This section explains how aids and appliances may be considered and provided through the rehabilitation provisions of the Military Rehabilitation and Compensation Act 2004 (MRCA) and the Safety, Rehabilitation and Compensation (Defence-related Claims) Act 1988 (DRCA).
If the requested aid and/or appliance is not available through the Rehabilitation Appliances Program (RAP), it may be provided through section 39 of DRCA [3] or section 54 to 59 in Chapter 3 of MRCA [4]. The requested aid or appliance must be reasonably required by the client to meet their needs or enable them to reach their rehabilitation goals. Aids and appliances must also be provided under the rehabilitation provisions where clients do not have a DVA Health Card. Any requests for vehicles, including modifications to vehicles, should not be referred to RAP and should be considered under the relevant vehicle schemes. Further information about the relevant schemes can be found in section 10.12 [5] of this library for the Motor Vehicle Compensation Scheme under MRCA, section 6.4 [6] of the Compensation and Support Policy Library for the Vehicle Assistance Scheme under the VEA and section 10.10 [7] of this library for the relevant DRCA provisions.
To be eligible for the provision of alterations, modifications, aids and/or appliances under the rehabilitation provisions, clients must meet the following criteria:
In some circumstances, aids and appliances may be provided to serving members where Defence remains the person’s rehabilitation authority. Further information about aids and appliances for serving members can be found in section 10.8 [8] of this chapter.
When reviewing requests for alterations, modifications, aids and/or appliances to be provided through the rehabilitation provisions, the following issues are to be considered:
whether, based on an assessment from a suitably qualified health provider and advice from the client’s treating practitioners, Occupational Therapist (OT), Physiotherapist, Podiatrist or other allied health provider, the client has an assessed need for the item or service due to their accepted conditions;
whether the items or services will have a positive impact on the client’s:
whether provision of the support requested is above the level that would normally be required for the medical condition or level of impairment.
Where there are concerns about the type of support that is being requested, a DVA Rehabilitation Coordinator may seek advice from an appropriate Departmental Adviser, or seek further information from the health professional who conducted the assessment. DVA Rehabilitation Coordinators can access the list of the department's Advisers from the CHO.SUPPORT.UNIT@dva.gov.au [10].
Serving ADF members
If the client is still fulfilling a role within the ADF, the following issues must also be addressed when considering if the item requested is reasonably required:
Further information about providing alterations, modifications, aids and/or appliances to serving members can be found in section 10.8 [8] of this chapter.
Determining the most appropriate way to provide the item
Once the above issues have been considered a number of additional issues must be considered in the context of determining the most appropriate means to provide the item to the client. These include:
There may be instances where clients request a different aid to that recommended by the OT or other suitably qualified health professional. For example, an OT may recommend a shower chair to assist a client with bathing and grooming. The client may, for aesthetic reasons, ask that a stool be provided instead. In these circumstances, Rehabilitation Coordinators must contact one of the department's OT Advisers, for their opinion on whether the requested alternative aid is likely to create a health and safety risk, or be unsuitable for the client's needs, given their accepted conditions.
Rehabilitation Coordinators must take the OT Adviser's feedback into account when deciding whether to approve purchase of the client's requested item, and document the reasons for their decision in the determination letter to the client.
Workplace aids and appliances
As the rehabilitation authority, DVA has a responsibility to ensure that a client has access to appropriate aids and appliances to meet their needs. This applies regardless of what type of rehabilitation support the person is receiving. Therefore, requests for the provision of, workplace aids and appliances must always be considered, regardless of whether the client is already employed in either the public service or private enterprise. This particularly applies where a client’s employment is in jeopardy due to the impact of their accepted conditions.
DVA Rehabilitation Coordinators are asked to refer to section 10.7.4 of the Rehabilitation Policy Library [11] for information to guide their decision making about considering workplace aids and appliances.
Aids and appliances to support psychosocial rehabilitation
Clients undertaking psychosocial rehabilitation activities may need access to adaptive or other types of equipment to enable them to participate in community activities. These may include activities such as leisure/lifestyle programs to help overcome social isolation, sporting activities and programs or short adult learning courses. It is important that a lack of appropriate equipment does not create a barrier to a person being able to participate in these types of activities. Further details about the provision of equipment to support participation in psychosocial rehabilitation activities can be found in 6.7 Equipment for psychosocial activities [12]
Prior to any aid or appliance being issued under the rehabilitation provisions, the Rehabilitation Coordinator should request a RAPTOR report to ensure that they have a good understanding of what aids and appliances have been previously provided to the client. A RAPTOR report can be requested by contacting the Manager, RAP Operations. If requested, RAPTOR reports should be printed and placed on the client’s file and in the client’s UIN container in TRIM.
