The Guides to Social Policy Law is a collection of publications designed to assist decision makers administering social policy law. The information contained in this publication intended only as a guide to social security payments. The information is accurate as at the date listed at the bottom of the page, but may be subject to change. To discuss individual circumstances please contact Services Australia.

1.1.R.95 Recognised medical condition (CA)

Definition

For the purposes of CA (child), a recognised medical condition is one of a category of recognised disabilities (1.1.R.90) as included in the DCLAD. These conditions:

  • consistently require medical treatment and supervision for a continuous period of at least 12 months, AND
  • result in significant restriction to the child's normal activities, AND
    • Example: Repeated hospitalisation, absences from school, risk of injury at play.
  • require significant levels of personal care by the parent/carer.

Medical conditions

The following medical conditions do not have to be tested against the DCLA:

  • Chronic or end stage organ failure where the child is receiving organ specific treatment and/or awaiting transplant.

    • Note: This condition applies to those cases where life will not continue without a transplant of the failed organ (or organs).
    • Example: Kidney failure, heart failure, heart/lung failure, liver failure.
  • HIV/AIDS where the child is symptomatic (in addition to having lymphadenopathy) and requires treatment with a 3 or more drug antiviral regimen.
  • Immunodeficiency where the child requires regular immunoglobin infusions.
  • Chronic respiratory disease requiring home oxygen.
  • A condition where the child is dependent for his or her health on an external apparatus/machine called a ventilator to assist with breathing, either on a continuous or intermittent basis.
  • Long term tracheostomy where the child is cared for at home.
  • Leukaemia, Haemophagocytic Lymphohistiocytosis and other childhood malignancies where the child is undergoing chemotherapy, radiotherapy or palliative care.
  • Haemophilia with Factor VIII or Factor IX deficiency (less than 10%).
  • Thalassaemia or Haemoglobinopathy requiring chelation therapy.
  • Chronic Transfusion Dependent Anaemia requiring chelation therapy.
  • Langerhorn Cell Histiocytosis: disseminated (multi-organ) disease requiring chemotherapy for longer than 6 months.
  • Severe congenital Neutropenia (Kostman's variant, dependent on Filgrastin).
  • Severe atopic dermatitis which involves at least 75% of the body surface and which has required 2 or more hospitalisations of at least 5 days duration in the previous calendar year, and/or the use of immunosuppressive therapy.
  • Significant burn where more than 30% of body surface area is affected, or a lesser burn where there is significant impairment of function of the hands or feet or assistance is required with feeding or toileting to a greater degree than is age appropriate for the child.
  • Gastroenterological condition or other medical condition requiring total parenteral nutrition for an extended period, with medical treatment and medical supervision required for at least 12 months.
  • Final stage of Ulcerative Colitis where the condition is no longer responding to medical treatment and where a sub-total colectomy and ileo-rectal anastomosis with formation of a J-pouch is required.
  • Polyarticular course Juvenile Arthritis requiring regular multi-disciplinary therapy, including immunosuppressive medication.
  • Diabetes Mellitus Type 1.

Act reference: SSAct section 953 Qualification for CA-caring for either 1 or 2 disabled children

Policy reference: SS Guide 3.6.7.30 Qualification for CA

Last reviewed: