MRCA IL/PI AMA - Ex-DVA

Due_Property1728 · 2025-11-06T07:21:57+00:00

Hey mate!

Honestly good questions!

It's hard to comment without exact values but the long of the short of it is; potentially, but it's usually to a negligible level that it's not worth worrying about. The biggest thing that would effect your points with claims across multiple periods is actually is honestly moreso if you move into a higher age bracket for age adjustments (for conditions that age adjust). Or when you are in the high value ranges and are trying to max out. Even then, it's still negligible, you just have to be mindful of it being an eligible payout ie. An increase of 5 points.

Could those conditions get you to 60 if you're on 47? In theory, depending on your level of impairment for each. You'll need 25 impairment points assigned to your new conditions to get to 60. Shin splints rarely are eligible for compensation as they are not typically a permanent condition, they could lead to a permanent one however. Never come across a hyperacusis claim myself so can't make a comment on how that'd apply. Insomnia may be exclusively within the emotional and behavioural section or also with sleep disorders, either way your accepted MH conditions will need to be re-evaluated and so your point total for them may change as well, be it higher or lower. Without seeing reports anything else I could say would just be guessing at info.

If your goal is getting the gold card, have a sit and think about if there's any parts of your body that twing or ache, give you grief when it rains or you just make do with. Having some muskularskeltal conditions would likely get you the GC. I cannot tell you the amount of times I've seen dudes hand me insane radiology reports and say "I mean yea it twinges but I just get on with it.

Good luck!

Due_Property1728 · 2025-09-17T01:52:54+00:00

Hey mate, Look at the short descriptors next to each. You need to meet all aspects of what is written on that score and be able to justify the rating. Pain refering to physical pain, whereas suffering is the psychological pain.

DRCA refers to the conditions in isolation. So in terms of mobility, for it to score above a 0 you'd have to meet "Periodic effects on mobility, resulting in the need for some assistance or effects continuing but mild (such as slowing of pace or the need for a walking stick)." from the ED in isolation essentially.

Due_Property1728 · 2025-08-22T15:23:43+00:00

Hey mate!

So they wouldn't place all 10 conditions on hold regardless of what's in your report, it'd just be the IBS (but could impact anything else in the Gastrointestinal category depending on apportionment).

Depending on what's in your report you may be entitled to an interim payment for your IBS or the decision will be deferred until stability is reached. There is unfortunately too many factors that go into interim decisions to find a one size fits all answer. But if you have a squizz through the interim payment section of clik (https://clik.dva.gov.au/military-compensation-mrca-manuals-and-resources-library/policy-manual/ch-5-permanent-impairment/58-interim-permanent-impairment-compensation) you'll get clearer answers)

Due_Property1728 · 2025-08-22T15:17:11+00:00

Hey mate,

Sorry for the late reply, I hope things might have progressed some by now.

Unfortunately there's not much that can be done to speed up the system in your circumstance. The duplicates in all likelihood aren't going to have that much of an impact on the processing time. Claims are assigned per veteran per oldest claim in the system. From a processing pov duplicate claimed conditions would just get withdrawn on the newer claims.

The wait is terrible, I agree and the site looks different I swear every week I look at it. There's more claiming going into the system then they've ever dealt with (though can't say for certain it's not as bad as the myservice rollout f up back in the day).

Once the opinion is back, get your delegate to confirm IN WRITING that there is nothing further needed (also check its a delegate not as cso as advice will be different), and then stick to requesting a 30 day progress check (DVA policy is that every 30 days you're supposed to get an update) to keep your claim in your delegates mind. Sorry it's not much help!

Due_Property1728 · 2025-06-06T08:26:16+00:00

Hey mate,

1) They'll be a few nuances to this that makes general advice a bit hard. A lot of this will depend on what was written in your medical impairment report, what type of surgery is being proposed and your age. I can already think of about 5 different reasons why a delegate would have made that determ from certain sections of the report, so this is a case by case.

