External

As indicated earlier, approval of services should never be an open ended decision and must be reviewed and supported by the treating doctor after 3 months, except where it is clear from the nature and extent of injury that ongoing or permanent assistance will be required.

For such cases, review should still be conducted, but on an annual basis, to ensure that the employee's needs continue to be met.

Review by an Occupational Therapist should be undertaken where more than 6 months of assistance is claimed and the employee does not have an active Return to Work plan (RTWP).

Where a RTWP is currently in place, an updated assessment of the employee's circumstances should still be obtained from the rehabilitation provider, following 6 months of assistance.

In all cases, the assessment should include:

  • discussion with the employee, medical practitioner and Case Manager (where applicable);

  • a functional capacity evaluation and/or Activities of Daily Living assessment; and

  • workplace evaluation and job analysis, where applicable.

Consideration must be given to ensuring that provision of household services does not become an ongoing expectation for employees, except where long term or permanent injury conditions prevail.

Generally, for most injuries, the provision of household services is a short term assistance measure, designed in the early stages of the injury to assist the employee to recuperate to a level where he or she is able to take on more and more tasks over time.

Ideally, an overall planned approach should be taken from the outset with provision of household services.

The following example provides a guide to how a RTWP may be developed and should be designed in conjunction with recommendations from the doctor or rehabilitation provider.  This example is for an employee with a severe arm injury.

DURATION

TASKS

First month services are claimed

All services recommended by the treating doctor or rehabilitation provider.

  • ironing;

  • dusting and other forms of cleaning above shoulder height;

  • cleaning the bath and toilet;

  • making beds;

  • vacuuming; and

  • all laundry requirements.

Second month services are claimed

Tapering off of tasks as the employee is able to take on more household duties him or herself (again, subject to doctor or rehabilitation provider recommendations).

  • half amount of ironing;

  • vacuuming;

  • hanging out washing only; and

  • cleaning the bath.

Third month services are claimed (if required)

The employee is able to undertake all tasks except:

  • hanging out washing; and

  • cleaning the bath.

While not intended to be prescriptive, the example demonstrates that generally, over time, an employee's injury is expected to improve and full assistance is only really required in the most severe stages of the condition.

Specific household services may not necessarily need to be spelt out in such detail, but the amount of hours commensurate with a reduction in specific services should decrease accordingly.

Example

An employee, in the first month of her injury, is provided with payment for 8 hours household services per week.

In the second month, this reduces to 5 hours per week, and in the third month, is only required for 3 hours a week.

By the fourth month of injury, the employee is able to undertake all household services herself.

The intention to taper approval of the benefit, related services and costs should all be conveyed to the employee as part of the letter of approval which is provided prior to the commencement of payment of household services.

In instances where there is a RTWP, it should never be assumed that, because the RTWP may take 3 to 6 months (or longer) to complete, household services will be provided for the full duration of the RTWP.

While a RTWP should be taken into consideration when assessing the need for household services, benefits associated with household services form their own distinct section in the SRC Act, outside the rehabilitation clauses of Part III.