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4 The ADF Rehabilitation Programs

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Last amended 
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WORK IN PROGRESS


We are improving this policy library.  While work is underway, content of this chapter may not be the most current information available.  Please contact rehabilitation@dva.gov.au [2] if you have any questions.

 

This chapter provides information about the Australian Defence Force Rehabilitation Program (ADFRP) and the Rehabilitation for Reservists Program.

4.1 Overview of the ADF Rehabilitation Programs

Date published 
Tuesday, June 2, 2015
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Last amended 
4 October 2017

The Chief of the Defence Force is the rehabilitation authority for all serving members, including Permanent Force members, Reservists on continuous full-time service (CFTS) and Reservists not on CFTS which includes part-time, inactive and standby Reservists. This applies to ADF members regardless of whether they are covered under the Military Rehabilitation and Compensation Act 2004 (MRCA) or the Safety, Rehabilitation and Compensation Act 1988 (SRCA).

For further information about specific service categories and service options, refer to the ADF Total Workforce Model [4].

Australian Defence Force Rehabilitation Programs

There are two separate Australian Defence Force (ADF) rehabilitation programs, the ADF Rehabilitation Program and the Rehabilitation for Reservists Program. These programs have been developed to assist ADF members to return to a state of service readiness as soon as is practicable after injury or illness, through the provision of occupational rehabilitation services. For detailed information about these programs, refer to section 4.1.1 [5] of this guide.

ADF Rehabilitation Program (ADRFP)

Rehabilitation for Reservists Program (R4R)

Provides rehabilitation services to:

  • full-time permanent force members;
  • part-time permanent force members; and
  • Reservists on CFTS

irrespective of whether a member's injury or illness is related to work.

Provides rehabilitation services and early intervention treatment to:

  • Reservists not on CFTS including:
    • part-time reservists;
    • inactive reservists; and
    • standby reservists

for service related injuries only.

ADF Cadets

Members of the Cadets, including Cadet Instructors, Officers of Cadets and School Cadets, are provided with treatment and rehabilitation coverage under the MRCA for periods of instruction, training, performance of duty, and travel to and from places of approved activity. They are not eligible for treatment or rehabilitation assistance through the ADF rehabilitation programs.

4.1.1 The ADF Rehabilitation framework

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4 October 2017

Principles

The principles of the ADF Rehabilitation Programs are:

  • early intervention and the provision of a biopsychosocial model of rehabilitation to reduce the impact of injury, illness or disease and contribute to enhanced capability through a durable return to work;
  • evidence-based rehabilitation assessments and programs based on an individual's needs and the inherent requirements of their ADF service. This includes the identification and facilitation of suitable alternate or modified duties;
  • workplace-based rehabilitation to provide, where possible, the most realistic environment to assess fitness for work;
  • coordinated participation of the member, health practitioners, command elements, Rehabilitation for Reservist (R4R) Case Manager/ADF Rehabilitation Program (ADFRP) Rehabilitation Consultant and other relevant stakeholders in the development and execution of rehabilitation programs;
  • a coordinated approach towards a common goal, maximising the potential for a positive rehabilitation outcome for the individual, the ADF and the community;
  • regular review of rehabilitation progress and risk factors for a durable return to work;
  • clear roles and responsibilities reflected in organisational performance agreements combined with accountability; and
  • confidentiality and privacy of information obtained about the member during the rehabilitation program is maintained.

 

Key components

The key components of ADFRP and R4R Programs are:

  • a Rehabilitation Assessment of a member's capacity to undertake rehabilitation. This includes an assessment of the member across clinical, occupational and psychosocial parameters; and
  • the development and implementation of an appropriate Rehabilitation Program, providing a structured series of activities and services designed to meet the member's rehabilitation needs. The program outlines what should be done during the member's rehabilitation including the responsibilities, services, time frames and goals.

 

Goals

The three goals of ADF rehabilitation are, in priority order:

Goal 1

Fit for duty in the pre-condition work environment. This relates to deployability as well as day-to-day tasking. It means that, as a result of a Rehabilitation Program, it is likely that the member will return to their pre-condition level of physical and mental fitness and duties.

Goal 2

Fit for alternative duty in another ADF occupation as MEC* 4 J41 (implies MEC 1 or 2 in new trade/category/muster/corps or service). As a result of a Rehabilitation Program, it is likely the member will be able to remain in the ADF and return to work with different duties and/or in a different location and/or in a different Service.

Goal 3

The member is unable to perform any duties within the ADF as a result of the injury or illness. The member will be transitioned out of the ADF for medical reasons (i.e. MEC* 4 or 5 and therefore medical discharge).

Rehabilitation goals may change during the Rehabilitation Program process depending on the member's condition or circumstances.

*Refer to section 4.1.3 [7] for further information about the Medical Employment Classification (MEC) system.

 

4.1.2 ADF Rehabilitation Assessment Triggers

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4 October 2017

The ADF may undertake a rehabilitation assessment in any of the following circumstances:

  • a member's treating Medical Officer (MO) recommends a rehabilitation assessment due to the nature of the injury or illness;
  • the treating MO places the member on sick or convalescence leave or medical restrictions for greater than 28 days;
  • a member's Commanding Officer requests a rehabilitation assessment;
  • a member may request or self-refer for a rehabilitation assessment;
  • a DVA delegate recommends a rehabilitation assessment be undertaken after conducting a Needs Assessmen or following the receipt of incapacity payments – refer to section 4.2.1 [9] of this Library for information about how to refer a serving member to the ADF Rehabilitation Programs; or
  • a mandatory referral for members with a diagnosed mental health condition, which is not short term or self-limiting as part of their treatment or care planning.

4.1.3 The ADF Medical Employment Classification System

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4 October 2017

The table below provides broad definitions of the five categories within the Medical Employment Classification (MEC) system.

The MEC is determined according to each member's primary military occupation. The assessment takes into account the environment in which the person is expected to perform when deployed, as well as any additional tasks which a member could be expected to perform as part of their general military duties. The MEC is reviewed on an ongoing basis to ensure that it is appropriate for the person's current circumstances.

