9.13.4 Rehabilitation support following a return to work

Monitoring

Streamlined Access to Incapacity Payments allows a veteran to utilise rehabilitation support for up to 12 months following their return to work. During this 12 month period, it is expected the Rehabilitation Provider  will maintain regular contact, which is agreed upon with the client to allow proactive identification and resolution of  emerging issues while ensuring the client has adequate space and time to focus on their new employment.  For example, one client may want weekly calls and another client may need only 3 monthly calls from the provider, but also be willing to the call the provider themselves if they need assistance.  

Additional rehabilitation activities can be approved during the 12 month monitoring timeframe to assist the client to maintain employment. It is still important to close any existing goals that have been met, and set new activities under an appropriate goal related to monitoring employment.  Activities appropriate for this monitoring period might include:

• working with the employer to help resolve any difficulties in the workplace, or with the client fulfilling their work role;
• working with treating health professionals to ensure the client accesses appropriate medical support to help them get better as soon as possible;
• counselling on resilience and understanding healthy relationships; and
• developing management strategies to overcome work and personal issues impacting the client.

Ceasing or reducing hours of work due to accepted conditions

If the client needs to cease their employment or reduce their hours because of their accepted conditions, they are not required to submit a new claim for incapacity payments. Once notified, the Rehabilitation Coordinator will liaise with the client’s incapacity claims manager to ensure that incapacity payments are reactivated.

Reinstatement of incapacity payments under this policy is not restricted to the client’s mental health condition(s) impacting their employment, however their accepted mental health condition must be a contributing factor.  As long as the Rehabilitation Coordinator is satisfied that the reason for the change affecting their employment is genuine and that their accepted mental health condition has contributed to the change, the impact on their employment can be due to any of their accepted conditions,  Clients who have not been previously accepted under Streamlined Access to Incapacity Payments will need to follow the normal procedures, which may include a new Incapacity Payments claim.

Streamlined Access to Incapacity Payments provides additional rehabilitation support for clients who are vulnerable to moving in and out of employment due to their accepted mental health conditions. It is also important that clients continue to access appropriate treatment and support from their treating health professionals, to ensure that any flare in symptoms can be managed as quickly as possible.

For this reason, DVA expects that a client who is accessing support through Streamlined Access to Incapacity Payments will visit their GP, psychiatrist, psychologist or other appropriate health provider when they begin to experience difficulties in managing their employment responsibilities. A medical certificate from any treating health professional, including their GP, will provide DVA with required assurance that the client’s mental health condition(s) is a main contributor to the client needing to reduce their hours of employment, or to cease their employment. This certificate must be provided to the client’s DVA Rehabilitation Coordinator.

Where the person remains in employment at a reduced number of hours, it is important that DVA has evidence of the client’s current rate of pay, as this will ensure that the correct rate of incapacity payments is paid, and will reduce the risk of overpayments. If the person has completely ceased employment, an employment separation certificate will be required before incapacity payments can be reinstated. If the client is having difficulty accessing these documents, the Rehabilitation Provider can assist and ensure that they are forwarded to the client’s DVA Rehabilitation Coordinator. The Rehabilitation Coordinator will then liaise with the client’s incapacity claims manager so that incapacity payments can recommence as quickly as possible.

There are no barriers to a client being able to participate in Streamlined Access to Incapacity Payments on more than one occasion, however, each incident cannot be extended beyond 12 months. For example, a client may commence employment two times and can access streamlined access to incapacity payments both times. But if the client remains in employment for 12 months and asks for an extension to the Streamlined Access to Incapacity Payments, then this cannot be granted and the client will need to re-claim for payments in the normal way.

Ceasing or reducing hours of work due to other reasons

If the client needs to cease their employment or reduce their hours, because of a reason that is not their accepted conditions, they cannot automatically have their incapacity payments reinstated.

Other reasons might include when the client;

• has a family emergency;
• has parental duties;
• doesn’t like the work;
• is moving out of commutable range;
• is wanting time off to travel;
• has their employment contract ceased due to employment performance issues; or
• has an unrelated health issue which is the cause of leaving employment or reducing hours.

In this case, if the client must choose if they wish to submit a new Incapacity Payments claim, which may or may not be accepted.

Non-compliance

The expectations of clients accessing additional support through this policy are available at section 9.13 of the Rehabilitation Policy Library. The general rights and obligations of clients undertaking rehabilitation can be found at section 13 of the Rehabilitation Policy Library.

Clients accessing additional support through this policy have been identified as requiring additional support due to the episodic nature of their mental health conditions.  In keeping with the intent of this policy, clients should be given every assistance in meeting their obligations before any action is taken to remove benefits. In all likelihood, non-compliance may be as a result of clients being involved in their new employment and not believing they require any assistance.

It is essential that if the plan is being closed due to non-compliance, that it is the Rehabilitation Coordinator that discusses this with the client, and informs them that the plan will be closed, and the consequences of this occurring. At no time must a Rehabilitation Provider progress a discussion regarding, or be asked to communicate closure of a plan due to non-compliance with rehabilitation obligations with a client. The policy regarding closure of a rehabilitation plan can be found at section 3.10 of the Rehabilitation Policy Library.

Successful return to work at 12 months

At the end of the 12 month monitoring period, where the Rehabilitation Coordinator is satisfied that the client has returned to sustainable employment and all other goals are closed, the rehabilitation plan will be closed. 

In situations where the client needs ongoing assistance, due to their mental health conditions or other conditions, and an appropriate goal is still active, then the rehabilitation plan can continue. However, the Streamlined Access to Incapacity Payments flag should be removed at the 12 month mark.

Ceasing/reducing work after the 12 month approved period

There is a 12 month maximum period to Streamlined Access to Incapacity Payments, and after this period, rehabilitation (and access to incapacity payments) reverts to BAU.