12.6.1 Aggravation occurred on or after 1 July 2004

For a service-related “aggravation” of an accepted VEA disability to be considered under the MRCA, the aggravation must relate to service rendered on or after 1 July 2004.  Delegates should establish on the balance of probabilities the date the aggravation occurred by reference to the appropriate medical evidence (see 3.4.3 of Chapter 3: Liability).  If this date is before 1 July 2004, the MRCA does not apply to that aggravation.  However, as noted at the beginning of this Chapter, only those claims where an election was made prior to 1 July 2013 can be determined as aggravations under the MRCA.

Example 1

On 11 July 2013, a former member submits a claim under the MRCA for an aggravation of a pre-existing lumbar spondylosis (LS) condition.  The former member enlisted in the Army in 1985 and was discharged on 10 July 2005.  LS was accepted under the VEA on the basis of operational service in East Timor during 2000.  The LMO finds that a slight deterioration in the member's LS has occurred, but believes this is simply due to a natural progression of the disease.  The delegate checks the former member's medical documents and does not find any evidence of an aggravation prior to her discharge.  The delegate decides that (on the balance of probabilities) no aggravation has occurred on or after 1 July 2004.  The delegate phones the former member and explains the situation to her.  The former member agrees to withdraw her MRCA claim and lodge an AFI of her accepted disability under the VEA.  The delegate ensures that an “informal claim” under the VEA is registered with the original receipt date, noting that a formal AFI claim must be lodged by the client prior to any determination under the VEA.

Example 2

On 4 May 2013, a member lodges a claim for “degenerative changes to the right ankle”.  The delegate notes that the underlying right ankle injury is a VEA AD relating to an incident on operational service in East Timor in June 2004.  The member contends that there has been an aggravation of the condition during a training exercise in March 2012.  The Medical Officer supports the member's contention and attaches copies of service medical documents describing the incident.  The delegate notes that the last VEA assessment of the right ankle awarded the member a Disability Compensation Payment at 10% of the General Rate.  Irrespective, this assessment was conducted in mid-2004 and the delegate is still not reasonably satisfied as to whether this claim is related to a MRCA aggravation of a pre-existing injury or a recurrence (or natural worsening) of the previous injury.  In order to clarify, the delegate requests Unit Medical Records (UMRs).  When the UMRs arrive, the delegate consults with a DMO and decides that the incident in March 2012 aggravated the underlying VEA AD.

On 20 June 2013, the delegate invites the claimant to lodge an election under section 12 but the claimant fails to make an election prior to 1 July 2013.  As no choice had been made to pursue a claim under the MRCA prior to 1 July 2013, the claim must be considered as an AFI of the VEA claim.