Medical Employment Classification (MEC) System

The categories according to the Defence Instructions General (DIG) Pers 16-15

Category

Definition

Medical Employment Classification (MEC) System

MEC 1

Fully Employable and Deployable

Sub-classifications

J11 — Fully Employable and Deployable

J12 — Fully Employable and Deployable with an Identified Requirement for Limited Materiel Re-supply

MEC 2

Employable and Deployable with Restrictions

Sub-classifications - Joint

J21 Restricted Deployment – Defined Limitations

J22 Restricted Deployment – Defined Limitations and/or Required Materiel Support

J23 — Restricted Deployment – Defined Limitations and/or Required Materiel Support and/or access top Health Support up to Medical Officer Support – reviewed at Unit Medical Employment Classification review (UMECR) at least every two years

J29 — Limited Deployment – MECRB assigned only – Defined Limitations and/or Required Material Support and Defined Access to Role 2E Health Service

 

Sub-classifications – Maritime

M24 — Maritime Environment – Defined Limitations and/or Required Materiel support and/or access to Health Support – minimum of Advanced Medical Assistant or Nursing Officer support

M25 — Maritime Environment – Defined limitations and/or Required Materiel Support and/or Access to Health Support – minimum of Clinical Manager

M26 — Maritime Environment – Defined Limitations and/or Required Materiel Support and/or Access to Health Support – minimum Nurse Practitioner, Physician Assistant or Medical Officer Support (Fleet Medical endorsed only)

 

Sub-classifications - Land

L27 — Land Environment – Restricted Deployment – MECRB assigned only capable of performing limited offensive and full combat defence duties

L28 — Land Environment – Limited Deployment – MECRB assigned only – capable of performing combat defensive duties only

MEC 3

Rehabilitation

Sub-classifications

J31 — Rehabilitation – defined period up to 12 months

J32 — Extended Rehabilitation – MECRB assigned only – defined period up to 24 months

J33 — Pregnancy – defined period of up to 24 months

J34 — Temporarily non-effective – defined period between 28 days and four months

MEC 4

Employment Transition

Sub-classifications

J40 — Holding temporary – Confirmation and allocation of suitable MEC classification pending MECRB determination

J41 — Alternate Employment – MECRB assigned only

J42 — Employment at Service Discretion – MECRB assigned only – duration up to five years at any one time

J43 — Extended Transition – MECRB assigned only – Duration up to three years to support transition from the ADF

J44 — Extended Non-effective – MECRB assigned only – Not fit for work for a defined period between four and 12 months

MEC 5

Separation

Sub-classifications

J51 — Not Employable on Medical Grounds – Medically unfit and not employable other than within applicable restrictions in the period leading up to termination

J52 — Not Employable on Medical Grounds – Non-effective and unable to be employed in the period leading up to termination

 

4.1.4 The ADF Rehabilitation Case Management Pathway

Last amended 
Wednesday, October 4, 2017

The following diagram illustrates the ADFRP Rehabilitation Case Management Pathway for serving members. Note: the diagram has been made available below as an image and in plain text.

The ADF Rehabilitation Case Management Pathway

Plain text version of the above diagram

Main Heading: ADFRP Rehabilitation Case Management Pathway

Starting point: Injury or Disease Occurs

PATHWAY 1: Member seeks treatment from ADF treating Medical Officer (MO) or displays behaviours which indicate treatment may be required

Step 1 (a): Rehabilitation Assessment triggered by or when a:

  • treating Medical Officer (MO) considers an assessment is necessary
  • member has been on sick leave or restricted duties or convalescing for greater than 28 days
  • member self refers for an assessment
  • member’s Commanding Officer (CO) requests that an assessment be undertaken
  • MRCC delegate, based on outcomes of a completed neds assessment
  • mandatory referral for Members with a mental health condition which is not short term or self limiting

Step 1 (b): Rehabilitation assessment is undertaken:

  • occurs at the earliest possible time
  • identifies the member’s suitability to undertake rehabilitation
  • is work-place based (if possible); and
  • is structured to identify one of three possible goals

Step 1 (c): Rehabilitation Program developed and implemented around one of three possible goals

  • Goal 1: Member is fit for pre-injury duty/status
  • Goal 2: Member is fit for duty in a different position and or service
  • Goal 3: Member is stabilised and supported out of the ADF with an optimal level of functioning
  • A member’s rehabilitation program is developed around providing individually tailored services to achieve one of the above goals. Service provision and liaison is managed/coordinated by the Rehabilitation Consultant with ADF and other medical and allied health practitioners, the members Chain of Command, if applicable, Defence Community Organisations, CTAS, MRCC etc.

Step 1 (d): Rehabilitation Program Closed

  • Goal 1 or 2: Member reintegrated back into the ADF structure in some capacity.
  • Goal 3 - Member provided with assistance to transition them through the medical discharge process.
  • Goal 3 - Member with an accepted SRCA/MRCA claim becomes responsibility of DVA. New Needs Assessment undertaken at point of discharge or on receipt of discharge date.
  • Goal 3 - Member discharging on medical grounds without an accepted claim is directed to community health and support agencies for further assistance to address needs.

PATHWAY 2: Member Submits Compensation Claim to DVA, following MO/CO recommendations

Step 2 (a): Needs Assessment undertaken by MRCC Delegate - ADFRP provided with notification of identified rehabilitation needs

Step 2 (b): Member’s claim determined by MRCC Delegate - Member and ADF Health Services provided with notification of decision

Step 2 (c): Pathway may then lead to either of the previous steps 1 (a) or 1 (c)

PATHWAY 3: Member seeks treatment independently of the ADF health system


 

4.2 Interaction between the ADF rehabilitation programs and DVA

Date published 
Tuesday, June 2, 2015
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Last amended 
4 October 2017

At certain times throughout the case management process, DVA and Defence will need to exchange information about individual clients. These times may include:

  • When a serving member* approaches DVA for assistance and is referred to the ADF Rehabilitation Program (ADFRP) or the Rehabilitation for Reservists Program for rehabilitation assistance – refer to section 4.2.1 [9] for specific information about referrals to the ADF Rehabilitation Programs;
  • when a claim for acceptance of liability or permanent impairment compensation is lodged by a serving member;
  • where a client is identified as being “at risk” because of their mental health issues, and in need of timely and appropriate treatment and rehabilitation services and support;
  • when a claim for liability or permanent impairment is determined for a serving member;
  • when a Needs Assessment has been completed for a serving member, which identifies a rehabilitation need;
  • where a delegate has determined that a serving member is eligible for incapacity payments and has identified that a rehabilitation assessment is required due to this incapacity; and
  • in the ADFRP Handover Report phase, when the serving member is being prepared for the final stage of discharge.

*Serving member includes full-time permanent force members, part-time permanent force members, Reservists on CFTS, Reservists not on CFTS including part-time reservists, inactive reservists, and standby reservists.

