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 is intended only as a guide to relevant legislation/policy. 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.

6.2.5.120 CA (child) - disabilities & medical conditions recognised for review purposes only

Summary

This topic explains CA (child) reviews of disabilities and conditions that are recognised for review purposes ONLY. This topic covers the following:

  • assessing disabilities and medical conditions recognised for review purposes only
  • disabilities and medical conditions recognised for review purposes only
  • reasons why disabilities and medical conditions are NOT recognised, and
  • disabilities and medical conditions NOT recognised for review purposes.

Assessing recognised disabilities & medical conditions

When reviewing CA (child) entitlement, certain disabilities and medical conditions are treated as recognised disabilities (1.1.R.90), although they are NOT on the list of recognised disabilities and recognised medical conditions (1.1.R.95).

This means the delegate may exercise some discretion in deciding when to treat a disability or condition as recognised for review purposes.

The discretion may be applied to disabilities and conditions that display a consistently high level of severity.

Note: The exemption cannot be applied for 2 consecutive reviews - it only applies if the child was assessed under the DCLA at the previous review.

Recognised disabilities & medical conditions for review purposes ONLY

The following disabilities and medical conditions are treated as recognised disabilities for review purposes ONLY. The list is NOT exhaustive:

  • rare conditions that are consistently highly severe
  • CHARGE syndrome
  • Sotos syndrome
  • hydrocephalus
  • spina bifida
  • brain injury
  • Klinefelter syndrome
  • osteogenesis imperfecta
  • pervasive developmental disorder not otherwise specified
  • connective tissue disorders
  • Tourette's syndrome
  • hemiplegia
  • severe learning disorder
  • achondroplasia.

Reasons why disabilities & medical conditions are NOT recognised

A delegate MUST consider whether a child's disability is appropriate for exemption from the medical review regime. Some disabilities and medical conditions are NOT treated as recognised disabilities for review purposes. Children with such conditions are always reviewed by being tested against the DCLA. This is because the medical conditions:

  • are difficult to diagnose consistently
  • respond to methods of treatment
  • can be stabilised
  • vary according to age
  • are episodic, or
  • are typically of shorter duration.

Disabilities & medical condition NOT recognised

Generally, the disabilities and medical conditions in the following table are NOT treated as recognised disabilities for review purposes for the reasons listed in the second column. The list is NOT exhaustive.

Disability or conditionReason
Cornelia de lange syndromeDiagnostic difficulties.
Tuberous sclerosisVaries according to age.
GalactosaemiaResponds to dietary modification.
AsthmaVaries from child to child and according to age, episodic.
ADD/ADHDResponds to treatment.
AllergiesResponds to treatment.
Chronic breathlessnessDiagnostic difficulties.
Severe cyanotic congenital heart diseaseDiagnostic difficulties.
Chronic, severe cardiac conditionDiagnostic difficulties.
Organic acidaemias and aminoacidopathiesResponds to dietary modification.
Marfan syndromeDiagnostic difficulties.
Severe expressive communication impairmentDiagnostic and assessment difficulties.
Sleep apnoeaLevel of severity varies.
OstomiesNot usually severe, may not be permanent.

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