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7.2 Treatment under Non-Liability Health Care (NLHC) arrangements

Document
Last amended 
5 July 2017

VEA

Who is eligible for treatment?

Mental health conditions

Any person who is or has been a permanent member of the Australian Defence Force (ADF), irrespective of the length of their service, when they served, or the type of service, is eligible for treatment for any mental health condition under Non-Liability Health Care (NLHC) arrangements.

Reservists who have rendered any period of continuous full-time service (CFTS), are also eligible to receive NLHC for these conditions.

Eligibility for treatment for these mental health conditions is provided under the Veterans' Entitlements (Extension of Non-Liability Health Care for Mental Health Treatment) Determination 2017 (Instrument 2017 No. R24) made under section 88A of the Veterans’ Entitlements Act 1986 (VEA).

What is a mental health condition?

A mental health condition is a condition that could be assessed and diagnosed as such by a mental health profession in accordance with recognised criteria for such assessment and diagnois.

A mental health professional capable of delivering such assessment and diagnosis includes general practitioners, pychiatrists and clinical psychologists registered with the Australian Health Practitioner Regulation Agency (AHPRA) to practise in Australia.

Medical reference materials used by Australian mental health professionals in the assessment and diagnosis of mental health conditions include:

  • the DSM-5 (fifth edition of the American Psychiatric Association: Diagnositc and Statistical Manual of Mental Disorders); and
  • Chapter V of ICD-10-AM (the International Statistical Classification of Diseases and Related Helath Problems, 10th Revision, Australian Modification).

The DSM-5 is copyrighted and available for purchase as an e-book or subscription from the American Psychiatric Association website.  It is expected that relevant mental health professionals would have access to this as part of their professional pracice.  Members of the public may arrange to inspect a copy of DSM-5 free of charge at the VVCS Counselling centre in their nearest capital city or in Townsville by phoning 1800 011 046.  ICD-10 is available online free of charge through the World Health Organisation website.

Please note that a diagnosis is not required to access mental health treatment under Non-Liability Health Care arrangements; the above is to assist on defining a mental health condition.

Malignant neoplasm (cancer) and pulmonary tuberculosis

Veterans and former and current members of the Australian Defence Force (ADF) with the following types of service:

  • eligible war service under the VEA,
  • operational service under the VEA,
  • warlike and non-warlike service under the VEA or the Military Rehabilitation and Compensation Act 2004,
  • peacekeeping service,
  • hazardous service,
  • British Nuclear Test defence service as defined in the VEA, and
  • peacetime service between 7 December 1972 and 6 April 1994, where the current or former member:
  • completed 3 years CFTS by 6 April 1994, or
  • was discharged on the grounds of invalidity or physical or mental incapacity to perform duties before completing 3 years CFTS between 7 December 1972 and 6 April 1994 inclusive, but was engaged to serve not less than 3 years, or
  • was a National Serviceman serving on 6 December 1972 and completed the contracted period of National Service on or after 7 December 1972

who are diagnosed by a medical practitoner as having malignant neoplasm (cancer) or pulmonary tuberculosis as defined in the relevant Statement of Principles are eligible for treatment for these conditions at departmental expense.

Eligibility for treatment for malignant neoplasm (cancer) and pulmonary tuberculosis is set out at subsection 85(2) of the VEA.

British nuclear test participants and British Commonwealth Occupation Force members

Australian participants in the British Nuclear Tests in Australia and members of the British Commonwealth Occupation Force in Japan at the end of World War Two are entitled to health care for any medical condition on a non-liability basis.

Applying for treatment under NLHC arrangements

To receive NLHC treatment for a specified mental health condition, an eligible person must make a request to the Department. This request can be made in writing (including via email to NLHC@dva.gov.au), in person or by phone call.

Alternatively, a person may choose to lodge an application using form D9213 Application for Health Care for Mental Health Condition(s).

To receive NLHC treatment for malignant neoplasm (cancer) or pulmonary tuberculosis, an eligible person must lodge a completed application form using D9215 Application for Health Care for Cancer (Malignant Neoplasm) or Tuberculosis. This can be lodged with the Department in person, by mail, or by email to NLHC@dva.gov.au.

Australian participants in the British Nuclear Tests in Australia and members of the British Commonwealth Occupation Force in Japan at the end of World War Two can claim for treatment through the D9056 Application for a Gold Card for Australian British Nuclear Test Participants and Australian British Commonwealth Occupation Force Participants.