Privacy

In communicating with Defence about individuals, DVA is bound by the Privacy Act 1988 (the Privacy Act) and the Australian Privacy Principles (APPs). DVA’s Privacy Policy [12] outlines how the Department manages the personal information of our clients.

When engaging in written communication with Defence regarding individuals, DVA Rehabilitation Coordinators must classify all correspondence, including emails, as ‘Sensitive - Personal’.

Transfer of rehabilitation authority

As outlined in section 4.3 [13] of this Guide, there may be circumstances where it is more appropriate for a full transfer of rehabilitation authority, from the Chief of the Defence Force (CDF) to DVA, to occur prior to the serving member’s separation from the ADF. This option should always be considered where a client has been identified as being likely to separate from the ADF for medical reasons, and it is likely that the client would benefit from the wider range of support that could be provided through a DVA rehabilitation program.

In accordance with Schedule 16 of the Memorandum of Understanding (MOU) between Defence and DVA, DVA can also provide specific assistance, such as household services and attendant care services to serving members while CDF remains the member’s rehabilitation authority. A transfer of rehabilitation authority is not required for these services to be provided. For further information please see section 4.5 of this Guide [14].

4.2.1 Rehabilitation referrals to the ADF Rehabilitation Programs

Date published 
Thursday, November 3, 2016
Last amended 
Wednesday, October 4, 2017

Rehabilitation support and services are provided to serving members through the following programs:

ADF Rehabilitation Program (ADRFP)

Rehabilitation for Reservists Program (R4R)

Provides rehabilitation services to:

  • full-time permanent force members;
  • part-time permanent force members; and
  • reservists on CFTS

irrespective of whether a member's injury or illness is related to work.

Provides rehabilitation services and early intervention treatment to:

  • non- CFTS reservists including
  • part-time reservists;
  • inactive reservists; and
  • standby reservists

for service related injuries only.

When a DVA delegate identifies that a serving member has a requirement for rehabilitation support and services, a referral must be made to the appropriate ADF Rehabilitation Program, using the standard letters developed for this process. A separate referral letter is required for each client - multiple clients cannot be covered in one determination. These letters available from the R&C ISH standard letters. Letters generated from R&C ISH will automatically attach to the client’s UIN folder in TRIM.

It is important to note that DVA can provide some specific services and support to serving members as outlined in section 4.5 [14] of this chapter and section 10.8 [15] of this Guide.

Referral following needs assessment

If the needs assessment delegate decides that it is appropriate to refer the serving member to the ADFRP or R4R Program the referral must include:

  • a brief summary of the rehabilitation need identified through the needs assessment process;
  • a summary of any available medical evidence related to this identified need; and
  • any other relevant documentation such as medical reports.

The DVA Privacy Officer has advised that client consent is not required for a brief summary of a person’s rehabilitation needs and medical evidence to be included in the referral. However, if medical reports are included, then client consent is required before sharing this information with Defence. An email from the client confirming that they consent to the information to being shared and understand that it may be used to inform whether a transfer of rehabilitation authority may occur, is sufficient for this purpose.

Referral following receipt incapacity benefits

If the incapacity delegate decides that it is appropriate to refer the serving member to the ADFRP or R4R Program, where possible, the referral should include:

  • the medical evidence of incapacity for the relevant period; and
  • any medical reports relating to the incapacity.

Including medical documentation in the referral ensures that Defence can explore:

  • whether the member is likely to be able to perform their ADF duties due to their incapacity;
  • whether the member may require rehabilitation through the appropriate ADF rehabilitation program; and
  • whether an early transfer of rehabilitation authority may be more appropriate.

However, the client’s consent is required for medical documentation to be shared with Defence. An email from the client confirming that they consent to the information being shared and understand that it may be used to inform whether a transfer of rehabilitation authority may occur, is sufficient for this purpose.

Protocols for all referrals

The standard referral letter in ISH must be used when a serving member is referred to the ADFRP or R4R Program. There are separate email addresses in this referral letter for the ADFRP or R4R Program. Delegates must send all referrals to the relevant email address, using a 'Sensitive - Personal' email classification.

Delegates who make a referral must ensure that:

  • the client is informed that the referral to the ADFRP or R4R has been made;
  • the rehabilitation team in their location is made aware that the referral has been made; and
  • if medical or other sensitive information is being provided, ensure that client consent has been obtained.

Protocols for referrals of reservists

The R4R Program provides rehabilitation assistance for all non-CFTS reservists which includes:

  • part-time reservists;
  • inactive reservists; and
  • standby reservists

If a non-CFTS reservist who has lodged a claim for liability approaches DVA directly for rehabilitation assistance it is important that a Needs Assessment is conducted, to identify any support and services that can be provided by DVA, prior to the client being referred to the R4R program. Support and services that can be provided by DVA to non-CFTS Reservists include:

  • medical treatment for an accepted injury or disease;
  • incapacity payments;
  • permanent impairment payments;
  • household or attendant care services;
  • rehabilitation aids and appliances; and
  • assistance under the motor vehicle assistance schemes.

If a rehabilitation need is identified during this process, a referral should be made to the R4R program using standard letters and processes outlined above.

The referral letter asks that the ADF Rehabilitation Programs inform the DVA Rehabilitation Coordinator of any determinations that are made in relation to the client's rehabilitation. The DVA Rehabilitation Coordinator will then need to liaise with the incapacity and/or permanent impairment delegate in that location, to ensure that the client continues to receive their correct entitlements from DVA while undertaking a ADF rehabilitation program.

If the Needs Assessment identifies that the Reservist is “at risk” because of mental health issues, it is important that this is brought to the attention of the R4R Program Regional Rehabilitation Manager and the client's R4R Case Manager as part of the referral process.


4.2.2 Transition due to medical separation

Date published 
Thursday, November 3, 2016
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Last amended 
4 October 2017

Where a serving member with an accepted condition is identified as likely to be discharged on medical grounds, the Chief of the Defence Force (CDF) will retain responsibility for the member’s rehabilitation until the actual date of separation from the ADF. However, early liaison and communication between the ADFRP Rehabilitation Consultant/Rehabilitation for Reservist (R4R) Case Manager and the DVA Rehabilitation Coordinator will help facilitate a smooth transition when the rehabilitation authority changes from the CDF to the Military Rehabilitation and Compensation Commission (MRCC).

