Part One-Evidence And Investigation
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation
Why Investigate?
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/why-investigate
Principles Of Investigation And Evidence
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/principles-investigation-and-evidence
Investigation Principles
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/principles-investigation-and-evidence/investigation-principles
Disclaimers
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/principles-investigation-and-evidence/disclaimers
Evidence Principles
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/principles-investigation-and-evidence/evidence-principles
'... Without Regard To Technicalities (Section 72)'
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/principles-investigation-and-evidence/without-regard-technicalities-section-72
Onus Of Proof
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/principles-investigation-and-evidence/onus-proof
Powers Of Investigation
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/powers-investigation
Section 57
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/powers-investigation/section-57
Section 57 (1)
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/powers-investigation/section-57/section-57-1
Sections 57 (2) and 57 (5)
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/powers-investigation/section-57/sections-57-2-and-57-5
How 'without reasonable excuse' is interpreted
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/powers-investigation/section-57/how-without-reasonable-excuse-interpreted
What 'suspended until the examination takes place' means
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/powers-investigation/section-57/what-suspended-until-examination-takes-place-means
Suspending the claim on PRACSYS
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/powers-investigation/section-57/suspending-claim-pracsys
Standard letters
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/powers-investigation/section-57/standard-letters
Section 57 (3)
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/powers-investigation/section-57/section-57-3
Costs
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/powers-investigation/section-57/costs
Paying section 57 accounts
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/powers-investigation/section-57/paying-section-57-accounts
Section 57 (4)
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/powers-investigation/section-57/section-57-4
Section 57 (6)
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/powers-investigation/section-57/section-57-6
Time Off Work To Attend The Examination
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/powers-investigation/time-work-attend-examination
Why Review?
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/powers-investigation/why-review
Section 58
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/powers-investigation/section-58
How (And How Not) To Use Section 58
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/powers-investigation/how-and-how-not-use-section-58
Failure To Provide Requested Evidence
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/powers-investigation/failure-provide-requested-evidence
Sections 71 (1) And (2)
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/powers-investigation/sections-71-1-and-2
Summary
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/powers-investigation/summary
The Investigation Process
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/investigation-process
Evaluating Evidence
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/evaluating-evidence
Information Comcare Uses As Evidence
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/evaluating-evidence/information-comcare-uses-evidence
Medical Reports
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/medical-reports
When To Seek Medical Reports
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/medical-reports/when-seek-medical-reports
Asking Appropriate Questions
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/medical-reports/asking-appropriate-questions
What to provide the doctor with
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/medical-reports/asking-appropriate-questions/what-provide-doctor
A case summary
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/medical-reports/asking-appropriate-questions/case-summary
Other types of medical report requests
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/medical-reports/asking-appropriate-questions/other-types-medical-report-requests
Other forms of information which may be provided
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/medical-reports/asking-appropriate-questions/other-forms-information-which-may-be-provided
Possible Vs Probable
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/medical-reports/possible-vs-probable
Considering Medical Evidence
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/considering-medical-evidence
Full Claim Review
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/full-claim-review
Initial Liability
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/full-claim-review/initial-liability
Determining liability
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/full-claim-review/initial-liability/determining-liability
Liability review dates
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/full-claim-review/initial-liability/liability-review-dates
Using the Guide
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/full-claim-review/initial-liability/using-guide
Advising the employee
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/full-claim-review/initial-liability/advising-employee
Claim comments
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/full-claim-review/initial-liability/claim-comments
Claim Review Following Initial Liability
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/full-claim-review/claim-review-following-initial-liability
Where there is incapacity only
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/full-claim-review/claim-review-following-initial-liability/where-there-incapacity-only
Where there is medical treatment only
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/full-claim-review/claim-review-following-initial-liability/where-there-medical-treatment-only
Where rehabilitation is involved
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/full-claim-review/claim-review-following-initial-liability/where-rehabilitation-involved
Claims made following the expiration of the set review date
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/full-claim-review/claim-review-following-initial-liability/claims-made-following-expiration-set
The Importance Of Comments On PRACSYS
Evidence and investigation are very important to the claims manager's role.
Gathering the correct evidence and conducting relevant investigations not only saves time and effort in the longer term, but will provide a specific and accurate result.
Past volumes have indicated:
-
sometimes the decisions which are made can have repercussions for other staff in the office (Volume 1);
-
decisions must be supported by good arguments, based on the Act and other information, such as medical evidence (Volume 1);
-
is it really necessary to seek medical evidence from three, four or even five doctors before making a decision? (Volume 1);
-
always bear in mind the expected outcome of seeking further evidence. Is more information going to alter the decision? If not, there is really no reasonable basis for requesting further information (Volume 4);
-
the decision making process is all about managing risk (Volume 4);
-
don't get information just for the sake of it. With each case being dealt with on its merits, there are no cut and dried 'rules' (Volume 4).
Remember, what it all boils down to is weighing up and managing the risks associated with the decision making process. Ask what the likely implications are of saying 'yes' or 'no'? Is it more practical to say 'yes' to a claim that is straightforward?
Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-seven-review-processes/part-one-evidence-and-investigation/importance-comments-pracsys