the claimed period of incapacity.

This is not an exhaustive list.  In fact a delegate may challenge a medical opinion and/or seek another opinion provided they have a reasonable basis for doing so.