3.4.5.2 Sequelae streamlining policy
The MRCC and RC have approved an additional streamlining policy for certain sequelae of service-related medical conditions. This policy allows Delegates to streamline the investigation and decision-making approach in relation to 44 conditions (sequelae) where they arise from specified service-related conditions. The SoPs for these sequelae contain factors providing a simple link between the sequelae and their corresponding identified causal condition, namely that the causal condition was present either ‘before’ or ‘at the time of’ the clinical onset of the sequela. The streamlining policy for these conditions simply requires the Delegate to be satisfied that:
- The claimant has a diagnosis for the claimed sequela and
- the corresponding causal condition
- has already been accepted as service-related and
- was present before/at the time of clinical onset of the claimed sequela (depending on the requirements of the relevant SoP)
Any policies requiring Delegates to re-assess the complete propagation chain do not apply in relation to claims for the 44 sequelae to which this streamlining policy applies. The sequelae approved for inclusion in this streamlining policy are listed below, along with the causal conditions which must have been accepted as service-related for the streamlining policy to apply.
Certain sequelae are streamlined under the MRCA and VEA in relation to certain causal conditions only, as follows:
Sequela condition | Causal service-related condition which must be present | SOP factor requires the causal service-related condition to be present… |
| acquired cataract | diabetes mellitus | Before clinical onset of sequela |
| alcohol use disorder* | substance use disorder | At the time of clinical onset of sequela |
| depressive disorder | At the time of clinical onset of sequela | |
| anosmia | alcohol use disorder | At the time of clinical onset of sequela |
| aortic aneurysm or aortic wall disorder | hypertension | Before clinical onset of sequela |
| aortic stenosis* | hypertension | Before clinical onset of sequela |
| diabetes mellitus | Before clinical onset of sequela | |
| atrial fibrillation or atrial flutter | hypertension | At the time of clinical onset of sequela |
| bipolar disorder | substance use disorder | At the time of clinical onset of sequela |
| bronchiectasis | inflammatory bowel disease | At the time of clinical onset of sequela |
| cardiomyopathy | diabetes mellitus | At the time of clinical onset of sequela |
| carotid artery disease* | diabetes mellitus, | Before clinical onset of sequela |
| hypertension | Before clinical onset of sequela | |
| cerebrovascular accident | diabetes mellitus | At the time of clinical onset of sequela |
| chronic pruritus ani* | diabetes mellitus | At the time of clinical onset of sequela |
| inflammatory bowel disease | At the time of clinical onset of sequela | |
| conjunctivitis | diabetes mellitus | At the time of clinical onset of sequela |
| depressive disorder | alcohol use disorder | At the time of clinical onset of sequela |
| Dupuytren disease* | diabetes mellitus | Before clinical onset of sequela |
| alcohol use disorder | At the time of clinical onset of sequela | |
| erectile dysfunction* | depressive disorder, | At the time of clinical onset of sequela |
| diabetes mellitus, | At the time of clinical onset of sequela | |
| hypertension | At the time of clinical onset of sequela | |
| female sexual dysfunction | depressive disorder | At the time of clinical onset of sequela |
| gingivitis | diabetes mellitus | At the time of clinical onset of sequela |
| heart block | diabetes mellitus | At the time of clinical onset of sequela |
| IgA nephropathy | inflammatory bowel disease | At the time of clinical onset of sequela |
| immune thrombocytopaenia | inflammatory bowel disease | At the time of clinical onset of sequela |
| ischaemic heart disease* | diabetes mellitus | Before clinical onset of sequela |
| hypertension | Before clinical onset of sequela | |
| non-aneurysmal aortic atherosclerotic disease* | diabetes mellitus | Before clinical onset of sequela |
| hypertension | Before clinical onset of sequela | |
| non-Hodgkin lymphoma | inflammatory bowel disease | Before clinical onset of sequela |
| osteomyelitis | diabetes mellitus | At the time of clinical onset of sequela |
| otitis externa | diabetes mellitus | At the time of clinical onset of sequela |
| periodontitis | diabetes mellitus | At the time of clinical onset of sequela |
| peripheral artery disease* | diabetes mellitus | Before clinical onset of sequela |
| hypertension | Before clinical onset of sequela | |
| peripheral neuropathy | diabetes mellitus | At the time of clinical onset of sequela |
| porphyria cutanea tarda | alcohol use disorder | At the time of clinical onset of sequela |
| renal artery atherosclerotic disease | diabetes mellitus | Before clinical onset of sequela |
| renal stone disease* | diabetes mellitus | At the time of clinical onset of sequela |
| inflammatory bowel disease | At the time of clinical onset of sequela | |
| retinal vascular occlusion* | diabetes mellitus | Before clinical onset of sequela |
| hypertension | Before clinical onset of sequela | |
| sick sinus syndrome | hypertension | At the time of clinical onset of sequela |
| steatohepatitis | diabetes mellitus | At the time of clinical onset of sequela |
| subarachnoid haemorrhage | hypertension | At the time of clinical onset of sequela |
| subdural haematoma | alcohol use disorder | At the time of clinical onset of sequela |
| substance use disorder* | alcohol use disorder | At the time of clinical onset of sequela |
| depressive disorder | At the time of clinical onset of sequela | |
| suicide or attempted suicide* | alcohol use disorder | At the time of clinical onset of sequela |
| depressive disorder | At the time of clinical onset of sequela | |
| substance use disorder | At the time of clinical onset of sequela | |
| tinea | diabetes mellitus | At the time of clinical onset of sequela |
| tooth wear (tooth attrition only) | bruxism | At the time of clinical onset of sequela |
| tooth wear (tooth erosion) | alcohol use disorder | At the time of clinical onset of sequela |
| trigeminal neuropathy | diabetes mellitus | At the time of clinical onset of sequela |
| trigger finger | diabetes mellitus | Before clinical onset of sequela |
| Tuberculosis | alcohol use disorder | Before clinical onset of sequela |