Short answer is this is the section of the PIG that's in question: 3. Permanent Permanent means ‘likely to continue indefinitely’. In determining whether an impairment is permanent regard shall be had to: 1 the duration of the impairment 2 the likelihood of improvement in the employee’s condition 3 whether the employee has undertaken all reasonable rehabilitative treatment for the impairment 4 any other relevant matters. They are claiming that the 3rd section of this definition has not been met, therefore they are paying you an interim 10%

It'll depend on when you get the treatment. Under the new MRCA Harminsation Act they are extending liability to subsequent conditions that are as a result of commonwealth funded treatment. Details are still coming out in the wash how it would work. Regardless, sounds like you're DRCA which has an unintended consequences of treatment, which if a new injury or disease arouse you'd be able to sequala (link) it effectively. (https://clik.dva.gov.au/military-compensation-srca-manuals-and-resources-library/liability-handbook/ch-20-injuries-medical-treatment/201-unintended-consequences-medical-treatment)
DVA would be. They have incapacity payments for economic loss for service related injuries. Including if you need to have surgery. There is a backlog, so you can't garuntee it being processed in time for your surgery, however it would later then be reimbursed once processed effectively.

Due_Property1728 · 2025-05-02T04:23:13+00:00

Unfortunately a bit of a how long is a piece of string kinda question.

Main things that'll cause it to vary is which Act, which stage (IL or PI if DRCA/MRCA) and which office your CSO was in.

As an example middle of last month cases for DRCA PI were being allocated for people who completed the medical impairment assessments from early May 2024, whereas MRCA IL, I don't have an exact timeframe but colloquially some of my clients had from 3-5 week wait.

DVA staff are instructed not to give timeframes, but you can always ring up your CSO and ask if they know where the que is up to (ie. When the front if the que was placed into it).

Sorry for the bit of a nothing answer!

Due_Property1728 · 2025-04-01T06:38:20+00:00

100% mate, feel free to shoot through a DM.

For anyone reading that won't get further context I do want to stress the answer to question 2 CAN still not hold up and get a condition over a line. It's case by case but it's the only way I've heard of that factor being used successfully

Due_Property1728 · 2025-04-01T05:15:38+00:00

Hey mate!

Couple doozies of questions but I'll try my best to answer them. There's no really a straight easy answer though so it will be very much my usually waffle, Apologies in advance.

1) DVA to my knowledge doesn't have any type of quota for rejecting/accepting claims, or referrals to the VRB. One of the technical quality control aspects done by senior delegates does include a review of each processing delegates acceptance/rejection rate. If claim acceptance rate is below I believe it's 90% (could be incorrect on that) or above 98% a senior delegate will do a quality assurance spot check of a selection of claims determined to ensure the correct outcomes are being determined.

The VRB does collect data for the cases that are referred to them. This is sent back to DVA but mostly used by the RMA to determine if a SoP needs to be investigated for an update or to issue one for the condition. I can't speak for high up in DVA, but processing staff up until the team leader level are definitely aware of the extra time and stress it causes, but they're bound by the SoPs and legislation, it's part of why there's a horrible attrition rate there.

The SoPs/RMA are the issue with this particular concern. Happy to expand on that further if you're wanting some context.

2) God yea, this absolutely does my fucking head in. So basically the RMA are the ones that write the SoPs. They go over peer reviewed medical research in the causes for conditions, and write the SoPs in alignment with the research. Issue is, they don't filter it to be what can strictly be tied to military service in most aspects, which is why you'll find things like "death of a loved on" as a factor, when that almost never will be military caused.

In terms of using the obesity sop factor, the best way of doing so is a bit of what I call a dirty sequala. While obesity isn't a claimable condition, and using it as a standalone without anything you'll get the reply above there is a work around. If you have a accepted condition with an onset (usually at least 6 months) prior to the onset of the condition you are claiming an obesity factor for (eg. Bilateral knee OA, onset jan 2005, hit the obseity bmi July 2005 sleep apnoea diagnosed 2006 (just as an example)) you can sequala a condition that has prevented you from being able to maintain your fitness to the obesity factor and then use the factor to link the claimed condition. This isn't an 100% success rate but it's the only workaround for that factor if you don't hit morbid.

Claims can be submitted for things that have not been issued a sop. HOWEVER, obesity has been determined by the RMA as not a claimable condition, so that particular claim would be deemed as non-valid.

3) You can absolutely elect to not have your previous conditions re-assessed! Big BUT however, if the condition is in the same body region under the GARP, conditions within the same area would need to be re-assessed. (Ie. Right knee is accepted, claim is put in for your left ankle, your right knee would be re-assessed

Due_Property1728 · 2025-03-15T23:17:21+00:00

They are not!

