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18.104.22.168 Table 8.1 and Dietary Modification
Table 8.1 also requires the finding of dietary modification needed for control at certain impairment levels. The following provides some broad guidance in relation to these claims.
The DRCA PI Guide is silent on what ‘dietary modification’ is, however in general medical practice ‘dietary modification’ means specific dietary recommendations scientifically validated to manage the symptoms of a disease and includes texture modified diets (e.g. soft, thickened fluids, minced, puree), allergy/intolerance diets (e.g. low additive, nut free, low FODMAP, gluten free), energy based diets (e.g. specific high or low caloric intake), fat modified diets, renal diets and more.
The description provided in the Comcare Guide, whilst not binding on the decision maker, also provides some good guidance as to the intended meaning of a modified diet. It says, “a modified diet does not include the avoidance of a few, or selected, food items. It refers to special diets devised medically to manage symptoms of the disease and maximise nutrition (for example, lactose-free diet, gluten-free diet).”
When deciding if dietary modification is needed for control for the purposes of meeting a particular criteria on Table 8.1, decision makers should turn their mind to whether the medical evidence supports the veterans requirement to modify their diet in such a way to exclude or include foods or food groups to medically manage the symptoms of the specific disease of which is subject to the claim.
If complex or unusual cases arise, delegates are encouraged to obtain specific advice from Benefits and Payments Policy (B&PP).