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2.11 Where several conditions combine to produce incapacity

Last amended 
8 August 2017

Where there are both accepted compensable conditions and non-compensable conditions contributing to a person’s incapacity, i.e. the incapacity is a result of a combination of causes, delegates should consider whether:

  • the compensable component of the whole suite of incapacitating factors would give rise to incapacity regardless of other factors. If not, liability to make payments may not exist.

  • the incapacity would exist if not for the effect of the compensable contribution. If the compensable condition, when added to any non-compensable conditions, leads to the person becoming incapacitated, or more incapacitated, then liability to make incapacity payments exists.

There are few rules to apply to these very variable circumstances. Delegates must apply their judgement and discretion to establish whether entitlement exists.

Entitlements in respect of an incapacitating medical condition do not cease because the person subsequently develops an additional non-compensable condition of greater severity. An entitlement to weekly payments continues while the incapacitating effects of that original, compensable condition also continue.

Where the person was already partially incapacitated due to a compensable condition/s before the introduction of non-compensable factors, then the non-compensable factors are probably not relevant, and liability to make incapacity payments continues.  Alternatively, where the person was already incapacitated due to the non-compensable condition/s before the introduction of compensable condition/s, and the non-compensable conditions do not increase that incapacity, then the compensable factors are probably not relevant, and liability to make incapacity payments does not exist.

A person has a pre-existing non-compensable condition but is able to work. This condition is then aggravated by service. The pre-existing condition of itself does not cause the incapacity, neither perhaps does the aggravation. Combine the effects of both and this prevents the person from working (wholly or partially). We continue to pay compensation as long as the medical evidence is that the compensable aggravation causes incapacity for work.