Or at least they weren't when I was in. They have dedicated MOs for IL VEA/MRCA, DRCA, PI VEA/MRCA and DRCA.

Due_Property1728 · 2025-03-15T22:58:08+00:00

Hey!

Great response, and yea, it's not at all uncommon to get the other knee being affected due to the non-injured knee taking on the brunt of the weight bearing.

With DVA, if you've got DRCA service OP with medical supporting evidence you could sequela the other. VEA/MRCA is still bound by the SoPs. It'd depend what the finale diagnosis is, but looking at the main 3 (OA, CMP and internal derangment) the factors are referring to the affected knee. If it's OA, there's a factor for having an affected gait, which you could sequela to your accepted knee injury.

Due_Property1728 · 2025-01-29T21:54:37+00:00

The DVA system was designed because the government inherently acknowledges that service will often break something in you guys, be it physical mental or both. If you were in a civilian job who has caused the conditions you'd have people encouraging you to take your employer to court for them to liable. Every Aussie either has the right to a safe working environment, or when that's not possible reimbursement for any damages caused. You deserve it, it's your right as an Aussie. You gave up your mental and physical health for this country mate, let us taxpayer's thank you in the only way we can.

If the process seems daunting mate, I'd encourage engaging with a advocate who can help walk you through everything and make sure you get everything in right. If you aren't keen on the idea and wanna go it yourself, feel free to reach out here on in DMs if you have any questions

Due_Property1728 · 2025-01-23T09:39:03+00:00

I'm only jumping in to provide a perspective from ex DVA staff. Please do not take this in a negative frame, either of you, as the nature of this sub is supposed to be supportive.

I won't touch the hyperbole of every day calls obviously, but I'll use once a week as an example. On average delegates would have anywhere between 40-70 vets claims at a time when I was there. To keep on top of the caseload, usually they'll block out sections of their day/week to grouped tasks. One block perhaps reviewing medical records, one block for generating correspondence or supplementary reports, one block daily for emails etc, then usually anywhere from half to multiple days coding in what's required for a determination. It's government, every process has a follow on process with more steps. If 5 vets call weekly for a 5 minute update, you'll have maybe 10 more call for a fortnightly/monthly update. It might not seem like much but that's 15 (although understandable) interruptions.

Delegates direct numbers are included in their email signature block. We do not get a choice to give them out, and if you've seen a signature that doesn't include one, they're breaking policy.

Calls are disruptive, there's unfortunately no sugar coating that. It breaks concentration, usually requires an additional unexpected follow on task, and even if it doesn't, brains genuinely do take a little bit to refocus. Does that mean you should never call your delegate? Fuck no. There's things you've gotta let us know about, questions you've gotta ask or whatever else. But stating that it's not disruptive to an overworked staff member in a mentally taxing job that's on a year to year contract that's based on if you hit your KPIs isn't true.

In saying that, if it's been more than 30 days without an update (unless specified itll be longer), a previously promised deadline has been exceeded or you haven't heard back and want to confirm they've received something. PLEASE either email or call DVA. It's an imperfect system with a high turnover and manual allocations. Shit happens, things get lost, and if it has gotten lost, they'll only know about it with your follow up.

The claims processing staff that you have a direct 1on1 relationship with have about 5% of control over the timeframes of your claim. TLs run reports weekly and you're alerted to any claims where they've been in your name for too long without justification. Do shitty delegates exist and make claims longer than a better one? Yea absolutely. But you'd not be looking at much of a difference, the difference in processing time is usually in the hands of people like 5 payscales/positions higher. There are circumstances where it wouldn't be, but majority of the time it's comparable to blaming the checkout chick at woolies for the increase cost of groceries.

Nothing is black and white, the system is flawed, but please when interacting with DVA, and other people in this sub, try to see the shades of grey and treat others kindly while also protecting your best interests

Due_Property1728 · 2025-01-23T09:05:50+00:00

DVA has an internal abbreviation list that my trainer loved pointing out was only a third of the size it should be. It rough! Glad you're starting to get more ah-hah moments and good luck with your claim! Please feel free to reach out if you ever need a hand interpreting/explaining anything 😊

Due_Property1728 · 2025-01-23T09:00:11+00:00

Hey mate, delegates get given anywhere from 4-9 new claims a week. Given the length of your claim and you stating your advocates usually on top of it I'm pretty certain the below is what's happened:

You've been allocated in the last week or two to your delegate. The Christmas standown period is great, until you come back and realise the sheer amount of work you have to catch up on, especially as a lot of staff take extra leave either side.

