DEFENCE COMPENSATION INSTRUCTION - NO 18 (Revision 1)
Military Compensation Scheme - Safety Rehabilitation and Compensation Act 1988
Subject
NATIONAL INTERIM REHABILITATION SYSTEM (NIRS) DATA ENTRY RULES
1.The purpose of this Defence Compensation Instruction (DCI) is to set out the data entry requirements for the National Interim Rehabilitation System (NIRS).
Background
2.NIRS is an interim system which will eventually be replaced by the DEFCARE system.
3.NIRS enables the Department to meet reporting requirements set by the Safety Rehabilitation and Compensation Commission (SRCC) for the performance of the military rehabilitation function.
4.NIRS also provides internal management tools through a suite of standard reports and an ad-hoc reporting facility.
Principles
5.The guiding principles for NIRS data entry are:
a.there should be national consistency in the recording of information on NIRS;
b.NIRS is the only computer system to be used for the management of military rehabilitation information;
c.NIRS data entry should be as complete as possible because the data are required for both the SRCC reports and for internal performance management; and
d.NIRS data entry must be accurate and input in a timely manner.
Field Definitions
6 — A full revised list of NIRS Field Definitions is attached (see Tables 1 and 2 attached).
7.It is especially important to distinguish between the similar-sounding but very different NIRS concepts of "No RTW" and "Non‑RTW". The following definitions are used for the purpose of this DCI:
a.No RTW - means the client was not working at the time their rehabilitation case was closed.
b.Non-RTW - is a type of rehabilitation program which does not have work as its goal, such as in cases involving quality of life, section 29 or section 39.
SRCC Performance Indicators
8.NIRS contains statistical information which is used to report on 4 separate SRCC Category 2 jurisdictional indicators.
9.The 4 rehabilitation indicators are provided twice yearly to the SRCC by Defence and the other jurisdictions (Telstra, Australia Post and Comcare). These reports are provided to the SRCC for the period 1 January to 30 June by 1 September, and for the period 1 July to 31 December by 1 March.
10.Whereas the 4 SRCC rehabilitation performance indicators do not provide a complete picture of Defence's rehabilitation performance, the relatively widespread external scrutiny of the published results demands that a high priority is placed on compliance with SRCC standards.
11.NIRS standard reports 1 to 4 provide the SRCC performance indicator information but these reports are for internal use only, as they contain case closure information which is excluded from the SRCC report. The actual SRCC report details are obtained from NIRS standard report 17.
12.The 4 SRCC performance indicators are:
a.Time taken to implement an RTW program (designated B5 by the
SRCC). This indicator measures process efficiency in getting rehabilitation programs started. The compliance standard in this indicator is for 90% of rehabilitation programs to be commenced in 14 days or less from the date of referral for an assessment of rehabilitation capability (ie. under section 36).
where:
(a) = Plan Commence Date minus Referral Decision Date (for Plan Commence Dates in the specified date range)
(b) = All cases with Plan Commence Dates in the specified date range
Note:The NIRS 'Plan Commence Date' is the date the Rehabilitation Co-ordinator agrees to the activities in the Plan. Accordingly the 'Plan Commence Date' may be earlier than the date the rehabilitation plan proforma (SF9) is signed by the section 37 delegate.
b.RTW Overall outcome (B6). This indicator measures the overall RTW success rate for rehabilitation cases at program closure. The compliance standard for this indicator is for 90% of clients to be involved in (full-time or part-time) work at the time of program closure.
Where:
(a) = Closure Outcomes with a RTW value (for Closure Dates in the specified date range)
(b) = All Closure Dates within the specified date range
Note: Non-RTW programs (eg. Quality of Life) and program closures which involve reduced incapacity payments (eg. Able to Earn) are excluded from the formula in NIRS Report 17.
c.RTW Quality of outcome (B7). This performance indicator counts the same cases as in B6 (above) except that the successful RTW outcomes are broken down into four descriptive categories:
- same employer same job
- same employer modified job
- same employer new job
- new employer any job
d.RTW Durability (B8). This indicator measures the long term success of rehabilitation programs. The compliance standard for this indicator is for 90% of employees to be still in employment exactly 6 months after their RTW rehabilitation program closure.
Where:
(a) = Cases with a “Yes” value in Work At 6 Month Follow Up (for Closure Dates minus six months in the specified date range)
(b) = Cases with Closure Date minus six months in the specified date range AND Closure Outcome is a RTW value )
13.It is important to note that whereas the 4 SRCC rehabilitation performance indicators provide useful internal management information, a number of other performance indicators are available from NIRS and are utilised by Defence to manage the rehabilitation function.