Handover reporting

When the member is being prepared for handover to DVA prior to their medical separation, a Handover Case Conference should take place between the ADFRP Rehabilitation Consultant/ R4R Case Manager, the DVA Rehabilitation Coordinator, and other stakeholders including the client (if appropriate). The conference should discuss and identify key issues relating to the member's rehabilitation and identify contact points that can be used if there are issues that need to be clarified once the MRCC becomes the person's rehabilitation authority.

Where a members has an open rehabilitation program, a Transfer Handover Report should be provided to DVA.

The Transfer Handover Report should provide detail on:

  • medical and rehabilitation aids and appliances, alterations and modifications;
  • vocational rehabilitation and related activities;
  • other rehabilitation services required such as household services and attendant care; and
  • outcomes identified if a Handover Case Conference had occurred.

Where the client provides consent, and they are available, the following documents should also be provided:

  • vocational assessments;
  • functional capacity evaluations;
  • activities of daily living assessments; and
  • any other relevant documents.

It is important that the DVA Rehabilitation Coordinator reviews the relevant information on the person's file and the ADF rehabilitation assessments to ensure that they have an understanding of the person's needs and circumstances, and what services and support have been provided by the ADFRP or R4R Program.

Ongoing communication between the ADFRP/R4R Program throughout the transition process will enhance the continuity and the coordination of:

  • the transition of a person's rehabilitation authority (see section 4.3 [13] of this chapter);
  • Career Transition Assistance in conjunction with post discharge rehabilitation planning (see section 4.4 [17] of this chapter);
  • income support or incapacity entitlements (see section 4.5 [14] of this chapter);
  • treatment/medical costs (see section 4.5 [14] of this chapter);
  • provision of aids and appliances, alterations to a person's place of residence, education or employment,
  • motor vehicle assistance;
  • services such as attendant care or household services (see section 4.5 [14] of this chapter); and
  • other benefits or entitlements (see section 4.5 [14] of this chapter).

4.3 Transferring rehabilitation authority from the CDF to the MRCC

Date published 
Tuesday, June 2, 2015
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Last amended 
4 October 2017

Section 39 of the MRCA [19] provides that the Chief of the Defence Force (CDF) is the rehabilitation authority for all serving members, including Permanent Force Members, Reservists on continuous full-time service (CFTS) and Reservists not on CFTS which includes part-time, inactive and standby Reservists.  This applies regardless of whether they are covered under the Military Rehabilitation and Compensation Act 2004 (MRCA) or the Safety, Rehabilitation and Compensation Act 1988 (SRCA).

For further information about specific service categories and service options, refer to the ADF Total Workforce Model [4]. 

Transfer of rehabilitation authority prior to separation from the ADF

There are times when it may be more appropriate for DVA to become the rehabilitation authority for a serving member, prior to their actual date of separation from the ADF. A transfer of rehabilitation authority from the CDF to the Military Rehabilitation and Compensation Commission (MRCC) is required for this to occur.

There are two mechanisms that enable a transfer of rehabilitation authority. These are:

  • section 10 of the MRCA; or
  • section 39(3)(aa) of the MRCA.

Further details about the use of these sections can be found in sections 4.3.1 [20] and 4.3.2 [21]of this library.

4.3.1 Section 10 transfer of rehabilitation authority

Date published 
Tuesday, October 3, 2017
Last amended 
Wednesday, October 4, 2017

Transfers of Rehabilitation Authority under section 10 of the MRCA are currently being evaluated and are thus not taking place at this time. DVA delegates are asked to contact rehabilitation@dva.gov.au [2] if they have any queries about section 10 transfers.

While an ADF member is still serving, the Chief of the Defence Force (CDF) is their rehabilitation authority. Section 10 of the MRCA enables a transfer of rehabilitation authority from the CDF to the MRCC so that rehabilitation services can be provided by DVA. MRCA section 10 can only be used to transfer rehabilitation authority for part-time reservists and cadets.

The key features of a section 10 transfer of rehabilitation authority are:

  • that the CDF advises a delegate of the MRCC that a part-time Reservist or cadet is unlikely to return to defence service as a result of their incapacity;
  • that if DVA is provided with this advice, the part-time Reservist or cadet is taken to have ceased to be a member for the purpose of the MRCA; and
  • that the advice must specify the date (which must not be retrospective) from which the person is taken to have ceased to be a member for the purposes of the MRCA.

A section 10 transfer of rehabilitation authority means that the person is regarded as a former member for the purposes of the MRCA, and DVA automatically becomes their rehabilitation authority.

Being regarded as a former member for the purposes of the MRCA does not change the person’s ADF service status. That is, the person is still a serving ADF member, unless they actually go through the formal ADF separation process. This means that the ADF is able to:

  • re-activate that person to carry out their Reserve duties, at any point of time in the future;
  • transfer that person between types of Reserve service (Active/Standby) at any point of time in the future; or
  • transfer that person on to Continuous Full Time Service.

Implications of a section 10 transfer of rehabilitation authority

There are a number of implications that result when a person becomes a former member for the purposes of the MRCA. These are outlined below:

  • DVA becomes responsible for all services

Once a section 10 transfer of rehabilitation authority has occurred, DVA is responsible for all of a client’s treatment, compensation and rehabilitation support and services. Furthermore, as DVA adopts a whole-of-person rehabilitation approach, clients will be able to receive a broader range of psychosocial, medical management and vocational support and services they require, to establish a new life outside the ADF.

  • Incapacity payments

Incapacity payments represent the difference between a person’s normal earnings (NE) and their ability to earn when they are incapacitated for service or work. For former members, after the first 45 weeks of incapacity payments at 100 per cent of a person’s NE, a step down in incapacity payments will occur. Therefore, once a section 10 transfer of rehabilitation authority occurs and a person becomes a former member, the incapacity “step-down” can be applied. Further information about the “step down” can be found in Chaper 7 of the Incapacity Policy Manual. [22]

  • Special Rate Disability Pension (SRDP)

SRDP provides an alternative form of periodic compensation, instead of incapacity payments, for people whose capacity for work has been severely restricted because of conditions due to military service. SRDP is not automatically granted.  Eligibility for SRDP can only be assessed and considered once a person is regarded as a former member for the purposes of the MRCA.

When a section 10 transfer of rehabilitation authority is appropriate

A section 10 transfer of rehabilitation authority should only be considered when:

  • the person is a non-CFTS Reservist – this includes part-time, inactive and standby Reservists or a cadet;
  • DVA has accepted liability for a service injury or disease;
  • the person has separated from the ADF and remains on the ADF standby/inactive reserve list, but is not parading and has no active involvement in the Reserves;
  • there is medical evidence that the person is unlikely to be able to return to Defence service due to the incapacity resulting from their accepted conditions;
  • a determination has been made that the person is eligible for incapacity payments; and
  • the ADF/R4R rehabilitation consultant has an assurance that the person is fully informed about the implications of a section 10 determination, and understands the impact that the transfer of rehabilitation authority will have on their rehabilitation, compensation and treatment.

