What can I claim secondary to pulmonary thromboembolism?
2 conditions in the Repatriation Medical Authority's Statements of Principles list pulmonary thromboembolism as a factor. If DVA has accepted your pulmonary thromboembolism, each of these has a documented pathway to a further claim.
At a glance
- Accepted conditionPulmonary thromboembolism
- Conditions it may open2
- 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 pulmonary thromboembolism, and another condition's SoP lists pulmonary thromboembolism 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 pulmonary thromboembolism 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.
Atrial fibrillation and atrial flutter
RH No. 1 of 2023 · BoP No. 2 of 2023
Reasonable Hypothesis — factor (10): “having pulmonary thromboembolism within the 30 days before the clinical onset of atrial fibrillation or atrial flutter” [clinical onset] — factor (54): “having pulmonary thromboembolism within the 30 days before the clinical worsening of atrial fibrillation or atrial flutter” [worsening]
Balance of Probabilities — factor (10): “having pulmonary thromboembolism within the 30 days before the clinical onset of atrial fibrillation or atrial flutter” [clinical onset] — factor (47): “having pulmonary thromboembolism within the 30 days before the clinical worsening of atrial fibrillation or atrial flutter” [worsening]
Heart block
RH No. 23 of 2022 · BoP No. 24 of 2022
Reasonable Hypothesis — factor (2): “having pulmonary thromboembolism within the 7 days before the clinical onset of heart block” [clinical onset] — factor (35): “having pulmonary thromboembolism within the 7 days before the clinical worsening of heart block” [worsening]
Balance of Probabilities — factor (2): “having pulmonary thromboembolism within the 7 days before the clinical onset of heart block” [clinical onset] — factor (29): “having pulmonary thromboembolism within the 7 days before the clinical worsening of heart block” [worsening]
Other accepted conditions that also open atrial fibrillation and atrial flutter
If any of these is also on your file, it reaches some of the same conditions pulmonary thromboembolism does.
What DVA means by pulmonary thromboembolism
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.
Pulmonary thromboembolism, for the purposes of the Statement of Principles, for the purposes of this Statement of Principles, pulmonary thromboembolism means obstruction of the pulmonary artery or one of its branches by a mass of clotted blood. (3) While pulmonary thromboembolism attracts ICD-10-AM code I26, in applying this Statement of Principles the meaning of pulmonary thromboembolism 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 Modification (ICD-10-AM), Tenth Edition, effective date of 1 July 2017, copyrighted by the Independent Hospital Pricing Authority, ISBN 978-1-76007-296-4.
Aggravation-only factors. In this instrument, subsections 9(29) apply only to material contribution to, or aggravation of, pulmonary thromboembolism where it was already present before or during service. If service caused pulmonary thromboembolism outright, those factors are not available to you.
RH No. 37 of 2021 · BoP No. 38 of 2021 · 25 factors
What could support a claim for pulmonary thromboembolism?
The Statement of Principles for pulmonary thromboembolism names 6 other conditions among its own factors. If any of these is already accepted on your file, it may be the factor that carries a pulmonary thromboembolism claim — quoted here from the instrument.
Deep vein thrombosis
Reasonable Hypothesis — factor (1): “having a deep vein thrombosis within the six months before the clinical onset of pulmonary thromboembolism” [clinical onset]
Balance of Probabilities — factor (1): “having a deep vein thrombosis within the three months before the clinical onset of pulmonary thromboembolism” [clinical onset]
Chronic obstructive pulmonary disease
Reasonable Hypothesis — factor (8): “having chronic obstructive pulmonary disease at the time of the clinical onset of pulmonary thromboembolism” [clinical onset]
Sleep apnoea
Reasonable Hypothesis — factor (9): “having sleep apnoea at the time of the clinical onset of pulmonary thromboembolism” [clinical onset]
Balance of Probabilities — factor (8): “having sleep apnoea at the time of the clinical onset of pulmonary thromboembolism” [clinical onset]
Hepatitis C
Reasonable Hypothesis — factor (12): “having infection with human immunodeficiency virus or hepatitis C virus at the time of the clinical onset of pulmonary thromboembolism” [clinical onset]
Balance of Probabilities — factor (10): “having infection with human immunodeficiency virus or hepatitis C virus at the time of the clinical onset of pulmonary thromboembolism” [clinical onset]
Tuberculosis
Reasonable Hypothesis — factor (13): “having active tuberculosis disease within the 30 days before the clinical onset of pulmonary thromboembolism” [clinical onset]
Diabetes mellitus
Reasonable Hypothesis — factor (16): “having diabetes mellitus at the time of the clinical onset of pulmonary thromboembolism” [clinical onset]
Balance of Probabilities — factor (13): “having diabetes mellitus at the time of the clinical onset of pulmonary thromboembolism” [clinical onset]
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 →
Pulmonary thromboembolism accepted?
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