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4.5 What Assistance can DVA Provide to Serving Members?
Schedule 16 of the Memorandum of Understanding between Defence and DVA provides the agreed framework for DVA to provide specific supports and services to Australian Defence Force (ADF) members who are still serving and have not been identified as “likely to be discharged” for medical reasons.
It is important to note that household services, attendant care services and assistance under the Motor Vehicle Compensation Scheme are contained in the compensation provisions in Chapter 4 of the MRCA. This provides the legislative basis for these services to be provided to full time serving members, reservists on Continuous Full Time Service (CFTS) and non CFTS reservists even though the Chief of the Defence Force (CDF) remains the rehabilitation authority.
Defence responsibilities for full time serving members
For full time serving members including Permanent Force members and reservists on CFTS, the CDF is their rehabilitation authority and therefore Defence carries the overall responsibility to provide for their member's assessed rehabilitation needs including:
- medical treatment;
- medical aids and appliances;
- rehabilitation (non clinical) aids and appliances identified by the rehabilitation assessment;
- alterations and modifications to Defence Housing Australia (DHA) accommodation; and
- rehabilitation assessments and occupational rehabilitation programs.
For details about which aids and appliances can be provided by the ADF Rehabilitation Programs, please see the table in section 10.8 of this Guide.
Defence normally provides full time serving members with medical treatment under Regulation 58E of the Defence Force Regulations. However, under section 272 or 279 of the MRCA respectively, the costs of treatment can be reimbursed or treatment can be provided under DVA Health Card arrangements to serving members for an accepted condition, outside that offered by the ADF. This may occur where the CDF considers it more appropriate that this occurs, and the Commission agrees. This would usually occur where a member is in the process of being discharged from the ADF and has a condition for which liability has been accepted. This is also discussed in chapter 8.5 of the MRCA policy manual.
DVA responsibilities for full time serving members
There are some situations where DVA can provide rehabilitation assistance for a serving member, including full time ADF members and reservists on CFTS, where liability has been accepted and a formal request for these services is made to the ADFRP or Rehabilitation for Reservists Regional Rehabilitation Manager.
Once this formal request has been made, DVA can provide the following assistance to serving members whose rehabilitation authority continues to be the CDF:
- vehicle modifications under motor vehicle assistance schemes;
- household services where supported by an assessment report from the ADF or Rehabilitation for Reservists Program;
- attendant care services where supported by an assessment report from the ADF or Rehabilitation for Reservists Program; and
- household alterations of private (non-DHA) accommodation where identified through the ADFRP or the Rehabilitation for Reservists Program, or a DVA needs assessment.
The exception to this general rule is where a serving member contacts DVA directly for these services. Further direction can be found under “Access to Services and benefits” in this section.
DVA is also able to provide aids and appliances to full time serving members and reservists on CFTS in the following circumstances:
- where the Rehabilitation Authority is transferred to DVA by Defence; or
- where the request is made by Defence and the DVA delegates considers that it is appropriate for DVA to provide the recommended aids and/or appliances through section 58(2) of the MRCA because doing so would be likely to increase the length of time that the client would serve as a Permanent Forces Member or CFTS Reservist.
Please refer to section 10.8 of this Guide for more information about how to provide aids to full time serving members.
Defence responsibilities for non CFTS reservists
Following amendment to section 39 of the MRCA (effective 1 July 2013), Defence is now responsible for providing the following services for all non CFTS reservists with a Defence service related injury or illness:
- medical treatment (until DVA accepts liability for the service related injury or illness);
- medical aids and appliances;
- rehabilitation assessment and development of rehabilitation plans;
- occupational rehabilitation programs – including addressing civilian employment issues; and
- rehabilitation (non-clinical) aids and appliances identified by the rehabilitation assessment (including those required to assist a person in their civilian employment).
The CDF continues to be the non CFTS reservist's rehabilitation authority until their successful rehabilitation or medical discharge from the ADF. Rehabilitation assistance for non CFTS reservists is provided through the ADF Rehabilitation for Reservists Program.