Policy
Data Entry Timeframes
14.All relevant red and blue coloured NIRS data entry fields should be completed on NIRS as soon as possible and data must be entered within 7 days of the event.
Field Definitions
15.NIRS data entry fields are to be completed in accordance with the NIRS Field Definitions (see Tables 1 and 2 attached). The field definitions are also listed in the NIRS 'Help' screen (ie. select “Help” then “Contents” from the top menu).
Front of Line Sorts
16.Claims which are examined as a “front of line sort” only are not to be recorded on NIRS. However, all other cases which are referred to the Rehabilitation Co-ordinator for a decision about proceeding with rehabilitation (eg on a SF1a or SF1b), must be entered on NIRS. This includes Referral Decision entries where the decision is “No Rehab Required”.
Non-RTW Programs
17.Cases involving quality of life programs and, specific section 29, or section 39 assessments should be recorded on NIRS as Plan Type = 'Non-RTW program'.
18.When assessing and determining section 29 eligibility, a case record should be opened on NIRS. However, when the active rehabilitation involvement is concluded (ie. when there is no further activity apart from the ongoing payment of section 29 costs) the case is to be closed on NIRS.
19.A separate NIRS case record should be opened and closed each time an annual review of section 29 eligibility is conducted.
20.Payments for services under section 29 are not rehabilitation costs so they are not required to be recorded on NIRS, rather they should be processed and recorded by the Compensation area.
Multiple Rehabilitation Goals
21.Many rehabilitation programs contain both RTW and Non-RTW elements. In such instances of multiple goals, the case is entered on NIRS as one rehabilitation program, with the Plan Type reflecting the primary goal (ie. the main focus of the rehabilitation activity).
22.If the primary goal of a rehabilitation program changes substantially following the plan commencement (eg. from an RTW focus to a Non-RTW focus - or visa versa) then this is reflected on NIRS by closing the case and commencing a new case. It is not permitted to simply change the Plan Type on the Plan screen of the existing case when the primary rehabilitation goal changes.
Long Term Training Courses
23.The NIRS case record for rehabilitation programs involving tertiary training should remain open for the entire duration of the program until a Closure Outcome has been achieved.
Case Closures
24.Cases should only be closed on NIRS when a decision is made to provide no further rehabilitation assistance, either because a RTW outcome has been achieved, or one of the other eight No RTW Closure Outcomes (see 26. below).
25.If rehabilitation activity is suspended (or is expected to be suspended) for more than 6 months (such as during periods of medical treatment or recuperation) then the case will be closed on NIRS.
If rehabilitation activity is resumed within 6 months of suspension, then the existing case is reopened on NIRS (ie. by removing the Closure Outcome and Closure Date entries on the Plan screen). Otherwise, a new NIRS case record is created.
26.There are eight No RTW Closure Outcomes. As these outcomes are not mutually exclusive, they are to be selected in hierarchical order. Only one Closure Outcome is selected and if more than one choice is true, then the topmost true choice is selected from:
a.No RTW - Deceased;
b.No RTW - Liability Ceased;
c.No RTW - Incapacity benefits ceased due to non compliance;
d.No RTW - Incapacity benefits ceased or reduced due to an ability to earn;
e.No RTW - Incapacity benefits ceased for other reasons;
f.No RTW - Successful Quality of Life Program;
g.No RTW - Further gains unlikely; and
h.No RTW - Transferred interstate.
Key Fields
27.As outlined in the Military Rehabilitation Coordinator Procedures, there are six key stages of the rehabilitation process which require a NIRS entry.
These are the most important entry fields on the NIRS system and they are therefore required to have the highest priority assigned for prompt and accurate input:
a.'Referral Decision' and 'Referral Decision Date' on the Commence Screen, are entered when a decision is made about whether or not to proceed with rehabilitation. The 'Referral Decision' information is usually entered when 'Add client' or 'Add case' details are first entered on the Client Screen of NIRS.
b.'Assessment Decision' and 'Assessment Decision Date' on the Commence Screen, are entered when a decision is made whether the case will proceed to development of a rehabilitation plan. This decision is usually made upon receipt of the rehabilitation assessment proforma SF8.
c.'Plan Commence Date' and 'Plan Type' details are entered on the Plan Screen, following approval of the Rehabilitation Plan.
d.The 'RTW' check-box and 'RTW Date' are entered on the Plan Screen to reflect the current work status of the client. If the client is working at the time of referral and plan commencement, then the 'RTW Date' will be entered with the same value as the 'Referral Decision Date'.
e.'Closure Outcome' and 'Closure Date' details are entered on the Plan Screen at case closure.
f.“Work At 6 Mth Follow Up” RTW durability follow up details are entered onto the Plan Screen 6 months following case closure.
