9.13.3 When to consider Streamlined Access to Incapacity Payments

Streamlined Access to Incapacity Payments should be considered for specific clients:

• who are undertaking a vocational rehabilitation program with the goal of securing employment; and
• may be particularly vulnerable to experiencing difficulties in managing and maintaining employment because of mental health conditions for which DVA has accepted liability under the MRCA or DRCA (refer to flags below); and
• would benefit from additional support as they test their ability to return to, and maintain employment.

Through this policy, clients who meet the criteria can access rehabilitation support through the continuation of their rehabilitation plan for up to 12 months once they have secured employment. This will enable them to access the support of a Rehabilitation Provider to manage any issues they are experiencing in the workplace and in the event that they need to cease or reduce their hours due to their accepted mental health condition, their incapacity payments will recommence.
 

Identifying eligible clients

There are many individual differences in the way that mental health conditions impact on a person’s life. For example, having a particular diagnosed condition may manifest in an episodic flare of mental health symptoms for some clients which impacts on their ability to manage in a workplace. In contrast, another client with the same condition, who has developed a range of strategies and skills to manage their symptoms effectively may not require a break from their employment.

Rather than this policy applying to all clients with mental health conditions, consideration must be given to if a client’s accepted mental health condition is contributing to their incapacity.  The flags outlined below are intended to guide Rehabilitation Providers to identify issues that may place a client at risk of managing and sustaining their return to work due to their mental health conditions:

• reduced cognitive function - concerns about the person’s ability to process information and effectively undertake tasks required for their work role
• interpersonal function - the client has an inability to work collaboratively as a member of a team, or to manage any conflict in a workplace, a lack of coping strategies, or limited supports that a person may have available to them;
• medication and drug use -  the client  is struggling to find the right combination of medication to stabilise their symptoms.  The client  may require maximum levels of medication to be able to function in a work role and may experience side effects that could impact on their work role
• affect/mood - reduced energy level, decreased motivation, increased pain levels, a lack of resilience, and concerns about work goal orientation and commitment;
• personal confidence - lack of confidence for the specific work role and for returning to work generally;
• personal defensiveness - sense of injustice, or concerns about condition stigma;
• health literacy - concerns about the client’s understanding of their personal health conditions, management of their symptoms and the course of the condition;
• lifestyle balance - sleep issues, social isolation and a lack of positive recreation activities or other commitments which may make it challenging for them to be able to maintain a healthy lifestyle, which includes work;
• clients’ co-morbidities - including non-accepted conditions, which may add to the complexity of managing their employment obligations; and
• client’s attitude to other’s behaviours -  ie of supervisors and co-workers, indicating concerns about their ability to maintain positive working relationships with others;
   

Where the Rehabilitation Provider and/or the client identify any of the above flags that are likely to make the client vulnerable in an employment setting, then they are expected to discuss this with the DVA Rehabilitation Coordinator, to determine suitability for streamlined access to incapacity payments.

Early identification of these flags and pro-active management of issues is more likely to result in the client better handling their situation and recovering sooner. Identifying these issues quickly can also enable whole-of-person rehabilitation support to be provided, which may help the client to overcome some of their concerns about managing their work role.

Informing Incapacity Payments

The Incapacity delegate must be informed when considering and approving Streamlined Access to Incapacity Payments, as they need to be aware of the implications. As part of this process Rehabilitation Coordinators will need to check that the person’s accepted mental health condition is contributing to their incapacity. Approval for Streamlined Access to Incapacity Payments is recorded in the rehabilitation claim in R&C ISH, and also creates a flag in the Incapacity claim screen for the incapacity payment delegate.