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7.2 Criteria for assessing what is reasonable
The key concept in considering any proposal for the provision of household services is whether or not the person reasonably requires the services, and that requirement is as a result of their service injury or disease.
Household services can only be provided when a formal determination has been made by a DVA delegate that the services are reasonably required. The determination to accept or reject a claim for household services must be based on evidence. For new claims, it is recommended that an assessment is conducted by a suitably qualified and experienced Occupational Therapist* (OT) of the person's ability to undertake tasks which are required for the proper running and maintenance of their household. For claims for renewals of household services, an OT assessment will generally not be required each time, unless the claim indicates that the client's circumstances or needs have changed. It is expected that an OT assessment will be conducted at least every five years.
* OTs undertaking an assessment for household services do not need to be DVA accredited rehabilitation service providers. They must however, be Comcare accredited, appropriately qualified and experienced.
In determining the reasonable requirement for provision of household services, the delegate must consider the criteria in section 215 of the MRCA and subsection 29(2) of SRCA and address all of the matters relevant to the client's circumstances in the determination letter. These criteria are:
(a) the extent to which household services were provided by the person before the service injury or disease;
(b) the extent to which he or she is able to provide those services after the service injury or disease;
(c) the number of other persons (household members) living with that person as members of his or her household;
(d) the age of the household members and their need for household services;
(e) the extent to which household services were provided by household members before the service injury or disease;
(f) the extent to which household members, or any other relatives of the person, might reasonably be expected to provide household services for themselves and for the person after the service injury or disease;
(g) the need to avoid substantial disruption to the work or other activities of the household members; and
(h) any other matter that the Commission considers relevant.
Further details about these criteria are explained in the following subsections and must be used to guide decision making.
Provision of aids and appliances rather than household services
One of the advantages of making a referral for an OT assessment is that the OT may consider whether the client may benefit from aids and appliances that would enable them to self-manage their household services without the requirement for a household services provider. Aids and appliances could include, for example, a lightweight pool cleaner or vacuum cleaner or other similar items. A recommendation like this should be considered if:
- providing the aid or appliance will enable a person to reach a rehabilitation goal; and
- the client is responsible for the given tasks and there is no-one else who can be reasonably expected to undertake them; and
- the client cannot safely undertake these tasks without the requested items; and
- providing the aid or appliance does not expose the client to an unsafe situation; and
- providing the aid or appliance will enable the client to undertake these tasks, allowing greater independence and assist the person to manage the impact of their accepted conditions; and
- providing the items is a more cost effective option than providing ongoing household services for these tasks.
Note: Under paragraph 39(1)(e) of the SRCA and paragraph 56(1)(c) of the MRCA, DVA is responsible for the maintenance and replacement of any aid or appliance that we provide. This should be taken into consideration when assessing each individual case and making a judgement about the most cost effective option.
Further information about the provision of aids and appliances can be found in chapter 10 of this Guide.