Appendix D: Claims, service and liability provision statistics
Tables D1 to D8 provide an overview of the claims processed and transport arranged by DVA under the Veterans’ Entitlements Act 1986 (VEA), the Safety, Rehabilitation and Compensation (Defence-related Claims) Act 1988 (DRCA) and the Military Rehabilitation and Compensation Act 2004 (MRCA) in 2018–19.
Tables D9 and D10 provide an updated actuarial assessment of movement in the liability for income support, compensation, health and other care services under the DRCA and MRCA.
Veterans’ Entitlement Act
Claims processed
Table D1: VEA claims processed, 2017–18 and 2018–19
2017–18 |
2018–19 |
|
Income support new claims |
10,945 |
10,863 |
Pensioner-initiated reviews |
63,210 |
58,268 |
Funeral benefit claims |
4,443 |
3,837 |
VEA = Veterans’ Entitlements Act 1986
Note: Where results for 2017–18 are provided for comparison, they have been updated based on information available after the end of the financial year and therefore may differ from the results published in the 2017–18 annual report.
Compensation claims
Table D2: VEA compensation claims, 2017–18 and 2018–19
2017–18 |
2018–19 |
|
Disability support |
||
Primary disability claims received1 |
12,267 |
19,859 |
Net claims received |
n/a |
10,7482 |
Conditions determined3 |
14,272 |
15,858 |
Proportion of conditions accepted |
61.2% |
55.8% |
Applications for increases in disability pension determined |
1,517 |
1,489 |
Proportion of increases in disability pension accepted |
66.2% |
75.2% |
Cases on hand at 30 June |
2,819 |
4,640 |
War widow/ers and dependants |
||
Claims received |
1,316 |
1,111 |
Net claims received |
n/a |
1,0034 |
Claims determined |
1,130 |
982 |
Proportion of claims accepted |
68.1% |
64.1% |
Cases on hand at 30 June |
129 |
104 |
VEA = Veterans’ Entitlements Act 1986
1 Includes applications for disability pensions, applications for increases in disability pension and assessments/reviews.
2 DVA’s digital platform allows each condition to be registered as an individual claim. When multiple claims are lodged by a client on the same day, these are bundled into the one claim to streamline the investigation and finalisation of the claim.
3 While a claim can be lodged with one or more conditions, each condition is determined separately.
4 This is different from claims received, as withdrawn cases are excluded (for example, automatic entitlement case).
Top 15 claimed conditions
Table D3: Top 15 claimed conditions under the VEA (based on Statements of Principles), 2018–19
Condition |
Number accepted |
Acceptance rate (%) |
Number not accepted |
Total |
Osteoarthritis |
1,068 |
59.0 |
742 |
1,810 |
Tinnitus |
1,123 |
74.3 |
389 |
1,512 |
Sensorineural hearing loss |
1,106 |
78.1 |
311 |
1,417 |
Lumbar spondylosis |
561 |
62.1 |
342 |
903 |
Posttraumatic stress disorder |
391 |
72.5 |
148 |
539 |
Solar keratosis |
453 |
86.5 |
71 |
524 |
Non-melanotic malignant neoplasm of the skin |
397 |
83.1 |
81 |
478 |
Depressive disorder |
276 |
61.9 |
170 |
446 |
Sprain and strain |
207 |
50.7 |
201 |
408 |
Alcohol use disorder |
211 |
64.1 |
118 |
329 |
Rotator cuff syndrome |
76 |
25.3 |
224 |
300 |
Cervical spondylosis |
56 |
21.5 |
205 |
261 |
Fracture |
130 |
59.1 |
90 |
220 |
Ischaemic heart disease |
108 |
69.7 |
47 |
155 |
Anxiety disorder |
84 |
56.8 |
64 |
148 |
Total |
6,247 |
66.1 |
3,203 |
9,450 |
VEA = Veterans’ Entitlements Act 1986
Note: in determining the majority of liability cases, DVA refers to the Repatriation Medical Authority Statements of Principles (SOPs). The 15 most frequently used SOPs covered 59.6 per cent of the conditions determined under the VEA in 2018–19.
