How we will assess your claim

From 1 July 2026, all new compensation claims are assessed under the MRCA. This page explains, step by step, what a DVA Delegate does after receiving your claim – from gathering facts through to making a decision and telling you what comes next.

Overview

This page explains how a DVA Delegate assesses your liability claim after it has been submitted and assigned. It applies to claims submitted from 1 July 2026 and covers the process after your claim has been registered. For information about what happens before this point, see 'What to expect after you have submitted a compensation claim' on the DVA website.

Gathering the facts

The first step is for the Delegate to verify your identity, your service records, and your medical diagnosis. If any information is missing, you will be contacted. You may also be asked to attend appointments to help gather medical evidence.

Service assessment

The Delegate will confirm that you have 'rendered defence service'. Compensation only applies if your condition is service-related. Being enlisted alone is not enough. A condition needs to relate to service through a head of liability. You must have been on duty, or doing something that was authorised, required, or incidental to your duties. Some off-duty activities may count as service, but this is decided case by case.

Investigation

The Delegate will review all the evidence that has been provided and collected. They will then apply the relevant legislation and assess the evidence using the applicable standard of proof.

Standard of proof

There are two main standards of proof used in assessing claims.

The ‘balance of probabilities’ applies to peacetime service. It means your condition needs to be considered to be ‘more likely than not’ to be linked to your service. 

The reasonable hypothesis standard is the more generous standard. Under this standard, your claim can be accepted unless it can be disproven beyond reasonable doubt. This standard is used for non-peacetime service, such as warlike, operational, peacekeeping and hazardous service.

Investigating liability

The Delegate will determine whether DVA is legally responsible (liable) for your condition. The heads of liability are applied in the following order.

Presumptive liability is considered first. It applies to claims from 1 July 2026 and covers over 150 specified conditions. If the criteria are met, liability is automatically accepted and no further investigation is needed. If presumptive liability does not apply, the Delegate moves to the next test.

Medical event on duty is the second test. It applies to claims from 1 July 2026 and covers injuries (not diseases) that occurred while on duty. Examples include fractures, heart attacks and strokes. It does not cover diseases such as cancer or a causal exposure for a disease. The Delegate must confirm that the member was on duty at the time. If this test does not apply, the Delegate moves to the other liability tests.

The other heads of liability require demonstrating a link between your service and your condition. Common criteria are that your condition resulted from an in-service occurrence, or that it is attributable to your defence service. Statements of Principles (SoPs) are legislative instruments that are applied to most claims not determined under presumptive liability or the medical event on duty provisions. SoPs are evidence-based lists of known causes for a medical condition drawn from medical and scientific evidence. Two versions of each SoP exist: one uses the reasonable hypothesis standard and the other uses the balance of probabilities standard. They may differ in the causal factors they include. SoPs do not apply in some situations, for example in certain death claims or where no SoP exists for the condition. If a SOP applies, a causal factor in the SOP must be met and related to service.

Decision and next steps

You will receive a written decision that includes the reasons for the decision and information about your appeal rights.
If your claim is rejected, you can appeal the decision. You should follow the process and appeal timeframes set out in your decision letter.

Needs assessment

If your claim is accepted, a Needs Assessment will be conducted to determine your eligibility for medical treatment, rehabilitation, and payments and compensation.

A Needs Assessment is conducted after liability is accepted. It determines your need for treatment, rehabilitation, and financial supports and other assistance.

Appeals

If you disagree with the decision, you can appeal. You must lodge your appeal by the deadline and follow the instructions provided in your letter.

Other ways to access medical treatment

You may be able to access medical treatment outside the claims process. This includes non-liability health care and fully funded mental health treatment for eligible veterans, which does not require a claim. Some veterans may also be eligible for cancer treatment and pulmonary tuberculosis treatment.

Provisional Access to Medical Treatment (PAMT) covers treatment for common conditions while your claim is still being processed.

Support is available through DVA, including assistance with MyService.