AFCS

I claimed through the AFCS in 2008 after I had an ACL reconstruction in my left knee and received a payment. Over the past 12 years its hampered me but been constantly upgraded until I broke again and then downgraded. Last year I got sent for an MRI which showed severe arthritis in that knee and in july I had a total knee replacement. I put in a claim and while I've been waiting to hear back I've been told I am now getting medically discharged as a result. Yesterday I received a letter saying my claim has been rejected as they have already paid out and as this is a result of that injury I cant claim again. Anyone else been in this sort of situation and know what I can do?? If I hadn't claimed in 2008 I would have been told it's been over 8 years so wouldn't be able to claim but surely a total knee replacement means my knee has severely worsened since my first claim.
Thanks
 
I claimed through the AFCS in 2008 after I had an ACL reconstruction in my left knee and received a payment. Over the past 12 years its hampered me but been constantly upgraded until I broke again and then downgraded. Last year I got sent for an MRI which showed severe arthritis in that knee and in july I had a total knee replacement. I put in a claim and while I've been waiting to hear back I've been told I am now getting medically discharged as a result. Yesterday I received a letter saying my claim has been rejected as they have already paid out and as this is a result of that injury I cant claim again. Anyone else been in this sort of situation and know what I can do?? If I hadn't claimed in 2008 I would have been told it's been over 8 years so wouldn't be able to claim but surely a total knee replacement means my knee has severely worsened since my first claim.
Thanks
Consult a solicitor with a view to suing, save yourself the hassle of AFCS.
 
Consult a solicitor with a view to suing, save yourself the hassle of AFCS.
Before going down that expensive and stressful route I would recommend exploring other avenues first.

What to do if your condition worsens
Awards under AFCS are intended to be full and final, taking into account the expected development of an injury or illness.

Under certain circumstances, previous decisions to award injury benefit can be revised if there have been further developments since the original decision was made. For instance, if you feel that your injury or illness has worsened or caused a further injury to develop, you can ask us to review our decision.

The circumstances in which a review can be carried out and following which a decision may be revised are set out below:

Service Termination Review
Decision to be reviewed: Injury benefit award previously paid under AFCS for injury/illness following a claim made whilst still serving

Criteria for carrying out the review:

  • service ended on or after 9 May 11
  • application for review must be made within 1 year of service ending
  • previous decision to award injury benefit must have been made no more than 7 years before the day service ended
Other information:

  • a service termination review can only be carried out once for each decision made
  • the injury benefit award will only be revised if the injury/illness has become worse or caused a further injury to develop
Exceptional Review, within 10 years
Decision to be reviewed: Injury award previously paid for injury/illness

Criteria for carrying out the review: review application must be made within 1 year of the claimed worsening or further injury developing

Other information:

  • an Exceptional Review can only be carried out once for each decision made.
  • the injury benefit award will only be revised if the injury/illness has become worse or caused a further injury to develop, that the worsening or development is unexpected and exceptional and occurred within 10 years of the original decision
Review Final
Decision to be reviewed: injury benefit award previously paid for injury/illness.

Criteria for carrying out the review:

  • review application made 10 or more years after the previous decision to award injury benefit
  • review application must be made within 1 year of the claimed worsening or further injury developing
Other information:

  • a Review Final can only be carried out once for each decision made
  • the injury benefit award will only be revised if the injury/illness has become worse or caused a further injury to develop and that worsening or development is substantial, unexpected and exceptional

From

 
Before going down that expensive and stressful route I would recommend exploring other avenues first.

What to do if your condition worsens
1. Awards under AFCS are intended to be full and final, taking into account the expected development of an injury or illness.

2. Under certain circumstances, previous decisions to award injury benefit can be revised if there have been further developments since the original decision was made. For instance, if you feel that your injury or illness has worsened or caused a further injury to develop, you can ask us to review our decision.
1. Unlike the WPS there is no recourse for deterioration which is basically what the OP is pursuing as AFCS supposedly takes deterioration into account and veterans uk have said the arthritis and subsequent knee replacement is linked to the original claim ergo rejection of claim.

2. OP submitted a claim for the knee replacement which was rejected because he had already received an award which veterans uk class as covering the deterioration.

As far as I can see, the OP is left with appealing the decision at Tribunal where there is unlikely to be a finding in his favour because of the way AFCS legislation is written, or, pursuing his case through a solicitor.
 
1. Unlike the WPS there is no recourse for deterioration which is basically what the OP is pursuing as AFCS supposedly takes deterioration into account and veterans uk have said the arthritis and subsequent knee replacement is linked to the original claim ergo rejection of claim.

2. OP submitted a claim for the knee replacement which was rejected because he had already received an award which veterans uk class as covering the deterioration.

As far as I can see, the OP is left with appealing the decision at Tribunal where there is unlikely to be a finding in his favour because of the way AFCS legislation is written, or, pursuing his case through a solicitor.
The new claim was rejected because it was a new claim for an already claimed for injury, it appears the correct procedure, in such circumstances, is to submit for a review of the existing condition.

As you suggest, he can go to a solicitor, but I’d recommend the no cost review option first.

It‘s pointless referring to WPS because he’s not eligible and its pointless comparing WPS and AFCS because they are as chalk is to cheese.
 

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