Can the omission of secondary diagnoses at the reconsideration stage be considered a procedural error or an incomplete adjudication?
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The information on file does not indicate medical conditions have been cured.
Can the omission of secondary diagnoses at the reconsideration stage be considered a procedural error or an incomplete adjudication?
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The information on file does not indicate medical conditions have been cured.
You could give a little more context, i am not 100% sure what you are asking. For example, did you already have your General division hearing?
@David_Brannen Service Canada
In the original application the adjudicator used a primary ICD code and 2 secondary ICD codes to reference the medical conditions. These codes are found under the decision summary.
As a result, the applicant meets the severe criterion at this time.
In the reconsideration summary decision the adjudicator only referred to the primary ICD code. The secondary codes aren’t listed.
The current file information does support the applicant’s work participation or returns to work since
November 2022.
The limitations noted in the medical report dated March 23, 2023 do support a condition precluding all forms of work.
Given the applicant’s multiple functional limitations from xxx, Xyz conditions, it is reasonable to believe it is difficult for the applicant to return to working at this time.
Since the applicant does not retain the capacity to do alternative/any form of employment, she does have a severe medical condition.
According to the medical information on file the applicant’s overall condition has stabilized and should allow the applicant to return to some type of employment suitable to xxx limitations in the foreseeable future.
While recognizing the applicant’s current limitations, this information does not support a prolonged
condition because it is not likely to be of long, continuous and indefinite durations.
I am now in the process of appealing Service Canada decision at tribunal general division. No I have not yet had a hearing.
There is no information stating any medical condition has stabilized.
thank you for clarifying, the answer to your original question is - No - an adjudicator failing to mention a secondary ICD-9 code will not make the their decision invalid. You can mention this in your appeal if you think they did not take the secondary condition into account in the decision.
David Brannen
Disability Lawyer with Resolute Legal
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