Where relevant criteria are met, presumption will be applicable ‘unless the contrary is established’. However, any routine investigations of conditions and systemic approach to refutation of contentions will potentially jeopardise the effectiveness of a process aimed directly at simplifying claims and may undermine the policy intent of the change.
Where a condition has been diagnosed and relevant service and onset criteria have been met, any determinations to not apply the presumption should be made only at a relatively senior level. Such decisions should occur only in exceptional cases where there is existing clear, unambiguous and irrefutable evidence of causation of the condition being outside service.
An active investigation to establish a contrary finding would not usually need to occur, unless there is definitive extant evidence that indicates this would be appropriate.
Where documentation that is available points to a non-service causation, a claim can appropriately be denied, e.g. a causation of a condition that was diagnosed prior to enlistment (or for injuries or diseases with short latency well after service) or where there is clear evidence from the treating doctor that attributes causation solely to events outside service, without such evidence being actively sought.
Delegates should not initiate investigation or escalation to attempt to establish a ‘to the contrary’ finding unless such evidence already exists and is definitively established