3.4.14.8 Secondary conditions and sequelae

Where a person has a condition accepted on a presumptive basis and later develops another condition that is claimed because of the first, Delegates must consider whether the new condition itself appears in the presumptive instrument. If so, and if the relevant service parameters are satisfied, the second condition may also be accepted presumptively.

If the second condition is not listed in the instrument, the Delegate must determine liability using the relevant SoP (if applicable). In such cases, the presence of the previously accepted presumptive condition may satisfy a causal factor in the SoP for the second condition.  

The fact that the first condition was accepted through presumption does not diminish its standing as a service‑related condition for purposes of a SoP‑based assessment. In other words, if the causal connection is accepted for the first (causal) condition, then it may be used for the purposes of propagation through the SoPs for secondary conditions.  The accepted original causal condition’s connection to service does not need to be re-tested.

This approach ensures that presumptive acceptance continues to operate effectively throughout a person’s claims journey, including in circumstances where multiple interrelated conditions arise.