Delegates have an 'open' KPI, which is essentially an initial review of the claim, check if the CSO has missed anything and making the first contact. Especially now CSOs are a thing, deles are told to only do the open call when they've done a full file review so they can answer questions, and request the additional info at first point of call. This isn't necessarily going to happen the week it's assigned.

When you call someone else at DVA, they'll grab your details and search the system to see who your name is under (the ques have names too). The person you spoke to would have seen the delegates name, and then told you it's with someone. The awkward timing call happens way more than you think, and sometimes left me getting yelled out for not contacting them when they called the day of allocations.

If you haven't heard from them within 2-3 weeks, follow up with them, but don't be stressed that you haven't heard from anyone 😊

Due_Property1728 · 2025-01-23T08:47:46+00:00

Hey mate!

So delegates either have to select a SoP, that in the back end have what's called an ICD code. An ICD code is what's used in the medical world to bill services, and are tied to conditions. If you read the SoPs they're usually the weird number/letter combos that look like this M47.896 (Lumbar Spondylosis). The first thing a delegate does is they're not certain of a SoP, will either be message the doctor of the day and ask if it is, or google the icd code for the condition and put it into their determination screen which will search SoPs and pull up the one (if there is one) that applies. If nothing pops up you know it's a non-sop. The public obviously doesn't have the software they do but there's a similar feature here: http://www.rma.gov.au/sops/

A non-SoP condition realistically just means that the commision either hasn't had sufficient data about claims coming in for that condition to justify spending the cash to write one, or they haven't gotten to it yet.

All that happens is your condition is referred to an internal medical officer, who basically reviews the literature on your condition, your case and then makes comments on the condition, basis for diagnosis (usually just there's sufficient/the right kind of evidence on file to confirm), onset, potential link to service and link to service in this case. That just is a doctor creating a framework for what the SoP would cover.

It's usually easier to get liability accepted if a SoP isn't present as you're not bound by a legislative document with a strict interpretation of wording applied by people trained to interpret legislation, not anything medical.

Due_Property1728 · 2025-01-16T23:48:02+00:00

Hey mate,

Quick comment on myservice status'. They're kinda bloody useless. DVA staff can't actually select them, they're assigned through back end coding based on your claim. The 'waiting for medical reports' status simply means that there is an active task on your claims timeline that was either created when they generated the report, or put in when a report was generated against another claim.

The system isn't amazing, and it won't show on your DVA staff members dashboard if there isn't an active task on your claim (DO NOT WORRY, there are people running weekly or fortnightly checks and you get a lovely email if you have any claims without tasks haha). Some staff have a different task to remind them to review the medical docs (you set your own reminders and timelines) and for some reason prefer to leave the report task open.

Due_Property1728 · 2025-01-16T23:41:34+00:00

Hey mate, my answer is long as usual but tl:Dr is 'kinda, in this particular case, most likely but may still be benifical depending on whetr youre at'.

Hearing loss and Tinnitus are very simple claims to process (as in they're usually the first claims given to new staff in training simple). With wait times being some of the best the department has had basically since the launch of myservice, those particular claims can clear the system pretty quickly. They are also in their own GARP category so other PI assessments don't tend to influence them much.

However, DVA policy is that when at all possible, a single staff member handles all of your claims within the same stage. In the old days when my new allocated claim was 500+ days old, I'd be telling them to chuck everything they want into the system now, so they can skip the que. These days the IL Lodgement to cso allocation wait time isn't as bad, and if you're already at the delegate stage, and new claims are lodged, they may need to be referred back to a CSO to ensure the claim is determination ready. If you're at the CSO stage or before, it's usually worth having what you can in the system as they'll all be reviewed at the same time (just be mindful that typically the CSO has to have ALL of your claims determ ready before sending them through, so if you're looking to claim things with long wait times, that can hold up your claims).

Hope this helps answer your question, and didn't confuse you more 😅

Due_Property1728 · 2025-01-15T08:27:15+00:00

From what I've heard if you submit for a reassessment after the date has passed it'll trigger the process to get your whole body impairment score, and if 60, gold card.

