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3.4.6 Propagation and SOPs

Propagation is the process of linking a claimed condition with a separate injury or disease as part of the hypothesis.  It is a consideration wherever the hypothesis raised by the material includes a sub-hypothesis relating to another medical condition as the causal or aggravating factor, but which is not the subject of the claim. This includes sequelae, which are medical conditions arising from other medical conditions but which are distinct from those causal medical conditions.

 

For the claimed condition to be found to be service related, so too must the causal or aggravating factor (i.e. the medical condition) that forms part of the overall hypothesis.

 

Many RMA SOPs contain causal or aggravating factors that are discrete medical conditions in their own right and which are sometimes also the subject of a RMA SOP.  However, there are also many medical conditions that are not covered by a SOP.

 

Consequently, the case law has evolved in a manner that reflects the different scenarios that may arise in this context.

 

Where the causal condition has already been accepted

The law requires that when a sequela is claimed, all the SOPs relating to the contention must be applied, meaning that the SOPs for any causal conditions leading to the sequela as well as the SOP for the sequela itself must be considered at the time of determining the claim for the sequela.  This is the case even where the causal condition has already been accepted as service-related.

 

However, there are 44 sequelae to which a policy allowing streamlined decisions applies, and for decisions involving these sequelae the decision to accept the relevant causal condition is not revisited.  For further information on streamlined sequelae, see 3.4.5 Applying Streamlining Procedures.

 

Where limited liability has been accepted for the causal condition under MRCA s 30

Where the sub-hypothesis rests on a condition for which limited liability has been accepted under MRCA section 30 – aggravation of signs or symptoms – then the claim must fail as the injury or disease proper is not related to service.  SOPs are not used when applying section 30;  hence aggravation of signs or symptoms is not a valid consideration in the context of propagation.

 

When processing a relevant claim in the legacy CADET system it is important to note that where propagation applies, the MCE rulebase is constructed anomalously to consider a section 30 aggravation of signs or symptoms as a legitimate pathway to acceptance.  The subsequent MCE recommendation to accept a condition on this basis should be rejected.