Where these circumstances are met, a transfer of rehabilitation authority can be considered. To enable the transfer to occur, a delegate of the CDF must provide a written determination to the MRCC that the non-CFTS Reservist is unlikely to be able to perform their defence duties in the future as a result of their incapacity. It is important that consideration of the person’s capacity to perform the duties of a Reservist is not limited to their pre-injury employment. A transfer of rehabilitation authority under MRCA section 10 should only be considered when it is clear that the person has no capacity to perform any Defence duties, due to their accepted conditions.

Process for transferring rehabilitation authority under section 10

A section 10 determination must be made in accordance with section 10(4) of the MRCA. Section 10(4) requires that the determination includes the date from which the person to have ceased to be a member of the ADF for the purposes of the MRCA. The date must not be retrospective and a determination must be made separately for each client. Upon receiving the determination, the MRCC will automatically become the rehabilitation authority on and from the date specified in the determination.

A transfer of rehabilitation authority without the consideration or consent of a client can create barriers to the person fully participating, and being committed to, a DVA whole-of-person rehabilitation program. For this reason, it is important that the person understands the implications of a section 10 transfer of rehabilitation authority, and that DVA receives assurance from the ADF Rehabilitation consultant that the person has been fully informed about the implications of request for a transfer of rehabilitation authority. An information sheet has been prepared to assist with this process.

Revoking a section 10 determination 

If a section 10 transfer of rehabilitation authority occurs, there is no impact, legislatively or otherwise, on the ADF’s ability to re-activate a  person to perform defence duties at any time in the future. This may include a transfer to the Active Reserves or to CFTS. For example, there may be instances where a person recovers from their injuries to an extent that they are able to perform Reservist duties again. Under these circumstances, Defence may revoke the section 10 determination

If a person is transferred back to active ADF duties, and/or a section 10 determination is revoked, the person will automatically become a member again for the purposes of the MRCA and the CDF will becomes their rehabilitation authority again. This will apply from the date that the person returns to their defence duties, or DVA receives notification that the section 10 determination has been revoked. It is important that DVA is kept informed in all instances where this is being considered. This is because the DVA Rehabilitation Coordinator and the client’s rehabilitation provider will need to be able to answer any queries that the person may have.

4.3.2 Section 39(3)(aa) transfer of rehabilitation authority

Date published 
Tuesday, October 3, 2017
Last amended 
Wednesday, October 4, 2017

MRCA section 39(3)(aa) enables a delegate of the Military Rehabilitation and Compensation Commission (MRCC), after receiving advice from the CDF, to make a determination, that DVA is to become a specified person’s rehabilitation authority at a specified time. A determination under section 39(3)(aa) can be made for any serving member which includes:

  • full-time permanent force members;
  • part-time permanent force members;
  • Reservists on CFTS; and
  • Reservists not on CFTS including;
    • part-time reservists;
    • inactive reservists; and
    • standby reservists.

When a section 39(3)(aa) transfer of rehabilitation authority is appropriate

A transfer of rehabilitation authority using MRCA section 39(3)(aa) may be appropriate where:

  • DVA has accepted liability for a service injury or disease; and
  • the member is already receiving a range of services and support from DVA, and there are challenges in the ADF Rehabilitation Programs being able to meet the client's individual whole of person rehabilitation support needs – refer to section 4.5 [14] for information about what assistance DVA can provide to serving members; or
  • the member is experiencing personal/health/psychological issues and ongoing involvement with the ADF is likely to have a detrimental impact on their wellbeing and recovery; or
  • the person requires short term rehabilitation support, such as the provisions of aids and appliances that Defence cannot provide – refer to chapter 10.8 [15] for information about aids and appliances that DVA can provide to serving members; and
  • the advice from the relevant ADF rehabilitation program identifies a specific period of where it is more appropriate for the MRCC to be the member’s rehabilitation authority

Duration of the transfer of rehabilitation authority

The duration of the transfer will depend on the circumstances of the case.

Where a temporary transfer of rehabilitation authority is requested, because the member needs aids and appliances that the ADF is unable to provide, the transfer will only be required for the period it takes to approve the aid and make the formal determination. It is important that in this circumstance, the aid is provided as quickly as possible to prevent the person’s ADF rehabilitation plan from stalling. Communication with the ADFRP Consultant or Rehabilitation for Reservist (R4R) Case Manager is therefore important to ensure the agreed period is appropriate.

In some cases, an ongoing transfer of rehabilitation authority will be more appropriate. This may occur, even where a member does not have a definite date of separation. In this circumstance, a specific end date is not mandatory. Instead the determination letter can refer to “until such time that the person is no longer a serving member”. 

Process for transferring rehabilitation authority under section 39(3)(aa)

To enable a transfer to occur using MRCA section 39(3)(aa) the following actions are required:

  • discussion must occur between the ADFRP/R4R and the DVA Rehabilitation Coordinator to determine whether an earlier transfer of rehabilitation authority would be beneficial for the client;
  • DVA must receive written advice from the ADFRP/R4R Program that they would like a transfer of rehabilitation authority to occur;
  • discussion between the ADFRP/R4R and the DVA Rehabilitation Coordinator must confirm an agreed duration for the transfer of rehabilitation authority;
  • there must be evidence that the client is aware that the transfer of rehabilitation authority has been requested, why it has been requested and they are comfortable with this request;
  • there must be evidence sighted that the client has provided consent for information to be shared between Defence and DVA; and
  • the Rehabilitation Coordinator must issue a written determination that the MRCC is to be the rehabilitation authority for the client and to specify the time from which the determination applies. A separate determination must be made for each client – multiple clients cannot be covered in one determination.

Clear communication is essential when a transfer of a rehabilitation authority occurs. If an ongoing transfer of rehabilitation authority is requested, a Handover Case Conference, should be held. The Case Conference should discuss and identify key issues relating to the client's rehabilitation and identify contact points that can be used if there are issues that need to be clarified once the MRCC becomes the person's rehabilitation authority.

In addition, all members with an open ADFRP/ R4R rehabilitation program who are being transferred across to DVA should have a Transfer Handover Report, and all relevant documentation/reports prepared by the relevant rehabilitation program presented at the time of transfer.