In order to ensure an audit trail, where aids and appliances cannot be provided through RAP, they must be provided through a rehabilitation plan, even if this is an "in house" plan and aids and appliances are the only supports that are being provided through the plan.
This approach also helps to ensure that the Rehabilitation Coordinator has a good understanding of the client’s needs, including their psychosocial needs, and what supports and services could be utilised to assist a person to adjust to their accepted conditions, and to become as independent as possible in self managing their condition.
For example, if a functional, home or product assessment to investigate for aids and appliances highlights that the client is experiencing high levels of pain, and that they are having difficulties managing their conditions, then a psychosocial rehabilitation plan could be opened and a pain management course could be approved as part of this plan. A medical management rehabilitation plan could also be considered so that the person can get assistance in managing their appointments and ensuring that all treatment options are being explored.
All approvals for aids and appliances provided through the rehabilitation provisions must be recorded in the case notes in R&C ISH together with a list of the aids and appliances that were provided. These details should also be included on the client’s rehabilitation plan. A copy or print out of the RAPTOR report should also be included on the client’s file. If requested, RAPTOR reports should be printed and placed on the client’s file and in the client’s UIN container in TRIM.
Where a client is on a vocational rehabilitation plan, it is more likely that any aids or appliances that they require to assist them with retraining, study or work will need to be provided through the rehabilitation provisions. This is because items listed on the RAP Schedule could be classified as medical aids and appliances designed to address clinical needs rather than vocational needs.
If the client is receiving aids and appliances through the National Disability Insurance Scheme (NDIS)
Both the NDIS and DVA provide aids and appliances to help clients to manage their activities of daily living. DVA can provide aids and appliances through RAP or through a rehabilitation plan. The NDIS can provide aids and appliances, through an individual care plan.
An important principle is that the same aid or appliance must not be provided by both NDIS and DVA. Therefore, it is important for Rehabilitation Coordinators to advise Occupational Therapists or other allied health professionals undertaking assessments for aids and appliances, that they should:
Links
[1] https://clik.dva.gov.au/user/login?destination=comment/reply/21192%23comment-form
[2] https://clik.dva.gov.au/user/login?destination=comment/reply/78286%23comment-form
[3] https://www.legislation.gov.au/Series/C1988A00156
[4] https://www.legislation.gov.au/Series/C2004A01285
[5] https://clik.dva.gov.au/rehabilitation-policy-library/10-alterations-modifications-aids-appliances-and-motor-vehicle-assistance/1012-motor-vehicle-compensation-scheme-mvcs
[6] https://clik.dva.gov.au/rehabilitation-library/6-psychosocial-rehabilitation/64-what-should-happen-when-client-requires-psychosocial-rehabilitation
[7] https://clik.dva.gov.au/rehabilitation-policy-library/10-alterations-modifications-aids-appliances-and-motor-vehicle-assistance/1010-provision-motor-vehicle-assistance-under-section-39-drca
[8] https://clik.dva.gov.au/rehabilitation-policy-library/10-alterations-modifications-aids-appliances-and-motor-vehicle-assistance/108-provision-alterations-aids-appliances-and-services-serving-adf-clients
[9] https://clik.dva.gov.au/user/login?destination=comment/reply/78287%23comment-form
[10] mailto:CHO.SUPPORT.UNIT@dva.gov.au
[11] https://clik.dva.gov.au/rehabilitation-policy-library/10-alterations-modifications-aids-appliances-and-motor-vehicle-assistance/107-consideration-specific-aids-and-appliances/1074-ergonomic-equipment-workplace-aids-and-appliances-and-workplace-assessments
[12] https://clik.dva.gov.au/rehabilitation-policy-library/6-psychosocial-rehabilitation/67-equipment-psychosocial-activities
[13] https://clik.dva.gov.au/user/login?destination=comment/reply/78289%23comment-form