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12.5.2 Aggravation relates to service on or after 1 July 2004
The aggravation must relate to defence service rendered on or after 1 July 2004 (see 3.2 of Chapter 3: Liability). However, it is not necessary for the aggravation to relate solely to defence service rendered on or after the 1 July 2004. The MRCA will also apply to an aggravation that relates to defence service rendered before the 1 July 2004, but only if the aggravation also relates to defence service rendered on or after 1 July 2004. In other words, the MRCA will apply if the aggravation relates to service before and on or after 1 July 2004. Defence service taken into account can span 1 July 2004 or be rendered during separate periods (including periods of service separated by a period of non-service).
On 19 May 2006 the member submits a claim for aggravation of chondromalacia patellae (CMP) of the left knee. The member enlisted in the Army in 1998 and is still serving. Liability for CMP was accepted under the SRCA on 18 August 2003. The DMO confirms from the medical evidence on file a further breakdown in the underlying pathology of the member's CMP following clinical onset in 2003. The delegate takes a look at the Repatriation Medical Authority (RMA) Instrument No.34 of 2001 and notes that the only factors relating to the clinical worsening of CMP involve a direct trauma to or abnormal tracking of the patellae, or meniscal damage or permanent ligamentous instability. The delegate reviews all evidence including service medical records looking for evidence that service rendered after 1 July 2004 has aggravated the member's condition. The only evidence is of a trauma on 12 April 2004 when the member fell on her left knee. The delegate decides MRCA does not apply to the member's aggravation because the aggravation only relates to defence service rendered before the 1 July 2004. He phones the member to discuss the matter with her. The member agrees that the claim should be assessed under the SRCA.
On 9 August 2006 a member submits a claim for 'hearing loss' (no diagnosis on claim form). The member enlisted in the Navy on 4 May 1999 and is still serving. The member's claim form contends high noise levels on HMA warships as the cause of his hearing loss. A diagnosis of bilateral sensorineural hearing loss (SNHL) is obtained and the delegate refers the member for an audiogram to confirm a permanent hearing threshold shift of 25 decibels (dB) to confirm the application of RMA Instrument No.30 of 2001. The member has not previously claimed SNHL.
Periodic audiograms contained in the members service and medical documents show a gradual deterioration from about early 2000 to date. As this was the time medical evidence indicates that the member was first suffering symptoms which indicate that SNHL was present, the delegate, after conferring with the DMO, establishes this as the date of clinical onset. An audiogram conducted in March 2004 shows significant deterioration in hearing. Based on this medical evidence, it cannot be said that clinical onset of the member's SNHL occurred after 1 July 2004, or that clinical onset of the member's SNHL relates to service rendered on or after 1 July 2004. Therefore, the MRCA does not apply to any claim for clinical onset of SNHL. Instead, compensation coverage is available under the SRCA (assuming the member has no eligible VEA service) for hearing loss up to March 2004.
An audiogram in September 2004 shows a further deterioration from March 2004. Based on this medical evidence it could be said that an aggravation has occurred after 1 July 2004. Compensation coverage may be available under the MRCA for any hearing loss suffered after March 2004, because this is considered an aggravation which relates to service rendered (before and) on or after 1 July 2004.