Reservists on the standby reserve list are considered to be non CFTS reservists. The standby reserve list includes those ADF members who have voluntarily discharged from the ADF and may no longer have any active role as an ADF member.
A transfer of rehabilitation authority using MRCA section 39(3)(aa) can be considered where a client's individual circumstances are such that this may be a more beneficial option for them. Delegates are requested to review the information in chapter 4.3 of this Guide when considering this option.
DVA responsibilities for non CFTS reservists
Non-CFTS reservists should lodge a claim for their service related injury or illness within 28 days. This will allow them to access the full range of services and benefits from both the Rehabilitation for Reservists Program and DVA.
Once DVA accepts liability for a service-related injury or illness, DVA is responsible for the funding and provision of the following assistance:
- medical treatment;
- incapacity payments;
- permanent impairment payments;
- vehicle modifications or where specific criteria are met, provision of vehicles under motor vehicle assistance schemes;
- attendant care services;
- household services; and
- household alterations where identified through the ADF Rehabilitation for Reservists Program or DVA Needs Assessment.
In accordance with priority of claims protocols, DVA must provide priority to non-CFTS reservists where there is:
- any immediate or imminent financial hardship including loss of earning from their civilian employment; and
- a request from Defence through the Director Navy People, the Director General Personnel Army, or the Director General Personnel Air Force.
When a claim from a non-CFTS reservist has been accepted by DVA, they will be transferred to DVA in accordance with ss. 271 and 280 of the MRCA. DVA will provide advice to Defence and the reservist on how their health costs will be covered. Defence retains responsibility for occupational rehabilitation until the case is closed.
Access to services and benefits at the request of Defence
In most circumstances, in order to gain access to services and modifications from DVA, an ADF serving member with an accepted claim must have undergone a specific assessment through the ADFRP or Rehabilitation for Reservists Program process, by an appropriately qualified rehabilitation provider or health professional. The outcomes of the assessment should determine the clinical need for the recommended services. If Defence is unable to provide specific services then the Memorandum of Understanding between Defence and DVA provides the framework through which DVA can provide the service or support, based on evidence from the assessment.
Where this occurs, a rehabilitation plan should be opened through Defcare and the costs of the household services, attendant care services, household alterations or costs under the Motor Vehicle Compensation Scheme should be paid as a third party cost on the plan. It is important that a note is made on Defcare that the client is still serving and the service has been provided at the request of Defence. The intention of this approach is not to open a rehabilitation plan under section 51 of the MRCA, but rather to provide an administratively convenient mechanism which takes into account system constraints, and which otherwise facilitates the provision of services.
Access to services and benefits where the client approaches DVA directly
In some cases, a serving member may contact DVA directly for attendant care, household services or assistance under the Motor Vehicle Compensation Scheme. Where this occurs, DVA can provide these services, without a request from the ADFRP or Rehabilitation for Reservists Program, because these services are provided through the compensation provisions in chapter 4 of the MRCA, rather than the rehabilitation provisions in chapter 3 of the MRCA. The usual assessment processes should be followed, to ensure that there is evidence of the need for the services, due to the client's accepted conditions.
In this case, a rehabilitation plan should be opened through Defcare, and the costs of household services, attendant care services or costs under the Motor Vehicle Compensation Scheme should be paid as a third party cost on the plan. It is important that a note is made on Defcare that the client is still serving and has approached DVA directly for support. The intention of this approach is not to open a rehabilitation plan under section 51 of the MRCA, but rather to provide an administratively convenient mechanism which takes into account system constraints and which otherwise facilitates the provision of services.
If a rehabilitation need is identified through the assessment process, then Defence should be notified of this by modifying and sending the standard ADFRP referral letter available through the needs assessment pages or the incapacity pages of the Rehabilitation and Compensation support site. A copy of the Occupational Therapist report can only be provided to Defence if the client has provided permission or authority to do so.