What can I claim secondary to gingivitis?
1 condition in the Repatriation Medical Authority's Statements of Principles list gingivitis as a factor. If DVA has accepted your gingivitis, each of these has a documented pathway to a further claim.
At a glance
- Accepted conditionGingivitis
- Conditions it may open1
- SourceRMA SoPs
- Chart Review$600 + GST
How a secondary claim works
Some Statement of Principles factors are not about service at all — they name another condition. Where DVA has already accepted your gingivitis, and another condition's SoP lists gingivitis as a factor, that part of the next claim is already established on your file. How a secondary claim works, in full →
Conditions that list gingivitis as a factor
Quoted from the instrument. A pathway existing is not the same as a claim succeeding — each factor carries thresholds your record has to satisfy.
Periodontitis
RH No. 27 of 2022 · BoP No. 28 of 2022
Reasonable Hypothesis — factor (1): “having gingivitis involving the affected region of the periodontium for a continuous period of at least the 6 months before the clinical onset of periodontitis” [clinical onset] — factor (17): “having gingivitis involving the affected region of the periodontium for a continuous period of at least the 6 months before the clinical worsening of periodontitis” [worsening]
Balance of Probabilities — factor (1): “having gingivitis involving the affected region of the periodontium for a continuous period of at least the 6 months before the clinical onset of periodontitis” [clinical onset] — factor (17): “having gingivitis involving the affected region of the periodontium for a continuous period of at least the 6 months before the clinical worsening of periodontitis” [worsening]
Other accepted conditions that also open periodontitis
If any of these is also on your file, it reaches some of the same conditions gingivitis does.
What DVA means by gingivitis
A claim is tested against the definition first. If the diagnosis on your file does not meet this wording, the factors below never get reached — so it is worth checking that what your doctor wrote matches what the instrument requires.
Gingivitis, for the purposes of the Statement of Principles, for the purposes of this Statement of Principles, gingivitis: (a) means an acute or chronic inflammation of the gums, limited to the mucosal epithelial tissue overlying the alveolar ridge and surrounding the necks of erupted teeth; and (b) includes: (i) acute necrotising ulcerative gingivitis; (ii) desquamative gingivitis; (iii) gingival abscess; (iv) linear gingival erythema; (v) peri-implant mucositis; and (vi) plasma cell gingivitis; and (c) excludes: (i) destructive gingival inflammation extending beyond the gums into the underlying supporting structures of the teeth; (ii) gingival hyperplasia and overgrowth; Compilation No. 1 Compilation date: 21/11/2022 Authorised Version F2022C01121 registered 21/11/2022 (iii) gingival recession; and (iv) oral aphthae. (3) While gingivitis attracts ICD-10-AM code A69.1, K05.0 or K05.1, in applying this Statement of Principles the meaning of gingivitis is that given in subsection (2). (4) For subsection (3), a reference to an ICD-10-AM code is a reference to the code assigned to a particular kind of injury or disease in The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modificatio
Aggravation-only factors. In this instrument, subsections 9(18) to 9(35) apply only to material contribution to, or aggravation of, gingivitis where it was already present before or during service. If service caused gingivitis outright, those factors are not available to you.
BoP No. 18 of 2022 · 35 factors
What could support a claim for gingivitis?
The Statement of Principles for gingivitis names 1 other condition among its own factors. If any of these is already accepted on your file, it may be the factor that carries a gingivitis claim — quoted here from the instrument.
Diabetes mellitus
Balance of Probabilities — factor (15): “having diabetes mellitus at the time of the clinical onset of gingivitis; Compilation No. 1 Compilation date: 21/11/2022 Authorised Version F2022C01121 registered 21/11/2022” [clinical onset]
Balance of Probabilities — factor (32): “having diabetes mellitus at the time of the clinical worsening of gingivitis” [worsening]
Reviewed by Dr Thomas Perkins
Founding doctor, Veterans Health Centre · former RAAF aviation medical officer · 13 years working exclusively with ADF members and veterans. Full profile →
Gingivitis accepted?
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