However, if, the rehabilitation authority is being transferred only for the purpose of providing aids and appliances that cannot be provided by Defence, a Handover Case Conference and Transfer Handover Report will not be required.

Implications of a section 39(3)(aa) transfer of rehabilitation authority

Unlike a transfer of rehabilitation authority under section 10, a transfer under section 39(3)(aa) does not mean that a person is regarded as a former member for the purposes of the MRCA. The person will continue to be regarded as a serving member. There are a number of implications that result from this:

  • Incapacity payments

    There is no impact on a person’s eligibility for incapacity payments or the level of payment they can receive.

  • Communicating with one department instead of two

For those instances where it is intended that the MRCC will be the person’s rehabilitation authority on an ongoing basis, a section 39(3)(aa) transfer of rehabilitation authority will allow clients to liaise with just DVA for all of their treatment, compensation and rehabilitation support and services. Furthermore, as DVA adopts a whole-of-person rehabilitation approach, clients will be able to receive the psychosocial, medical management and vocational support and services they require, to establish a new life outside the ADF.

  • Continuity of rehabilitation support and services

Subsection 40(3) of the MRCA [23] provides that where a transfer of rehabilitation authority occurs under section 39(3)(aa), the MRCC must abide by any rehabilitation determination made by the ADFRP or Rehabilitation for Reservists Program.  This means that DVA must continue a rehabilitation program that was commenced under the ADFRP or R4R Program.  Ideally, this should also entail continuing with the same rehabilitation service provider utilised under the ADFRP or R4R Program, and for Career Transition Assistance Scheme (CTAS) career coaching/training where possible. A new assessment will be necessary if the rehabilitation program requires amendment or variation. Accordingly, it is necessary for there to be ongoing dialogue between the ADFRP Rehabilitation Consultant/R4R Case Manager and DVA Rehabilitation Coordinators, prior to the Handover Conference if possible.

 

4.4 Interaction with CTAS for Goal 3 Clients

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4.4.1 Career Transition Assistance Scheme (CTAS)

Date published 
Tuesday, June 2, 2015
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14 July 2016

The aim of the CTAS is to provide ADF members with assistance that will facilitate their transition to civilian employment on separation from the ADF. CTAS is available to all Permanent and Reserve Force members who have rendered CFTS.

Benefits are determined based on length of service and the reason for separation from the ADF.

Members being medically discharged (Goal 3 under the ADF Rehabilitation Programs) have access to the maximum level of CTAS assistance.  This is covered in the 'CTA Level 3' row of the first table in section 4.4.2 [26] of this Guide.

A CTAS program for a Goal 3 client can run simultaneously with any DVA Rehabilitation Program. In developing a DVA Rehabilitation Plan, time can be allocated for the client to participate in CTAS approved activities. There should be no cost allocated on the DVA approved plan to CTAS approved activities.

Rehabilitation Consultants should recognise when a client has a CTAS entitlement and ensure that the client does not miss out on that CTAS entitlement due to the timeframe requirement of not exceeding the 12 month deferral option.

4.4.2 Eligibility for CTAS

Date published 
Tuesday, June 2, 2015
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2 June 2015

Qualifying service for the CTAS may be an aggregate of different periods of service, and can also be for service in one or more of the Army, Navy or Air Force.

The Career Transition Assistance (CTA) levels for the various types of separation from the ADF and qualifying service (as at the date of separation) are as follows.

CTA Level

Benefit

CTA levels and qualifying service at date of separation

CTA Level 1

Less than 12 years of service

CTA Level 2

Between 12 and 18 years of service

CTA Level 3 or

CTA Level 3 in one of these categories

(MED, CRA, MIER, RED)

18 or more years service, or has left the ADF compulsorily for any of the following:

  • medically unfit to continue service (MED)
  • Compulsory Retirement Age (CRA)
  • Management-initiated early retirement (MIER)
  • To meet the needs of the Service (ie declared Redundant) (RED)

 

Benefit

CTA Level 3 (18+ years, MED, RED, MIER)

CTAS Benefits for CTA Level 3 (MED)

Online information

Yes

ADF transition seminars

Yes

Approved absence for career transition activities

(see note 1)

23 days

Career Transition Training (CTT)

(See note 2)

Yes

Career Transition Management Coaching (CTMC)

(See note 2)

Yes

Curriculum Vitae Coaching

Yes

Financial Counselling

(See note 3)

Only for certain members

Notes
  • Note 1: A member may only access approved absence if they have completed their initial category, corps or mustering training at the time of separation.
  • Note 2: A member may only access career transition training or career transition management coaching, not both.
  • Note 3: A member is entitled to financial counselling if they have left the ADF compulsorily for any of the following:
    • medically unfit to continue;
    • to meet the needs of the Service (ie declared redundant); or
    • Management-initiated early retirement.

For more information, refer to the Department of Defence's Career Transition Assistance Scheme [28] webpage.

4.5 What Assistance can DVA Provide to Serving Members?

Date published 
Tuesday, June 2, 2015
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14 July 2016

Schedule 16 of the Memorandum of Understanding between Defence and DVA provides the agreed framework for DVA to provide specific supports and services to Australian Defence Force (ADF) members who are still serving and have not been identified as “likely to be discharged” for medical reasons.

It is important to note that household services, attendant care services and assistance under the Motor Vehicle Compensation Scheme are contained in the compensation provisions in Chapter 4 of the MRCA [23]. This provides the legislative basis for these services to be provided to full time serving members, reservists on Continuous Full Time Service (CFTS) and non CFTS reservists even though the Chief of the Defence Force (CDF) remains the rehabilitation authority.

Defence responsibilities for full time serving members

For full time serving members including Permanent Force members and reservists on CFTS, the CDF is their rehabilitation authority and therefore Defence carries the overall responsibility to provide for their member's assessed rehabilitation needs including:

  • medical treatment;
  • medical aids and appliances;
  • rehabilitation (non clinical) aids and appliances identified by the rehabilitation assessment;
  • alterations and modifications to Defence Housing Australia (DHA) accommodation; and
  • rehabilitation assessments and occupational rehabilitation programs.

For details about which aids and appliances can be provided by the ADF Rehabilitation Programs, please see the table in section 10.8 of this Guide [15].

Defence normally provides full time serving members with medical treatment under Regulation 58E of the Defence Force Regulations. However, under section 272 or 279 of the MRCA [23] respectively, the costs of treatment can be reimbursed or treatment can be provided under DVA Health Card arrangements to serving members for an accepted condition, outside that offered by the ADF. This may occur where the CDF considers it more appropriate that this occurs, and the Commission agrees. This would usually occur where a member is in the process of being discharged from the ADF and has a condition for which liability has been accepted. This is also discussed in chapter 8.5 [30] of the MRCA policy manual.