Safety, Rehabilitation and Compensation (Defence-related Claims) Act
DRCA claims
Table D4: DRCA claims, 2017–18 and 2018–19
2017–18 |
2018–19 |
|
Liability |
||
Claims received |
10,122 |
15,842 |
Net claims received |
n/a |
7,4831 |
Conditions determined2 |
6,917 |
9,587 |
Proportion of conditions accepted |
56.0% |
75.9% |
Cases on hand at 30 June |
2,478 |
3,897 |
Permanent impairment |
||
Claims received |
6,423 |
11,494 |
Net claims received |
n/a |
9,7553 |
Claims determined |
5,453 |
7,238 |
Proportion of claims accepted |
33.9% |
38.8% |
One-off lump-sum payments |
2,017 |
2,927 |
Cases on hand at 30 June |
1,344 |
3,875 |
Incapacity compensation |
||
Compensation paid |
$80.3 million |
$93.1 million |
Payees |
2,185 |
2,331 |
Compensation for dependants |
||
Compensation paid |
$14.6 million |
$31.4 million |
Payees |
72 |
117 |
DRCA = Safety, Rehabilitation and Compensation (Defence-related Claims) Act 1988
1 DVA’s digital platform allows each condition to be registered as an individual claim. When multiple are claims lodged by a client on the same day, these are bundled into the one claim to streamline the investigation and finalisation of the claim.
2 While a claim can be lodged with one or more conditions, each condition is determined separately.
3 This is different from claims received, as it represents a correction of a system issue which incorrectly registered permanent impairment claims prior to the liability determination.
Top 15 most frequently claimed conditions
Table D5: Top 15 most frequently claimed conditions under the DRCA, 2018–19
Condition |
Number accepted |
Acceptance rate (%) |
Number not accepted |
Total |
Osteoarthritis |
920 |
63.1 |
539 |
1,459 |
Tinnitus |
670 |
71.1 |
272 |
942 |
Sensorineural hearing loss |
696 |
77.0 |
208 |
904 |
Sprain and strain |
722 |
84.1 |
136 |
858 |
Lumbar spondylosis |
393 |
59.5 |
268 |
661 |
Cervical spondylosis |
304 |
80.9 |
72 |
376 |
Depressive disorder |
226 |
66.3 |
115 |
341 |
Non-melanotic malignant neoplasm of the skin |
225 |
67.8 |
107 |
332 |
Posttraumatic stress disorder |
225 |
68.2 |
105 |
330 |
Fracture |
256 |
79.3 |
67 |
323 |
Solar keratosis |
217 |
71.9 |
85 |
302 |
Rotator cuff syndrome |
134 |
47.2 |
150 |
284 |
Alcohol use disorder |
88 |
50.0 |
88 |
176 |
Shin splints |
123 |
88.5 |
16 |
139 |
Joint Instability |
108 |
84.4 |
20 |
128 |
Total |
5,307 |
70.2 |
2,248 |
7,555 |
DRCA = Safety, Rehabilitation and Compensation (Defence-related Claims) Act 1988
Note: The 15 conditions most frequently claimed covered 78.8 per cent of the conditions determined under the DRCA in 2018–19.
Military Rehabilitation and Compensation Act
MRCA claims
Table D6: MRCA claims, 2017–18 and 2018–19
2017–18 |
2018–19 |
|
Liability |
||
Claims received |
13,185 |
29,777 |
Net claims received |
n/a |
21,9771 |
Conditions determined2 |
23,222 |
37,977 |
Proportion of conditions accepted |
79.3% |
84.1% |
Cases on hand at 30 June |
3,308 |
7,307 |
Permanent impairment |
||
Claims received |
7,295 |
14,354 |
Net claims received |
n/a |
12,7643 |
Claims determined |
6,088 |
8,833 |
Proportion of claims accepted |
74.7% |
64.9% |
One-off lump-sum payments |
3,398 |
5,993 |
Cases on hand at 30 June |
1,695 |
5,673 |
Incapacity compensation |
||
Compensation paid |
$153.8 million |
$201.6 million |
Payees |
4,910 |
6,185 |
Compensation for dependants |
||
Compensation paid |
$35.2 million |
$67.7 million |
Payees |
165 |
327 |
MRCA = Military Rehabilitation and Compensation Act 2004
1 DVA’s digital platform allows each condition to be registered as an individual claim. When multiple claims are lodged by a client on the same day, these are bundled into the one claim to streamline the investigation and finalisation of the claim.
2 While a claim can be lodged with one or more conditions, each condition is determined separately.
3 This is different from claims received, as it represents a correction of a system issue which incorrectly registered permanent impairment claims prior to the liability determination.
