COMMANDERS with concerns about medical "chits" have been reminded to check with medical practitioners before making a decision.

Director Personnel-Army Col Mike Milford said the consequences of ignoring a medical chit could aggravate a medical condition, cause a serious complication or, in extreme cases, endanger a member's life.

"One of the recommendations of the Burchett Inquiry into Military Justice in the ADF concerned medical certificates and the way commanders should deal with them," he said.

The certificates or "chits" are issued by authorised service or civilian medical officers on official ADF medical forms and might recommend a number of days sick leave or some form of restricted duty for members suffering medical conditions.

Chits are normally passed by members to their immediate superiors and there is usually no problem with acceptance of medical advice.

Difficulties could arise, however, when supervisors believed in a particular case, the restriction or time off work was not warranted.

There may be doubt in the mind of the supervisors about the severity of the injury or illness, or that the medical officer has been too conservative in his or her assessment of a soldier's condition.

He said the first consideration should be the welfare of the member, and commanders should consider very carefully any decision not to comply with a chit.

"Part of that consideration should be an acknowledgement that they will be pitting their judgement against that of a qualified medical practitioner," he said.

"The recommendations on the chit should not be ignored without first taking up any issues with the medical practitioner.

"For example, any evidence that might cast doubt on a member's claim to be suffering certain symptoms, should be provided to the medical officer.

"Discussions with the medical officer should resolve most issues, but where that is not possible for any reason, a second medical opinion could be sought.

He said there also might be rare occasions when the need for the particular skills of a member at a particular time may cause his or her commanders to be reluctant to observe medical restrictions or provide time off work.

Such a scenario would be more likely during operations, but Service needs were a legitimate consideration when decisions of this nature were being made.

Any final decision to not follow the recommendations on a chit should be made only by the commanding officer or senior unit representative authorised by the CO to do so, such as the unit 2IC.

"Challenges to medical chits should be the exception rather than the rule, but commanders are there to command and they have the authority to make decisions," Col Milford said.

"In doing so, they must carefully and responsibly weigh up all the factors, particularly members' health and safety and operational imperatives, and be prepared to stand by their decisions."

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