12.5.4 Claim for Clinical Onset and Aggravation

Often, delegates will receive a claim for a condition where:

• clinical onset of the condition relates to service rendered solely before 1 July 2004; and
• the condition is aggravated on or after 1 July 2004; and
• the aggravation relates to defence service rendered on or after 1 July 2004.

In such a scenario both the SRCA and the MRCA apply to the claim.  Unless instructed to do otherwise by the claimant or the claimant's legal personal representative, d — elegates should determine liability under the M — RCA first, before liability under the SRCA is determined.  After a determination is made under the MRCA, delegates can then make a liability determination under the SRCA.

Although liability under the SRCA may result in a component of PI compensation, a claim under the SRCA will probably not provide the claimant access to other compensation and benefits which they require to meet their immediate needs.  Therefore, a determination under the MRCA is made, and a n — eeds a — ssessment conducted, before determining whether there is any liability under the SRCA to ensure that the member is provided with early access to the appropriate incapacity compensation, rehabilitation and treatment benefits of the MRCA.

Where a claim is to be assessed under both the SRCA and the MRCA it will be necessary to obtain the person's consent to use the information on the claim form for both Acts.  It is recommended that for all claims encompassing both the MRCA and the SRCA, the member is asked to sign the following release:

“I (Name) of (Address), consent to the information collected pursuant to this form being used for the purposes of investigating my entitlement to benefits under both the SRCA and the MRCA

Signature                                                  Date”

Example:

A member submits a claim for thoracic spondylosis on 8 November 2005.  The member sustained a trauma to the spine while playing approved sport on 12 April 1998 which resulted in the clinical onset of the condition in 2002.  No claim for compensation was lodges at that time.  After operative treatment and rehabilitation the member seems to have been left with a residual impairment but it did not prevent him serving in a full capacity.  However, some time during October 2005 the condition rendered him unable to continue serving.  The member claims the deterioration of the condition has been accelerated due to the forced pack marches he has participated in over the course of his service.

Clinical onset of the condition was before 1 July 2004 and related to defence service rendered before the 1 July 2004.  Therefore, the SRCA applies to the claim for clinical onset of the condition.  The subsequent acceleration in deterioration of the condition is an aggravation of the condition.  The MRCA applies to this aggravation as it arose out of service rendered before and on and after 1 July 2004.  The delegate contacts the member and explains the situation to him.  The member understands that the impairment he suffers from his condition is covered under two separate pieces of legislation and agrees to sign the release so that his claim for liability can be assessed under both the SRCA and the MRCA.