Catastrophic injury or disease

Last updated: 
20 January 2020

This page sets out the definition of a “catastrophic” injury or disease for the purposes of the Safety, Rehabilitation and Compensation (Defence-related Claims) Act 1988 (DRCA) and the Military Rehabilitation and Compensation Act 2004 (MRCA).

Why is the definition important?

Provisions relating to catastrophic injuries (and diseases) were introduced under the MRCA and the DRCA in recognition of the fact that individuals with severe injury and/or illness often require higher than usual levels of support at home. Accordingly, members and former members of the Australian Defence Force (ADF) with catastrophic injuries under the DRCA or the MRCA are now entitled to receive all household and attendant care services reasonably required, without regard to the statutory limits that would ordinarily apply. Refer to Attendant Care and Household Services for more information regarding the statutory limits.

Satisfying the definition of catastrophic injury is not, however, a guarantee that individuals will receive higher levels of household and attendant care services. Those services will be provided on a needs basis subject to an assessment of individual circumstances.

What is the definition of a catastrophic injury or disease?

The DRCA and the MRCA both contain the same definition of a catastrophic injury and prescribe that an injury is a “catastrophic injury” if both of the following conditions are satisfied:

  1. The injury results in an impairment assessed by a FIMTM credentialed medical or health care professional at a score of 5 or less on any of the items on the FIMTM score sheet;
  2. The Military Rehabilitation and Compensation Commission is satisfied that the injury is:
  • A catastrophic nerve injury; or
  • A catastrophic brain injury; or
  • A catastrophic amputation injury; or
  • A catastrophic burn injury; or
  • A catastrophic blindness injury.

What is the FIMTM Score Sheet?

The Functional Independence Measure (FIM) score sheet is a basic indicator of severity of functional limitation and is published be the Australasian Rehabilitation Outcomes Centre. The FIMTM score sheet is available at https://ahsri.uow.edu.au/aroc/whatisfim/index.html by opening the page and clicking on the excel diagram under the heading “AN-SNAP Calculator With Benchmarks”.

What is a Catastrophic injury or disease?

Catastrophic nerve injury or disease

An injury or disease is a catastrophic nerve injury or disease if the injury or disease is a lesion of the spinal cord, cauda equina, brachial plexus, lumbosacral plexus, cervical plexus or coccygeal plexus which results in one or more of the following:

  • sensory deficit
  • motor deficit
  • bladder dysfunction
  • bowel dysfunction.

Catastrophic brain injury or disease

An injury or disease is a catastrophic brain injury or disease if the injury or disease results in an impairment of cognitive, physical or psychosocial functions and it results in one or more of the following:

  • a period of post traumatic amnesia of at least 7 days;
  • a significant brain imaging abnormality;
  • a score for the Standardised Mini-Mental State Examination (SMMSE) tool of less than 25; or
  • damage to the brain similar in effect and severity to that referred to in subparagraph (a)(i), (ii) or (iii).

Catastrophic amputation injury or disease

  1. An injury or disease is a catastrophic amputation injury or disease if the injury or disease results in one or more of the following:
    • a forequarter amputation
    • a shoulder disarticulation
    • a hindquarter amputation
    • a hip disarticulation
    • an amputation involving the loss of 65% or more of the length of the femur; or
  2. The loss of at least two of the following:
    • 50% or more of the length of the tibia of the left leg
    • 50% or more of the length of the tibia of the right leg
    • the thumb of the left hand at or above the first metacarpophalangeal joint
    • the thumb of the right hand at or above the first metacarpophalangeal joint.

Catastrophic burn injury or disease

An injury or disease is a catastrophic burn injury or disease if the injury or disease is:

  1. Full thickness burns:
    • for a person aged 16 years or above at the time of the injury or disease–greater than 40 per cent of the total body surface area; or
    • for a person aged under 16 years at the time of the injury or disease–greater than 30 per cent of the total body surface area; or
    • to the hands, face or genital area; or
  2. Inhalation burns resulting in vital capacity or forced expiratory volume in one second which is less than 50% of that predicted for the person’s age, height and ethnicity.

Catastrophic blindness injury or disease

An injury or disease is a catastrophic blindness injury or disease if the injury or disease results in one or more of the following:

  • visual acuity after correction by suitable lenses of less than 6/60 in both eyes
  • constriction to within 10 degrees of fixation in the better eye irrespective of corrected visual acuity
  • a combination of visual defects resulting in the same degree of visual impairment as that specified in paragraph (a) or (b).

Note: A person would have visual acuity of 6/60 if he or she is only able to see at a distance of 6 metres a symbol which a person with normal vision could see at a distance of 60 metres.

How do I seek assistance with household and attendant care services?

Please contact your nearest DVA office if you are experiencing difficulties in managing your household and/or attendant care needs. DVA will arrange for an independent assessment of your household and attendant care services requirements.

Example

A veteran suffers an injury or contracts a disease that meets the definition of a catastrophic injury under the DRCA or MRCA. The Department arranges for an assessment by an occupational therapist who identifies that the veteran requires specific attendant care services due to the injury/disease. The level of service required is above the statutory limitation normally applied. Because the injury is a “catastrophic injury”, the Department is able to pay the full cost of providing those services.

For more information regarding the provision of attendant care services, please refer to Attendant Care. For more information regarding the provision of household services, please refer to Household Services.

Can I receive household and attendant care services if I am receiving care through the Veterans' Home Care Program?

You are not able to access similar services from multiple sources. DVA will determine which source is the most appropriate for you to access the attendant care services you require.

Does having a “catastrophic injury” impact my other DVA entitlements?

Meeting the definition of catastrophic injury does not create a pathway to additional benefits under the MRCA or the DRCA. Eligibility for other benefits under DVA legislation (such as incapacity and permanent impairment payments) remain subject to separate assessment criteria and processes.