NIRS Payments Recording
28.Rehabilitation program expenditure is recorded on the Payments screen of NIRS against the following service descriptions:
a.Section 36 assessment;
b.Rehabilitation plan external provider costs;
c.Section 39 aids, appliances and modifications;
d.Sub sections 29(3) attendant care and 29(1) household services;
e.External rehabilitation coordination - administration;
f.External rehabilitation coordination - casework; and
g.Other - third party.
29.As a minimum standard, service description 'b' should be used to monitor provider costs, and service description 'g' used to monitor non provider plan costs. Local policy will dictate the use of the remaining Service Descriptions. It should be noted that expenditure information in respect of each section of the SRC Act can also be obtained from DEFMIS.
30.Service description 'd' may be used to record section 29 expenses, but these are technically not rehabilitation expenses and they should therefore normally be processed and recorded by the compensation section.
31.Service descriptions 'e' and 'f' are only relevant when the Departmental rehabilitation coordination function is contracted out. Accounts in respect of these services are paid as a MCRS administrative expense and are not paid using DEFMIS account codes detailed in DCI 10 for the Military Compensation and Rehabilitation function.
32.Non-compensation rehabilitation costs are recorded on NIRS the same as if there was an accepted compensation claim. For example, even though Section 36 does not apply to non-compensation cases, the cost of the assessment of rehabilitation capability would be recorded under 'a' (Section 36 Assessment).
NIRS System Maintenance
33.All queries or requests for changes to the NIRS system should be directed through the Defcare User Group (DUG) representative within each regional office by completion of a Systems Change Request.
34.The system (NIRS) must not be provided to areas outside of the Military Compensation and Rehabilitation Service without the written authority of the Director Military Compensation and Rehabilitation, Defence Personnel Executive, Canberra, so that DMCR does not unwittingly become responsible for additional management and technical support costs.
35.Any queries concerning this instruction should be directed to Glen Tye (ADCR) on (026) 266 8639.
[Original signed]
C. NEUMANN
ASPSIM
24 March 1998
NIRS Field Definitions
NIRS Field Colours
- Red = Mandatory
Fields with Red labels always require a valid entry and the system will prevent you from leaving a screen until either:
- a valid entry is entered, or
- all entries in the screen are abandoned (by clicking on the “Cancel” button)
- Blue = Mandatory (conditional)
Fields with Blue labels are mandatory but the system will allow you to leave a screen without making a valid entry in them. The requirement to make an entry in the Blue labelled fields is not enforced by the system, rather it is an administrative requirement which depends upon whether the Case has reached the relevant stage.
- Black = Optional
Fields with Black labels are optional and they can be completed or left blank according to local decision.
Many Black labelled fields should always have an entry because although they are optional, the data are valuable for performance monitoring and day-to-day utility.
Combo Boxes & Radio Buttons
Combo Boxes are the “pull-down”, “pick a choice” boxes which are recognisable by the button on the immediate right hand edge of the field entry box.
Radio buttons are “pick a choice” like Combo Boxes, except that with a Radio Button there is no pull-down because all the available choices are already displayed.
A full list of the NIRS Combo Box and Radio Button choices may be found at Table 2 (below).
Table 1. NIRS Field Definitions
|
Field Name |
Colour |
Field Type |
NIRS Screen |
Entry Details |
|
Address |
Black |
Text |
Client |
The client's street or postal address |
|
Amount |
Black |
Currency |
Payments |
The amount of a payment line entry |
|
Approved Limit |
Red |
Currency |
Payments |
The total allowed amount of all payments under a Service Description |
|
Assessment Sent Date |
Black |
Date |
Commence |
The date a request is sent to an external provider for a Section 36 Assessment |
|
Assessment Date Received |
Black |
Date |
Commence |
The date the request for a Section 36 Assessment is received back in the MCRS office from the provider |
|
Assessment Decision |
Blue |
Combo |
Commence |
The formal decision to either proceed to a rehabilitation plan or to proceed no further. The Assessment Decision usually leads to development of a rehabilitation plan and is usually associated with a determination under Section 36 of the SRC Act. |
|
Assessment Decision Date |
Blue |
Date |
Commence |
The date the Assessment Decision is made |
|
Birth Date |
Black |
Date |
Client |
The client's birth date |
|
Case Manager |
Black |
Combo |
Commence |
The current or latest MCRS Rehabilitation Co-ordinator assigned to the Case. |
|
Closure Outcome |
Blue |
Combo |
Plan |
The result of the rehabilitation Case |
|
Condition |
Red |
Combo |
Commence |
The main (medical) condition for which the rehabilitation case is being provided |
|
Condition Determined |
Black |
Text |
Commence |
The exact wording of the condition for which compensation liability has been accepted. This field may be used as a reference for official correspondence |
|
Consultant Name |
Black |
Text |
Plan |
The name of the provider's rehabilitation consultant who has been nominated to handle the rehabilitation case |
|
Dependent Children |
Black |
Number (0 to 99) |
Client |
The number of children who are financially dependent on the client |
|
Difficulty Index |
Black |
Number (0 to 9) |
Commence |
A rating of the difficulty (complexity) in obtaining a successful rehabilitation outcome in a Case. This field is used to adjust Rehabilitation Co-ordinator caseloads for complexity: 1 = standard case 2 = in-house (not referred to provider) 3 = complex case A (3) “complex case” rating must be approved by the MCRS Manager and is determined according to time demands caused by:
|
|
Discharged |
Black |
Check box |
Client |
Indicates whether the client is currently discharged from military service |
|
Emp Status |
Red |
Radio button |
Client |
The type of military service which is/was undertaken by the client |
|
End Date |
Red |
Date |
Payments |
The latest acceptable Pay Date for a payment line entry in a Service Description. |
Table 1. NIRS Field Definitions (Cont.)