Top 15 most frequently claimed conditions
Table D7: Top 15 most frequently claimed conditions under the MRCA (based on Statements of Principles), 2018–19
Condition |
Number accepted |
Acceptance rate (%) |
Number not accepted |
Total |
Tinnitus |
5,428 |
99.5 |
25 |
5,453 |
Sprain and strain |
3,277 |
94.3 |
199 |
3,476 |
Osteoarthritis |
2,544 |
96.3 |
97 |
2,641 |
Sensorineural hearing loss |
2,373 |
97.9 |
50 |
2,423 |
Lumbar spondylosis |
1,808 |
98.1 |
35 |
1,843 |
Rotator cuff syndrome |
1,398 |
97.4 |
37 |
1,435 |
Fracture |
1,136 |
90.4 |
121 |
1,257 |
Depressive disorder |
1,006 |
90.9 |
101 |
1,107 |
Posttraumatic stress disorder |
754 |
90.2 |
82 |
836 |
Chondromalacia patella |
613 |
94.6 |
35 |
648 |
Shin splints |
620 |
95.7 |
28 |
648 |
Joint Instability |
509 |
92.4 |
42 |
551 |
Labral tear |
516 |
97.5 |
13 |
529 |
Cervical spondylosis |
300 |
59.5 |
204 |
504 |
Adjustment disorder |
443 |
91.2 |
43 |
486 |
TOTAL |
22,725 |
95.3 |
1,112 |
23,837 |
MRCA = Military Rehabilitation and Compensation Act 2004
Note: In determining the majority of liability cases, DVA refers to the Repatriation Medical Authority Statements of Principles (SOPs). The 15 most frequently used SOPs covered 62.8 per cent of the conditions determined under the MRCA in 2018–19.
Repatriation Transport Scheme
Table D8: Claims for reimbursement and arranged transport, 2014–15 to 2018–19
2014–15 |
2015–16 |
2016–17 |
2017–18 |
2018–19 |
|
Claims for reimbursement |
150,871 |
146,357 |
143,256 |
168,970 |
174,943 |
Arranged transport trips |
1,273,128 |
1,211,805 |
1,323,956 |
1,301,691 |
1,210,032 |
Adjustments to the Military Rehabilitation and Compensation Act liability provisions
Tables D9 and D10 show the movement in the long-term liability for income support and compensation and health and other care services under the DRCA and MRCA over the past two years, based on the advice of the Australian Government Actuary. The movement is recognised as an expense in DVA’s financial statements. Due to the nature of the liability provision, significant adjustments can occur between years.
Table D9 Movement in DRCA and MRCA liability under Outcome 1, 2017–18 and 2018–19
2017–18 |
2018–19 |
|||||
DRCA ($m) |
MRCA ($m) |
Total ($m) |
DRCA ($m) |
MRCA ($m) |
Total ($m) |
|
Changes in valuation assumptions |
316.1 |
759.3 |
1,075.4 |
552.4 |
3,186.9 |
3,739.3 |
Movements in income support and compensation payments |
–142.7 |
227.3 |
84.6 |
–158.6 |
551.0 |
392.4 |
Interest rate |
46.0 |
253.7 |
299.7 |
345.7 |
1,615.4 |
1,961.1 |
Total expenses |
219.4 |
1,240.3 |
1,459.7 |
739.5 |
5,353.3 |
6,092.8 |
DRCA = Safety, Rehabilitation and Compensation (Defence-related Claims) Act 1988 (previously the Safety, Rehabilitation and Compensation Act 1988); MRCA = Military Rehabilitation and Compensation Act 2004
Table D10: Movement in DRCA and MRCA liability under Outcome 2, 2017–18 and 2018–19
2017–18 |
2018–19 |
|||||
DRCA ($m) |
MRCA ($m) |
Total ($m) |
DRCA ($m) |
MRCA ($m) |
Total ($m) |
|
Changes in valuation assumptions |
76.8 |
128.8 |
205.6 |
58.9 |
1,412.6 |
1,471.5 |
Movements in income support and compensation payments |
–26.2 |
250.6 |
224.4 |
–26.1 |
534.8 |
508.7 |
Interest rate |
56.5 |
351.5 |
408.0 |
226.9 |
1,748.6 |
1,975.5 |
Total expenses |
107.1 |
730.9 |
838.0 |
259.7 |
3,696.0 |
3,955.7 |
DRCA = Safety, Rehabilitation and Compensation (Defence-related Claims) Act 1988 (previously the Safety, Rehabilitation and Compensation Act 1988); MRCA = Military Rehabilitation and Compensation Act 2004
Visit
https://www.transparency.gov.au/annual-reports/department-veterans-affairs/reporting-year/2018-2019-56