You are here

2.10 Determining the 'reasonableness' of a request for a rehabilitation item or service

The key principle in considering any request or proposal for the provision of a rehabilitation item or service for a client, is whether or not the item being requested is reasonably required to assist the client to achieve a rehabilitation goal.

The first criteria in determining 'reasonableness' is the requirement for the request to be covered under current legislative/policy provisions.

To be eligible for the provision of household services, attendant care, alterations, modifications, aids and or appliances and other rehabilitation services, clients must meet the following criteria:

  • they have an accepted claim for compensation;
  • they have an impairment as a result of a service injury or condition; and
  • the client must either:
    • be undertaking, or has completed, an approved rehabilitation program in respect of the impairment; or
    • has been assessed (under section 44 of MRCA or section 36 of SRCA) as not being capable of undertaking a rehabilitation program.

Secondly, the client's rehabilitation and medical or allied health provider (i.e. GP, Specialists, Occupational Therapists, Physiotherapists, Podiatrists, Rehabilitation Service Providers or other allied health providers) is expected to provide objective, professional advice recommending or suggesting the item or service, based on the client's accepted medical condition and level of impairment and will help:

  • achieve an agreed rehabilitation goal;
  • the clients recovery (help alleviate pain/suffering);
  • provide remedial support for the accepted condition(s);
  • ensure the client's personal safety; and
  • impact on the client's quality of life – mobility, independence, community engagement, their maintenance of wellbeing, general functioning and or capacity to return to or perform at work.

Where necessary, further clarification from a rehabilitation or health professional or other source (eg. item manufacturer or supplier) may be required if the items or services are considered uncommon, expensive or a specific type of item or service is being requested.

Finally, other considerations which may have to be taken into account include:

  • the urgency of the request and availability of the items or services;
  • the length of time the items or services will be required;
  • the cost effectiveness in purchasing the item or service, which requires consideration of the:
    • cost of the item or service;
    • impact on future liability; and
    • improvements to the client's general functioning, and wellbeing;
  • possible alternatives to purchasing such as, leasing or hiring options;
  • the expected duration of the client's impairment and the likely time the items or services will be required;
  • client preference, possible contributions and input into the decision/agreement; and
  • whether provision of the support requested is above the level that would normally be required for the medical condition or level of impairment.