DVA responsibilities for full time serving members

There are some situations where DVA can provide rehabilitation assistance for a serving member, including full time ADF members and reservists on CFTS, where liability has been accepted and a formal request for these services is made to the ADFRP or Rehabilitation for Reservists Regional Rehabilitation Manager.

Once this formal request has been made, DVA can provide the following assistance to serving members whose rehabilitation authority continues to be the CDF:

  • vehicle modifications under motor vehicle assistance schemes;
  • household services where supported by an assessment report from the ADF or Rehabilitation for Reservists Program;
  • attendant care services where supported by an assessment report from the ADF or Rehabilitation for Reservists Program; and
  • household alterations of private (non-DHA) accommodation where identified through the ADFRP or the Rehabilitation for Reservists Program, or a DVA needs assessment [31].

The exception to this general rule is where a serving member contacts DVA directly for these services. Further direction can be found under “Access to Services and benefits” in this section.

DVA is also able to provide aids and appliances to full time serving members and reservists on CFTS in the following circumstances:

  • where the Rehabilitation Authority is transferred to DVA by Defence; or
  • where the request is made by Defence and the DVA delegates considers that it is appropriate for DVA to provide the recommended aids and/or appliances through section 58(2) of the MRCA [23] because doing so would be likely to increase the length of time that the client would serve as a Permanent Forces Member or CFTS Reservist.

Please refer to section 10.8 of this Guide [15] for more information about how to provide aids to full time serving members.

Defence responsibilities for non CFTS reservists

Following amendment to section 39 of the MRCA [23](effective 1 July 2013), Defence is now responsible for providing the following services for all non CFTS reservists with a Defence service related injury or illness:

  • medical treatment (until DVA accepts liability for the service related injury or illness);
  • medical aids and appliances;
  • rehabilitation assessment and development of rehabilitation plans;
  • occupational rehabilitation programs – including addressing civilian employment issues; and
  • rehabilitation (non-clinical) aids and appliances identified by the rehabilitation assessment (including those required to assist a person in their civilian employment).

The CDF continues to be the non CFTS reservist's rehabilitation authority until their successful rehabilitation or medical discharge from the ADF. Rehabilitation assistance for non CFTS reservists is provided through the ADF Rehabilitation for Reservists Program.

Reservists on the standby reserve list are considered to be non CFTS reservists. The standby reserve list includes those ADF members who have voluntarily discharged from the ADF and may no longer have any active role as an ADF member.

A transfer of rehabilitation authority using MRCA [23] section 39(3)(aa) can be considered where a client's individual circumstances are such that this may be a more beneficial option for them. Delegates are requested to review the information in chapter 4.3 of this Guide [32]when considering this option.

DVA responsibilities for non CFTS reservists

Non-CFTS reservists should lodge a claim for their service related injury or illness within 28 days. This will allow them to access the full range of services and benefits from both the Rehabilitation for Reservists Program and DVA.

Once DVA accepts liability for a service-related injury or illness, DVA is responsible for the funding and provision of the following assistance:

  • medical treatment;
  • incapacity payments;
  • permanent impairment payments;
  • vehicle modifications or where specific criteria are met, provision of vehicles under motor vehicle assistance schemes;
  • attendant care services;
  • household services; and
  • household alterations where identified through the ADF Rehabilitation for Reservists Program or DVA Needs Assessment [31].

In accordance with priority of claims protocols, DVA must provide priority to non-CFTS reservists where there is:

  • any immediate or imminent financial hardship including loss of earning from their civilian employment; and
  • a request from Defence through the Director Navy People, the Director General Personnel Army, or the Director General Personnel Air Force.

When a claim from a non-CFTS reservist has been accepted by DVA, they will be transferred to DVA in accordance with ss. 271 and 280 of the MRCA.  DVA will provide advice to Defence and the reservist on how their health costs will be covered.  Defence retains responsibility for occupational rehabilitation until the case is closed.

Access to services and benefits at the request of Defence

In most circumstances, in order to gain access to services and modifications from DVA, an ADF serving member with an accepted claim must have undergone a specific assessment through the ADFRP or Rehabilitation for Reservists Program process, by an appropriately qualified rehabilitation provider or health professional. The outcomes of the assessment should determine the clinical need for the recommended services. If Defence is unable to provide specific services then the Memorandum of Understanding between Defence and DVA provides the framework through which DVA can provide the service or support, based on evidence from the assessment.

Access to services and benefits where the client approaches DVA directly

In some cases, a serving member may contact DVA directly for attendant care, household services or assistance under the Motor Vehicle Compensation Scheme. Where this occurs, DVA can provide these services, without a request from the ADFRP or Rehabilitation for Reservists Program, because these services are provided through the compensation provisions in chapter 4 of the MRCA [23], rather than the rehabilitation provisions in chapter 3 of the MRCA [33]. The usual assessment processes should be followed, to ensure that there is evidence of the need for the services, due to the client's accepted conditions.

If a rehabilitation need is identified through the assessment process, then Defence should be notified of this by sending a referral for rehabilitation as outlined in section 4.2.1 [9] of this policy library.

4.6 Severely Injured and Transitioning ADF Clients

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Last amended 
14 July 2016

Definitions

A case will be high profile if:

  • the member was involved in a major incident involving deaths and/or severe injuries; or
  • the case could attract media attention.

A case will be complex if it is likely to require a greater input of resources, both in terms of the number of stakeholders involved and the input required from the ADFRP or Rehabilitation for Reservists Program Rehabilitation Consultant.

A Case Complexity Flags Model is used to assess:

  • the nature and severity of the member's clinical conditions, including for example, significant disability, multiple injuries or illnesses (red flags);
  • issues identified during the psychosocial assessment including for example, withdrawal from activity of daily living and work, or lack of family or social support (yellow flags);
  • perceived features of the work or social environment that may delay recovery or present a barrier to returning to work (blue flags); and
  • other objective risk factors relating to financial security, work contact and compensation and include for example, duration of sick/convalescence leave (black flags).

Each coloured flag has an associated rating and the total rating scored is used as an indicator in determining if a case is complex. A rating score of 10 or above may be considered complex, but it is the manner in which the individual manages the problems that identifies complexity, and not necessarily the score.

