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 NOS
  • 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, OR
  • respond to methods of treatment, OR
  • can be stabilised, OR
  • vary according to age, OR
  • 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 condition Reason
Cornelia de lange syndrome Diagnostic difficulties.
Tuberous sclerosis Varies according to age.
Galactosaemia Responds to dietary modification.
Asthma Varies from child to child and according to age, episodic.
ADD/ADHD Responds to treatment.
Allergies Responds to treatment.
Chronic breathlessness Diagnostic difficulties.
Severe cyanotic congenital heart disease Diagnostic difficulties.
Chronic, severe cardiac condition Diagnostic difficulties.
Organic acidaemias and aminoacidopathies Responds to dietary modification.
Marfan syndrome Diagnostic difficulties.
Severe expressive communication impairment Diagnostic and assessment difficulties.
Sleep apnoea Level of severity varies.
Ostomies Not usually severe, may not be permanent.

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