Procedures For Determining Section 39 Claims

The object of section 39 (1) is to approve and pay the reasonable cost for alterations, modifications, aids or appliances commensurate with an employee's needs.  In this regard, a number of procedures should be undertaken to ensure that this object is satisfied.

However, while the policy outlined in this part must be considered in all cases, procedures will vary according to the degree of complexity of the claim being considered.

In situations where claims are lodged which are:

  • low cost (under $100); and

  • endorsed by either medical or rehabilitation experts

claims should be accepted, without further investigation.  A letter of approval should be issued to employees prior to items being purchased.

For all other cases, varying degrees of investigation will be necessary to satisfy the requirements of section 39.  This will range from clarification of doctor's or rehabilitation provider's evidence, to consideration of all the following:

  • more extensive investigation of section 39 (2) provisions;

  • assessments by independent providers; and

  • potential cost discrepancies.

However, the approval process and PRACSYS procedures outlined below will remain consistent for all claims.

Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-nine-non-incapacity-payments/part-six-section-39-payments/procedures-determining-section-39-claims

Further Investigation Of Section 39 (2) Provisions

The object of section 39 (1) is to approve and pay the reasonable cost for alterations, modifications, aids or appliances commensurate with an employee's needs.  In this regard, a number of procedures should be undertaken to ensure that this object is satisfied.

However, while the policy outlined in this part must be considered in all cases, procedures will vary according to the degree of complexity of the claim being considered.

In situations where claims are lodged which are:

  • low cost (under $100); and

  • endorsed by either medical or rehabilitation experts

claims should be accepted, without further investigation.  A letter of approval should be issued to employees prior to items being purchased.

For all other cases, varying degrees of investigation will be necessary to satisfy the requirements of section 39.  This will range from clarification of doctor's or rehabilitation provider's evidence, to consideration of all the following:

  • more extensive investigation of section 39 (2) provisions;

  • assessments by independent providers; and

  • potential cost discrepancies.

However, the approval process and PRACSYS procedures outlined below will remain consistent for all claims.

Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-nine-non-incapacity-payments/part-six-section-39-payments/procedures-determining-section-39-claims/further-investigation-section-39-2-provisions

Independent Assessments

The object of section 39 (1) is to approve and pay the reasonable cost for alterations, modifications, aids or appliances commensurate with an employee's needs.  In this regard, a number of procedures should be undertaken to ensure that this object is satisfied.

However, while the policy outlined in this part must be considered in all cases, procedures will vary according to the degree of complexity of the claim being considered.

In situations where claims are lodged which are:

  • low cost (under $100); and

  • endorsed by either medical or rehabilitation experts

claims should be accepted, without further investigation.  A letter of approval should be issued to employees prior to items being purchased.

For all other cases, varying degrees of investigation will be necessary to satisfy the requirements of section 39.  This will range from clarification of doctor's or rehabilitation provider's evidence, to consideration of all the following:

  • more extensive investigation of section 39 (2) provisions;

  • assessments by independent providers; and

  • potential cost discrepancies.

However, the approval process and PRACSYS procedures outlined below will remain consistent for all claims.

Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-nine-non-incapacity-payments/part-six-section-39-payments/procedures-determining-section-39-claims/independent-assessments

Investigation Of Payment Discrepancies

The object of section 39 (1) is to approve and pay the reasonable cost for alterations, modifications, aids or appliances commensurate with an employee's needs.  In this regard, a number of procedures should be undertaken to ensure that this object is satisfied.

However, while the policy outlined in this part must be considered in all cases, procedures will vary according to the degree of complexity of the claim being considered.

In situations where claims are lodged which are:

  • low cost (under $100); and

  • endorsed by either medical or rehabilitation experts

claims should be accepted, without further investigation.  A letter of approval should be issued to employees prior to items being purchased.

For all other cases, varying degrees of investigation will be necessary to satisfy the requirements of section 39.  This will range from clarification of doctor's or rehabilitation provider's evidence, to consideration of all the following:

  • more extensive investigation of section 39 (2) provisions;

  • assessments by independent providers; and

  • potential cost discrepancies.

However, the approval process and PRACSYS procedures outlined below will remain consistent for all claims.

Source URL: https://clik.dva.gov.au/military-compensation-reference-library/historical-information/comcare-operations-manual/volume-nine-non-incapacity-payments/part-six-section-39-payments/procedures-determining-section-39-claims/investigation-payment-discrepancies