Phases of activity

There are two distinct phases of activity regarding serving members who are severely injured, have multiple and complex needs and who may also be classified as ‘high profile’ cases.

The two phases are covered in section 4.6.1 [35] and section 4.6.2 [36] of this Guide.

4.6.1 The ADF Process

Date published 
Tuesday, June 2, 2015
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14 July 2016

Please note that the Defence and DVA points of contact noted below are currently under review. Should there be any situations where contact is necessary please refer the matter to the Deputy Commissioner Victoria.

There are two distinct phases of activity regarding serving members who are severely injured, have multiple and complex needs and who may also be classified as 'high profile' cases.

Definitions

A case will be high profile if:

  • the member was involved in a major incident involving deaths and/or severe injuries; or
  • the case could attract media attention.

A case will be complex if it is likely to require a greater input of resources, both in terms of the number of stakeholders involved and the input required from the ADF Rehabilitation Consultant. A Case Complexity Flags Model is used to assess:

  • the nature and severity of the member's clinical conditions, including for example, significant disability, multiple injuries or illnesses (red flags);
  • issues identified during the psychosocial assessment including for example, withdrawal from activity of daily living and work, or lack of family or social support (yellow flags);
  • perceived features of the work or social environment that may delay recovery or present a barrier to returning to work (blue flags); and
  • other objective risk factors relating to financial security, work contact and compensation and include for example, duration of sick/convalescence leave (black flags),

Each coloured flag has an associated rating and the total rating scored is used as an indicator in determining if a case is complex. A rating score of 10 or above may be considered complex, but it is the manner in which the individual manages the problems that identifies complexity, and not necessarily the score.

Phase One

ADF Action

  • The ADF Rehabilitation Consultant uses the Case Complexity Flags Model tool during the initial rehabilitation assessment phase. The results of the Case Complexity Flags tool are documented in the Rehabilitation Assessment Report.
  • Where a case is identified as complex, the ADF Rehabilitation Consultant will raise the case with ADFRP or Rehabilitation for Reservists Program Regional Rehabilitation Manager.
  • Case complexity is reviewed on a three monthly basis as part of the Case Review Report.

ADF - DVA Notification

  • The Directorate of Rehabilitation and Compensation (DRC) will inform the Director General Garrison Health Operations (DGGHO) of the case and provide regular progress reports as directed.
  • The DGGHO will liaise with the Director General Defence Community Organisation (DGDCO) and the DVA Assistant Secretary, Determination Support and Reviews Branch.
  • This is the first formal (high level) communication between the ADF and DVA, which is the trigger point to managing these cases according to the High Profile Case Protocol and the case management framework described in this section of the Guide.

ADF - DVA Communication regarding Rehabilitation and Treatment Needs

  • The ADF Rehabilitation Consultant confirms with the DVA National Director, Rehabilitation and Benefits, Determinations Support and Reviews Branch (DS&R), to advise DVA of the status of this 'high profile and or complex case'.
  • This is the next level of two-way operational communication required between ADF and DVA.  National Director of Rehabilitation and Benefits will advise the ADFRP or Rehabilitation for Reservists Program Regional Rehabilitation Manager, who in DVA will be assisting in the management and, if required, the transitioning of this case.
  • The ADF Rehabilitation Consultant will provide the DVA contact with:
  • a report on the current assessed needs of the member, when the member's treating Medical Officer has determined and confirmed that the member is to be released from hospital (military or community);
  • details of the member's posting locality;
  • what has been recommended by home/ADL assessment;
  • what is being provided by other parties; and
  • what is being requested of DVA to provide.

Sound communication and regular reporting are essential for the management of these 'high profile / complex cases', especially during the early stages or key stages.  Any change in client's circumstances including for example, discharge from hospital to home, or commencing a Return to Work element of their Rehabilitation Program are of highest priority if the case progresses to the transitioning from the ADF phase.  Refer to Section 4.5 [38] of this chapter for information regarding what assistance DVA can provide to a serving member.

Case conferences are an excellent communication tool and should be conducted wherever appropriate to ensure all key stakeholders are kept informed of the case progress and provide opportunity for stakeholders to contribute to management strategies.

The ADF Rehabilitation Consultant will provide regular progress reports to the Senior Medical Officer/Senior Health Officer.  This is an internal ADF process.

4.6.2 Transitioning clients from ADF to DVA

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Please note that the Defence and DVA points of contact noted below are currently under review. Should there be any situations where contact is necessary please refer the matter to the Deputy Commissioner Victoria

Phase Two

There are two distinct phases of activity regarding serving members who are severely injured, have multiple and complex needs and who may also be classified as 'high profile' cases. Following are the Phase Two activities.

In situations where the case is to be transitioned across to full and ongoing DVA responsibility, due to actual or pending separation from the ADF, the ADFRP or Rehabilitation for Reservists Program Rehabilitation Consultant and/or the Regional Rehabilitation Manager  will maintain regular contact with the designated DVA staff. This is to ensure all required medical, allied health, rehabilitation, other services and supports are in place ready for the member at their post separation location. This information is to be provided through to the member's chain of command until the discharge date.

For those ADF clients who have sustained severe and catastrophic injury and have been clinically assessed as requiring high level care and multiple service provision, the following provides a guide to managing the client's transition from ADF service provision to DVA service provision.

Injury or Case Type

Typically, clients categorised as requiring high level care:

  • are individuals whose injury or condition has resulted in serious, long term or permanent disability;
  • require up to 24 hour/seven days per week care and assistance including nursing and personal care; and/or
  • may be wheelchair dependant as a result of a spinal cord injury or brain injury.

Management Pathway

1. Identification and Notification

Primary communication pathway entry point:

  • ADF through the DGGHO informs DVA Assistant Secretary DS&R Branch;
  • ADFRP or Rehabilitation for Reservist Program Consultant confirms case status with DS&R;
  • DS&R advises the client's state specific DVA Deputy Commissioner (DC), the DC's Director or Assistant Director responsible for Rehabilitation and Compensation claims and the Assistant Director DVA Community Nursing Policy (Clinical)*;

or

By the usual claims processes where:

  • the DVA Initial Liability Delegate (IL) or the Needs Assessment Delegate (NA) identifies a high care needs case;
  • the Delegate notifies their location Director, or where applicable their Assistant Director, who is to inform the National Director Rehabilitation and Benefits.

* Tasmanian cases are to follow the Melbourne location management pathway. However, where the case is or will be located in Tasmania, the National Director Rehabilitation and Benefits will advise the Tasmanian DC directly.

2. