External bruise - No appropriate clinical management for an external bruise or contusion Factor

An external bruise means a contusion or haematoma.  A haematoma is a swelling from an accumulation of blood in the tissues immediately under the skin.  This may be accompanied by discolouration of the unbroken skin as with a bruise.  An external bruise is bleeding from the capillary blood vessels immediately below the skin.  This is evidenced by discolouration of the unbroken skin which may appear black, blue or purple.  The area may be painful to touch.  As the bruise heals, the skin may develop a greenish or yellow tinge as the blood breaks down.  Sometimes, because of gravity, skin discolouration may appear at a lower location than where the actual trauma occurred eg a blow above the eye socket or on the bridge of the nose may result in bruising under the eye.  This skin discolouration does not appear immediately but may show within a few hours or days.

Inability to obtain appropriate clinical management

Last reviewed for CCPS 12 March 2008.

Investigative Documents

Type	Title	PDF Format	Word Format
Medical Report	Inability to Obtain Appropriate Clinal Management	GQACM.pdf [6]	GQACM.docx [7]

Preliminary questions [7087]

11109  the condition under consideration has been accepted on the basis of inability to obtain appropriate clinical management for the condition under consideration.

7066     there is some evidence that an inability to obtain appropriate clinical management for the condition under consideration may be a factor in the worsening of the condition under consideration.

7334     the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.

7335     the condition under consideration permanently worsened.

7378     the veteran was unable to obtain appropriate clinical management for the condition under consideration at some time.

7379     the inability to obtain appropriate clinical management for the condition under consideration contributed to the clinical worsening of the condition under consideration.

11234   the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and VEA service for the clinical worsening of the condition under consideration.

11235  the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and operational service for the clinical worsening of the condition under consideration.

or

11236  the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and eligible service for the clinical worsening of the condition under consideration.

Clinical worsening and operational service [11235]

7384     the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, during operational service.

21084 the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, during operational service, as a causal result of operational service.

7387     the veteran's inability to obtain appropriate clinical management for the condition under consideration during operational service was due to the veteran's serious default, wilful act or serious breach of discipline.

or

7389     the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, because of an illness or injury which is identifiable.

7390     the identified illness or injury which prevented the veteran from obtaining appropriate clinical management for the condition under consideration is causally related to operational service.

7392     the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury that prevented the veteran from obtaining appropriate clinical management for the condition under consideration is causally related.

Clinical worsening and eligible service [11236]

7385     the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, during eligible service.

7386     the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, during eligible service, as a causal result of eligible service.

7388     the veteran's inability to obtain appropriate clinical management for the condition under consideration during eligible service was due to the veteran's serious default, wilful act or serious breach of discipline.

or

7389     the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, because of an illness or injury which is identifiable.

7391     the identified illness or injury which prevented the veteran from obtaining appropriate clinical management for the condition under consideration is causally related to eligible service.

7393     the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the identified illness or injury that prevented the veteran from obtaining appropriate clinical management for the condition under consideration is causally related.

External bruise - Physical trauma Factor

Physical trauma means a knock, blow, hit or firm compression (as may occur with seat belt injuries).  Physical trauma does not have to be severe in order to cause an external bruise.  Some people bruise more easily than others because of an underlying fragility.

A history of physical trauma may be documented in the evidence.  However, unless the trauma was severe, the person probably would not have sought medical attention.  In addition, doctors' notes and hospitals' records may have been destroyed or can no longer be obtained.  If clinical records cannot be obtained, a statement regarding the circumstances of the physical trauma that caused the bruise will generally be accepted, unless there is contradictory evidence.

Last reviewed for CCPS 12 March 2008.

Investigative Documents

Type	Title	PDF Format	Word Format
Claimant Report	External Bruise	CR9297.pdf [8]	CR9297.docx [9]

Preliminary questions [7086]

7088     the veteran has had physical trauma to the area of side and site of the body at some time.

7093     the veteran satisfies the occurrence provisions for the physical trauma and VEA service for the clinical onset of external bruise.

7096     the veteran had physical trauma to the area of side and site of the body within the 72 hours before the clinical onset of the condition under consideration.

or

7101     the veteran had physical trauma to the area of side and site of the body within the 24 hours before the clinical onset of the condition under consideration.

7090     the veteran has established the causal connection between the physical trauma and VEA service for the clinical onset of external bruise.

7094     the veteran has established the causal connection between the physical trauma and operational service for the clinical onset of external bruise.

or

7095     the veteran has established the causal connection between the physical trauma and eligible service for the clinical onset of external bruise.

Clinical onset and operational service [7094]

7097     on operational service, the veteran had physical trauma to the area of side and site of the body within the 72 hours before the clinical onset of the condition under consideration.

7098     the physical trauma to the area of side and site of the body within the 72 hours before the clinical onset of the condition under consideration, on operational service, was due to the veteran's serious default, wilful act or serious breach of discipline.

or

7089     the veteran had physical trauma to the area of side and site of the body before the clinical onset of the condition under consideration as a consequence of an illness or injury which is identifiable.

7099     the veteran had physical trauma to the area of side and site of the body within the 72 hours before the clinical onset of the condition under consideration as a consequence of an illness or injury which is identifiable.

7100     the identified illness or injury which caused the physical trauma to the area of side and site of the body is causally related to operational service.

Clinical onset and eligible service [7095]

7102     on eligible service, the veteran had physical trauma to the area of side and site of the body within the 24 hours before the clinical onset of the condition under consideration.

7103     as a causal result of eligible service, the veteran had physical trauma to the area of side and site of the body within the 24 hours before the clinical onset of the condition under consideration.

7104     the physical trauma to the area of side and site of the body within the 24 hours before the clinical onset of the condition under consideration, on eligible service, was due to the veteran's serious default, wilful act or serious breach of discipline.

or

7089     the veteran had physical trauma to the area of side and site of the body before the clinical onset of the condition under consideration as a consequence of an illness or injury which is identifiable.

7105     the veteran had physical trauma to the area of side and site of the body within the 24 hours before the clinical onset of the condition under consideration as a consequence of an illness or injury which is identifiable.

7106     the identified illness or injury which caused the physical trauma to the area of side and site of the body is causally related to eligible service.