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21.1 Claimants Requesting Access to Treatment (within Australia)
Claimants should be requested to follow the instructions below:
- Identify a treating doctor who will be responsible for managing the condition.
It is advisable not to change doctors frequently as this may result in an ineffective management plan for the condition. Claimants should advise of changes to their treating doctor.
- For all treatment, claimants must obtain a current referral from their treating doctor.
The continuation of provision of services will depend on the continued provision of referrals for treatment, or the agreement to an indefinite referral for treatment.
- Present the referral and Treatment Authority letter to the proposed treating practitioner.
The referral should include the accepted condition/s treated, the number of treatments required to manage your condition and a prediction of the outcome of the treatment. This notification should take place at the first or second treatment. Use of Standard Letter 'Physiotherapy/Start Treatment' can be used for this purpose.
- The treating practitioner should send their accounts directly to DVA.
If the treating practitioner will not bill DVA directly, please contact DVA.
- The treating practitioner should be willing to discuss your case with DVA staff.
This may include progress reports as requested. The cost of these reports will be reimbursed to the provider. Make sure appropriate authorities are signed by the claimant.
- There should be no assumption that any treatment will continue indefinitely if an indefinite referral and treatment plan has not been approved by DVA.
All treatment is subject to approval (whether in a Treatment Authority or prior-approval) and must be clinically necessary for the conditions for which there is an accepted liability with DVA.
- Specific Treatment Expectations exist for different health disciplines.
Please refer to the DVA website or DVA staff for further information. Please note that the Treatment Expectations have been developed in line with current DVA health policy, injury management policies implemented by the health industry, workers' compensation, Comcare and compulsory third party insurers. The expectations have been developed to ensure that all injured persons receive treatment that is medically necessary, will cause no harm and ensure the achievement of identified functional outcomes.