Does an excessive demand assessment compare my treatment cost to my own case or to an average patient?

The assessment is built around the anticipated cost of services for the applicant's specific diagnosis and prognosis, but it's compared against a general threshold figure, not against what an average patient with any condition typically costs. In practice, that means a medical officer looks at what someone with this particular condition, at this particular stage, is likely to need going forward, and estimates the cost of those specific services, then checks that estimate against the relevant per-person threshold used for excessive demand purposes.

So it isn't purely personal in the sense of accounting for someone's unique financial situation or personal ability to pay privately without a mitigation plan, but it also isn't a crude average across all patients regardless of diagnosis. The estimate is meant to reflect what this specific condition typically requires, based on medical evidence and recognized patterns of care, applied against a standard cost benchmark.

Because the comparison depends heavily on how the condition and its likely trajectory are characterized, disputing an excessive demand finding often centres on challenging the medical officer's estimate of what services will actually be needed, rather than the threshold itself. Strong, specific, up-to-date medical evidence about the individual's actual prognosis matters most here.