Health Insurance (Bonded Medical Program) Rule 2020
13Evidential requirements for establishing a medical condition
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13 Evidential requirements for establishing a medical condition
(1) For the purposes of subparagraphs 124ZT(3)(e)(ii) and (iii), the bonded participant, or a member of the bonded participant’s family, must have a medical condition that: (a) either: (i) requires treatment or care for which Medicare benefits are payable under the Act; or (ii) requires treatment or care for which pharmaceutical benefits are payable under the National Health Act 1953; or (iii) requires treatment or care in a hospital; and (b) is a serious illness, unless there are exceptional circumstances relating to the illness; and (c) was not reasonably foreseeable when the bonded participant entered the Bonded Medical Program. (2) For the purposes of subsection (1), the bonded participant must provide evidence of the relevant medical condition from the treating practitioner of the bonded participant, or the treating practitioner of the member of the bonded participant’s family, as the case may be. (3) For the purposes of subsection (2), the evidence must meet the following requirements: (a) the treating practitioner must: (i) have sufficient expertise, qualifications and specialist registration to provide the medical evidence; and (ii) state for how long they have known the bonded participant, or the member of the bonded participant’s family, as the case may be; and (iii) state that they do not have a personal or professional relationship with the bonded participant or any potential conflicts of interest; and (iv) state why the bonded participant cannot complete their return of service obligation within the 18 year period required by paragraph 124ZF(2)(a) of the Act; (b) the evidence provided by the treating practitioner must be dated within 3 months from the date of the bonded participant’s application. (4) In this section, a serious illness means: (a) a life‑threatening illness; or (b) an illness that could become life‑threatening if not treated; or (c) a chronic illness or disabling condition whose treatment, or the illness itself, creates an insurmountable barrier to working in an eligible location.