|
Field Name |
Colour |
Field Type |
NIRS Screen |
Entry Details |
|
First Name |
Red |
Text |
Client |
The client's first name. This field may include the client's middle name &/or initial (eg. Michael, Michael D. or Michael David are all acceptable entries) |
|
File Number |
Black |
Text |
Commence |
Usually the Compensation Claim Number relating to the main condition for which rehabilitation assistance is being provided. However, some sites may choose to use the File Number field to record a Rehabilitation File Number. |
|
Gender |
Black |
Combo |
Client |
The gender of the client (male or female). |
|
Injury Date |
Red |
Date |
Commence |
The date of injury (or onset of condition) of the main condition for which the rehabilitation case is to be provided. Where the client has multiple conditions and multiple accepted compensation claims, only the main condition relevant to the rehabilitation program is chosen |
|
Invoice Number |
Black |
Text |
Payments |
The invoice number of an account rendered by a supplier of goods or services |
|
Last Visited Date |
Black |
Date |
Plan |
The date the client was last visited by the MCRS Rehabilitation Co-ordinator |
|
Next Action |
Black |
Text |
Plan |
A description of the next action required in the rehabilitation program. This field is used as work flow diary to ensure that cases are followed up in a timely manner. |
|
Next Action Date |
Black |
Date |
Plan |
The date that the Next Action (see above) is due to occur. An Ad Hoc report with this field as the first selected output, and Next Action as the second output produces a useful “To Do” list. |
|
Next Action By |
Black |
Text |
Plan |
The name or initials of the person who will be undertaking the Next Action (see above) |
|
Notes |
Black |
Text |
Notes |
A dedicated screen which will accept a virtually unlimited amount of text. When the content of Notes is longer than the screen, a scroll bar appears which allows the entire contents to be read. |
|
Ongoing Payments |
Black |
Check box |
Client |
Eligibility for ongoing (section 29) home help or attendant care payments. Indicates that these payments may be continuing after the case is closed. |
|
Pay Date |
Black |
Date |
Payments |
The date a payment is passed to DEFMIS for processing |
|
Payment Description |
Black |
Text |
Payments |
Description of the type of goods or services in a payment line entry. |
|
Phones |
Black |
Text |
Client |
The client's contact phone number(s) |
|
Plan Commence Date |
Blue |
Date |
Plan |
The date the rehabilitation plan is commenced and accepted by the Rehabilitation Co-ordinator. This is often the date of the Section 37 determination but in some circumstances, the Section 37 determination signature comes later. |
Table 1. NIRS Field Definitions (Cont.)
