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B11/1994 APPLICATION FOR RECREATION TRANSPORT ALLOWANCE - CHANGE IN INTERPRETATION OF "PUBLIC EXPENSE"

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DATE OF ISSUE:  2 MARCH 1994

APPLICATION FOR RECREATION TRANSPORT ALLOWANCE - CHANGE IN INTERPRETATION OF "PUBLIC EXPENSE"

The purpose of this instruction is to advise Branches of a change in policy following a Federal Court decision on the interpretation of the phrase "at public expense".

2.The current Form D302 is being updated and a draft will be circulated shortly for comment.  It is expected to be available by June 1994.

3.The existing Form D303: Medical Report on Application for Recreation Transport Allowance will remain unchanged and is available from the forms unit.

PARAGRAPH 3.8.5 - BEING CARED FOR "AT PUBLIC EXPENSE"

4.In the Federal Court decision in the case of Cyril George O'Donnell the court interpreted the phrase "at public expense" to mean that the Commonwealth is the sole contributor.  The Repatriation Commission has decided against appealing this decision further.

5.As a result paragraph 3.8.5 at part 3 of Guide to Supplementary Benefits no longer applies and should be deleted.  A veteran cannot be excluded from receiving RTA where he or she is being cared for in a hospital or other institution, and is paying a partial contribution towards that care.

6.For a veteran to receive the allowance all other eligibility criteria as set out in the legislation and Guide to Supplementary Benefits, must be met.

MEDICAL INVESTIGATIONS AND INCURRED COSTS

7.There is no change to the medical investigations required to establish eligibility and degree of disability.  The Incurred Cost requirement also remains the same but the new form will have extra space for details on how the expense is incurred in undertaking a recreational activity.

A W ASHFORD

NATIONAL PROGRAM DIRECTOR (BENEFITS)


ATTACHMENT

PART 3-6

3.7 - REGISTRATION AND CONTROL OF APPLICATIONS

3.7.1Upon receipt of an application, details should be registered on the Claims Management System.

3.7.2All applications should be attached to the veteran's medical file without delay, and all actions and directions should be made on that file.

3.8 - INVESTIGATION OF APPLICATIONS

Medical Investigation

3.8.1The investigation of an application for RTA will depend on the medical and other evidence held by the Department.

3.8.2Where there is evidence that a person has both legs amputated, or is incapacitated by war?caused injury and/or disease in a way which would qualify the veteran for the higher amount of the allowance; or where there is a current determination that the veteran is blinded in both eyes, then, subject to paragraph 3.8.5-, the facts relevant to the application should be referred to a delegate of the Commission.

3.8.3Other cases should be referred to a DMO for opinion or for direction as to the medical investigation required. Where there is recent medical or clinical reporting on the veteran, further investigation may not be required if the DMO is able to give an opinion regarding the nature or effect of the veteran's incapacity in relation to the RTA criteria. Clinical notes from a treating Specialist or from a hospital in which the veteran has recently been investigated may be obtained instead of a further medical examination, where these should provide sufficient information.

Other Investigation

3.8.5A veteran is not entitled to be paid RTA in respect of any period when he or she is being cared for in a hospital or other institution (such as a nursing home) at public expense. A veteran in a nursing home will be regarded as being cared for at public expense if all or part of the patient contribution is paid by the Commonwealth. Where the full patient contribution charged by the nursing home is paid by the veteran, the veteran is not being cared for at public expense. Where there is evidence to suggest a veteran has been in an institution since the claim was lodged, or since the determination was made that the injury or disease was war?caused, the period(s) of admission and details of liability for costs should be obtained before the application is referred for determination.

3.8.6The allowance is payable to a veteran for costs incurred by the veteran in travelling for recreational purposes. If the veteran does not incur such costs, there is no liability to pay the allowance. Where the evidence suggests the veteran would be unable, by reason of physical mental

Extract from Guide to Supplementary Benefits.