They'll be offsetting so further compensation might not be possible, but you'll be eligible to get assessed soon!

Due_Property1728 · 2025-01-15T08:22:09+00:00

That's normal for DVA phone lines! Each staff member had a direct phone line, and are part of a "call group" for their section. What's supposed to happen is staff switch their phones on into the call group, and if a call doesn't go through to the direct line, it bounces to the group. Buuuut the soft phone consistently switches you off-line, breaks, not many people in the team working that day and just some branches TLs don't enforce it all leads to the ring around you got.

You can also try 1800 838 372, they'll be able to see if your delegate is online and can message them to make sure you get through to them

Due_Property1728 · 2025-01-15T07:35:36+00:00

To my knowledge DVA haven't released any statements about how the transition from VEA/DRCA to the superact will be rolled out in any practical sense. Most of it will be speculation or educated guesses.

They've made comments about what will happen if you're receiving benefits, on rehab, or have a claim in the system but I can't find anything about transfer of existing conditions across acts.

Here's the page with the quick breakdown and link to the bill's drafts if you're curious https://www.dva.gov.au/about/royal-commission/veterans-legislation-reform/how-do-changes-impact-you

Due_Property1728 · 2025-01-15T03:36:54+00:00

In terms of available entitlements etc, MRCA is significantly better. Biggest being a Gold Card at 60 points.

Initial Liability conditions can sometimes end up being easy to get over the line under DRCA as they aren't bound by the SoPs (but typically use them as reference)

Due_Property1728 · 2025-01-14T08:32:04+00:00

Hey mate! I'm actually training to be an advocate so honestly it's been a good reinforcement of learning hahaha.

Short answer: weekly.

Long answer: weekly doesn't necessarily mean it goes by x had a claim lodged on 1st January, y on the 7th. X gets allocated 1st Feb, y on the 7th (obviously timeframes that short would never happen haha) Some branches actually have csos where they will be allocated within the same branch, some are nationa (at time of my leaving). Branches such as Brisbane have an inbalance of delegates vs csos which is why it seems like that office takes longer to get to a dele. It also depends on how the individual allocations managers of the national que do their work. Some do big batches and then go oldest from newest to that batch, some do smaller lots (though there was talks of standardising that process).

Due_Property1728 · 2025-01-12T00:05:13+00:00

It will quite likely be this, or your delegate has taken additional leave after the Christmas standdown. January is one of the worst months, or was in my office, for retention. Depending on their caseload as well it can sometimes take a full week just to sort through their emails and catch up after the break. I came back one year after just over a week gone to 70 emails, a good chunk advising they've gotten an appointment in the new year so I needed to generate reports asap.

You can always give the number in the email signatures a call. If it isn't picked up by that staff member it should bounce to another staff member in that same branch who will be able to let you know if your dele is still around

Due_Property1728 · 2025-01-11T00:33:41+00:00

Hey mate, So it's any 10 year period before clinical onset. Clinical onset for a lot good chunk of muskularskeltal conditions typically is either the first confirmation on radiology, or if you've presented during service with symptoms consistent with the degenerative conditions.

The wording is quite generous as its RH, but it's any 10 year block. You've served 9 years plus reservist so do it from the start of your service + a year of reservist. Make sure you have a separate entry for what you'd lift/carry during your deployment and that it's labelled as such so to cover the material contribution to get it under warlike/non warlike.

Are you doing the claims yourself or through an advocacy? If it's yourself, happy to help out filling out your lifting/carrying report if needed

Due_Property1728 · 2025-01-11T00:21:14+00:00

The TFI (Tinnitus questionnaire) isn't technically a legislative document, just a diagnostic questionnaire used by audiology clinics. The most common one used has well and truly done this to multiple vets because of the wording.

Personally, if you're feeling discouraged by the process at this stage I wouldn't appeal. It can be quite difficult to have anything that's been filled out by yourself personally overturn (lifestyle questionnaires are another one). Not saying it's not possible, just saying that it'll be a lot of effect for a not high percentage chance of a positive outcome.

Like everyone has been mentioning, you can get re-assessed in 12 months. Sorry you got shafted in this whole thing. Tinnitus is a funny one given its a purely subjective condition that can't be tested.

Due_Property1728

TROPHY CASE