|
Field Name |
Colour |
Field Type |
NIRS Screen |
Entry Details |
|
Plan Closure Date |
Blue |
Date |
Plan |
The date of the formal closure of the rehabilitation plan. |
|
Plan Type |
Blue |
Combo |
Plan |
The type of rehabilitation plan being undertaken in the rehabilitation Case. |
|
Postcode |
Black |
Text |
Client |
The postcode of the client's suburb of residence |
|
Program |
Red |
Radio button |
Client |
The client's Department of Defence program in which they sustained the condition for which the rehabilitation program is to be provided. Note: some program names changed recently - use the most applicable old program name. |
|
Provider |
Black |
Combo |
Plan |
The Comcare Approved Rehabilitation Provider to whom management of a Case has been assigned. If a Case is reallocated to a different Provider during a rehabilitation Case, then the Provider field is updated to the current Provider. NIRS allows only one Provider to be recorded per Case. |
|
Referrer |
Red |
Combo |
Commence |
The referral source of the rehabilitation Case |
|
Referral Received Date |
Black |
Date |
Commence |
The date on which the referral is received in the MCRS office. This field is used as the starting point, and is compared with the Referral Decision Date (see below) to measure the internal efficiency with which new referrals are processed. |
|
Referral Decision |
Red |
Combo |
Commence |
The initial decision to either investigate rehabilitation further (ie. to obtain an assessment of rehabilitation capacity) or to proceed no further. This Referral Decision is usually associated with a decision to refer for an assessment under section 36. |
|
Referral Decision Date |
Red |
Date |
Commence |
The date of the Referral Decision (see above) |
|
RTW |
Blue |
Check box |
Plan |
The current RTW status of a client. If a client engages in any kind of work during a rehabilitation Case, then the RTW checkbox is ticked. If the client subsequently ceases work during a Case, then the RTW checkbox is un-ticked. |
|
RTW Date |
Blue |
Date |
Plan |
The latest date of work commencement. If the client is already working at the time of referral to rehabilitation, then the RTW Date is entered as the same date as the Referral Decision Date. If the client subsequently ceases work during a Case, then the RTW Date is cleared. |
|
RTW Percent Hours |
Blue |
Number (0 - 100) |
Plan |
The percentage of the client's pre-injury work hours in which they are engaged at the time of plan closure. |
|
Service |
Red |
Radio button |
Client |
The client's military or civilian service in which they sustained the condition for which the rehabilitation program is to be provided |
|
Service Description |
Red |
Combo |
Payments |
The category of payment associated with the rehabilitation program. |
Table 1. NIRS Field Definitions (Cont.)
|
Field Name |
Colour |
Field Type |
NIRS Screen |
Entry Details |
|
Service Number |
Red |
Text |
Client |
The client's military service number. This may also be the AGS Number for civilians. |
|
Spouse |
Black |
Text |
Client |
The name of the client's spouse (if applicable) |
|
SRC Determined |
Red |
Combo |
Commence |
The current or latest status of any claim for compensation under the SRC Act, in respect of the condition for which the rehabilitation case is being provided. |
|
SRC Determined Date |
Blue |
Text |
Commence |
The current or latest date of determination of a claim for compensation under the SRC Act (see above) |
|
Start Date |
Red |
Date |
Payments |
The earliest acceptable Pay Date for a payment line entry in a Service Description. |
|
Suburb |
Black |
Text |
Client |
The client's suburb of residence |
|
Supplier |
Black |
Text or Combo |
Payments |
The name of the supplier of goods or services in a payment line entry. |
|
Surname |
Red |
Text |
Client |
The client's surname |
|
Voucher Number |
Black |
Text |
Payments |
The DEFMIS Voucher Number for a payment line entry |
|
Weekly Pay |
Black |
Currency |
Client |
The rate of gross weekly pay (or incapacity payments) to which the client is entitled on an ongoing basis (this field is used to calculate “Potential Cost” and “Cost Benefit” reports) |
|
Work at 6 Mth Follow Up |
Blue |
Combo |
Plan |
The work status of the client exactly 6 months after the Plan Closure Date. This field is only required for those clients who were working at the time of their plan closure. |
Table 2. Combo Box And Radio Button Choices
|
Field Name |
Colour |
Screen |
Choices |
|
Assessment Decision |
Blue |
Commence |
|
|
Case Manager |
Black |
Commence |
User Defined - in an Update Table |
|
Closure Outcome (If RTW box is checked) |
Blue |
Plan |
|
|
Closure Outcome (if RTW box not checked) |
Blue |
Plan |
|
|
Condition |
Red |
Commence |
|
|
Gender |
Black |
Client |
|
|
Plan Type |
Blue |
Plan |
|
|
Program (where Service = ADF) |
Red |
Client |
|
Table 2. Combo Box And Radio Button Choices (Cont.)
|
Field Name |
Colour |
Screen |
Choices |
|
Program (where Service = Civilian) |
Red |
Client |
|
|
Provider |
Black |
Plan |
User Defined - in an Update Table |
|
Referral Decision |
Red |
Commence |
|
|
Referrer |
Red |
Commence |
|
|
Service |
Red |
Client |
|
|
Service Description |
Red |
Payments |
|
|
SRC Determined |
Red |
Commence |
|
|
Work at 6 Mth Follow Up |
Blue |
Plan |
|
Page 1
Revised
11 March 1998