$802,000 DVA outcome for a Combat Medic with maximum impairment

The situation

Ryan left the Army after 9 years as a Combat Medic. He had PTSD, major depressive disorder, and alcohol use disorder. The AUD had developed as a consequence of his PTSD. He had also undergone right knee reconstruction during service, had chronic lumbar spondylosis from years of load carriage, and bilateral tinnitus from noise exposure. His wife found Clear Path Veterans when the family was at their lowest point financially.

Ryan had two children at home and the household had gone from two incomes to effectively none. He was not working, his wife had reduced her hours to help manage his care, and they were burning through savings.

The challenge

Ryan had already lodged a DVA claim on his own and been rejected across all conditions. The rejection was not because his conditions were not real. It was because the evidence package did not satisfy the Statement of Principles factors DVA needs in order to accept liability.

His PTSD report came from his treating GP and addressed his current symptoms clearly. But it did not document the specific operational stressor category required under the MRCA Statement of Principles. DVA needs a report that maps directly to a qualifying factor, not just a diagnosis.

His knee report described the surgical history but made no connection to service. There was no reference to his service medical records, no documentation of how the injury occurred during training or operations, and no SoP factor addressed.

The alcohol use disorder had not been claimed at all. Most veterans do not realise it can be claimed as a consequential condition when it arises directly from an accepted primary condition such as PTSD.

The approach

Clear Path Veterans started from scratch. The first step was pulling Ryan's complete service medical record and going through it with him to identify qualifying stressor events for the PTSD SoP factors, and documented incidents that connected to the knee injury.

We then coordinated a full set of specialist assessments: a psychiatrist experienced in DVA claims for PTSD and major depressive disorder, an alcohol and other drugs specialist to document and link the AUD as consequential, an orthopaedic surgeon for the knee, a pain medicine physician for the lumbar spondylosis, and an audiologist for the tinnitus.

Each practitioner was briefed on the relevant Statement of Principles factors before they wrote their report. That briefing process is what separates a report that gets a claim accepted from one that does not. It is not something most veterans, or most GPs, know how to do.

All six conditions were lodged together as a single submission, each supported by a specialist report that addressed the specific SoP factor DVA needed.

The outcome

DVA accepted liability for all six conditions. The permanent impairment assessment came back at 80 impairment points, the maximum score under GARP M. At maximum PI, the lump sum for Ryan's age and service type was $580,000 tax-free. With two dependent children, he was also entitled to the Young Person Supplement for each child, adding $111,173 per child.

The 80-point PI rating also meant automatic Gold Card entitlement, giving Ryan fully-funded medical treatment for all his conditions for life. We assessed Ryan for SRDP given his impairment level and inability to work more than 10 hours per week, and he elected to move onto SRDP in place of incapacity payments. His financial advice reimbursement was also approved.

• 6 of 6 conditions accepted at initial liability
• PI assessed at 80 points (maximum under GARP M)
• $580,000 permanent impairment lump sum (tax-free)
• $222,346 in Young Person Supplements for two children
• Gold Card issued
• SRDP assessed and elected
• Financial advice reimbursement approved