If an eligible person has made a claim for compensation for a condition covered under NLHC arrangements, a determination to provide treatment under NLHC arrangements can be made without a separate application form if the client provides written consent (e.g. by email to the specified email address NLHC@dva.gov.au). This would only be relevant to provide treatment coverage prior to the claim being determined, or where a determination is made for that claim that the Commonwealth is not liable.

Diagnosis

A diagnosis of malignant neoplasm (cancer) or pulmonary tuberculosis must be provided to DVA prior to making a determination to grant NLHC treatment. Diagnosis of malignant neoplasm (cancer) or pulmonary tuberculosis can be made by the treating medical practitioner.

For mental health conditions, a diagnosis is not required.  Proof of identity and service are required at the time of application.

Once DVA has all the required information to grant NLHC, a decision will be made and the client notified of the decision.

Backdating of provision of treatment

Where a request is made by an eligible person, DVA will pay for treatment for the eligible condition up to three months prior to the date a request is made to the Department.

If a compensation claim is lodged and the claimant is determined to be eligible for treatment under NLHC arrangements for a condition in that claim, then DVA will pay for treatment up to three months prior to the date the claim is lodged.

If no request was made, eligibility will be backdated from the date the client is advised that they are eligible.

Where a client is eligible under the Veterans' Entitlements (Extension of Non-Liability Health Care for Mental Health Treatment) Determination 2017 (Instrument 2017 No. R24) but would not have been eligible under the revoked Veterans' Entitlements (Extension of Non-Liability Health Care for Mental Health Treatment) Determination 2016 (Instrument 2016 No. R34), eligibility cannot be backdated prior to 1 July 2017.

Eligibility cannot be backdated for Australian participants in the British Nuclear Tests in Australia and members of the British Commonwealth Occupation Force in Japan at the end of World War Two.

Continuation of eligibility for treatment

Where all required documentation has been provided, eligibility will generally continue for as long as the veteran or current or former member requires treatment.

What type of treatment is available?

A range of treatments may be available, including treatment from a general practitioner, medical specialist, psychologist, social worker, occupational therapist, psychiatrist, hospital services, specialist PTSD programs, pharmaceuticals, or oncologist services as required to treat the condition.

Other treatment available for veterans

Veterans and Veterans Families Counselling Service (VVCS)

Veterans of all wars and conflicts who served in the ADF are eligible for counselling from the VVCS. The VVCS is a specialised, free, and confidential counselling service for veterans, their wives or partners, and dependant children.

The NLHC White Card also confers eligibility to access counselling services through the VVCS.

Urgent hospital treatment for Vietnam Veterans

Vietnam Veterans are generally eligible for urgent hospital treatment at DVA expense for any condition.

For a veteran to be eligible for urgent treatment under subsections 85(9) and (10) of the VEA, they must have rendered continuous full-time service in the area described in item 4 or 8 of Schedule 2 (column 1) of the VEA during the period from 31 July 1962 to 11 January 1973 inclusive. They do not need to have been allotted for duty in that area. 

Continuous full-time service in relation to a member of the Defence Force means that a person must have served on a continuous full-time basis, as opposed to a part-time basis.

A period of continuous full-time service is required by a member of the Defence Force if they are to be considered as having eligible war service, operational service or defence service and access to the benefits associated with those forms of service.

Continuous full-time service in relation to a member of the Defence Force means that a person must have served on a continuous full-time basis, as opposed to a part-time basis.

A period of continuous full-time service is required by a member of the Defence Force if they are to be considered as having eligible war service, operational service or defence service and access to the benefits associated with those forms of service.

The Australian Defence Force includes:

  • Australian Army
  • Royal Australian Navy (RAN)
  • Royal Australian Air Force (RAAF)

The Australian Defence Force includes:

  • Australian Army
  • Royal Australian Navy (RAN)
  • Royal Australian Air Force (RAAF)

Statement of Principles means:

  • a Statement of Principles determined by the RMA under section 196B of the VEA; or
  • a determination made by the Repatriation Commission under section 180A of the VEA; or
  • a Statement of Principles concerning a particular kind of injury or disease made available to the VRB by the Repatriation Commission under paragraph 138(2)(a) of the VEA.