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3.4.5.2 Sequelae streamlining policy

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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 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