Annex F - Medical Risk Matrix

A-MD-154-000/FP-000

Incorporation of a Risk Management Process in the Establishment of Medical Employment Limitations

Summary

1. The CAF Risk Matrix was developed by the D Med Pol in collaboration with DMCA (formerly DMCARM) in 2008 and was subsequently approved by Armed Forces Council. Its purpose is to translate MELs of members with significant medical conditions into a stratified Risk Assessment Matrix. This is based on prevalent scientific evidence to predict the likely future reoccurrence of the condition and their operational consequence(s), thus aiding the chain of command in its administrative deliberation, taking into consideration each member’s career.
2. The Risk Matrix can be formulated by combining knowledge of both the probability of an event occurring (Likelihood of Recurrence) and the medical consequences (Severity of Outcome), should the event occur. The intent is to balance an acceptable level of risk to the health and safety of the member, taking into account the potential unavailability of the appropriate level of medical care required for a medical condition, while simultaneously considering the effect on the operational mission. DMed Pol Med Stds reviews complex medical files and then provides the quantified information necessary to develop the member-specific Risk Matrix and relevant permanent MELs to assist DMCA in managing career implications. The Risk Matrix is not to be used by CAF clinicians at the CF Clinic level; it is used only by DMed Pol Med Stds.
3. The Likelihood of Recurrence is divided into four levels: <10%/ 10 years, 10-19%/ 10 years, 20-50%/ 10 years and >50%/10 years. The threshold for accepting these levels of risk is a DMCA decision.
4. The Severity of Outcome is divided into three levels:
   1. Level 1
      1. Adverse medical consequences are likely to cause physical or mental discomfort which would benefit from medical attention as soon as possible.
      2. Adverse medical consequences are likely to cause some decrement in performance and member would benefit from being removed from duty; however, member would be able to remain on duty and perform the mission.
   2. Level 2
      1. Adverse medical consequences are likely to be in the form of an acute medical crisis. While immediate attention may not be crucial, lack of timely medical attention could lead to some long-term consequences.
      2. Adverse medical consequences are likely to cause moderate decrement in performance; however, will have difficulty to fully safeguard self and could be unfavourable to the mission.
   3. Level 3
      1. Adverse medical consequences are likely to cause serious medical outcome to the member which could lead to serious permanent disability if medical support is not immediate.
      2. Adverse medical consequences are likely to cause serious outcome to the mission, as member will be totally incapacitated and incapable to defend self.
5. The Risk matrix is colour coded, utilizing a “stop-light” tool, in a Red-Yellow-Green diagram for easy visual comparison:
   1. Green: the Green category indicates a member with low medical risk within a military environment. This level represents a member who could contribute greatly to the CF within the assigned medical employment limitations;
   2. Yellow: the Yellow category indicates a member with moderate medical risk within a military environment. This level represents a member who could contribute acceptably in a specific MOC within the assigned medical employment limitations; and
   3. Red: the Red category indicates a member with high medical risk within a military environment. Caution should be taken when considering unrestricted retention in those cases.

Likelihood of Recurrence vs. Severity of Outcome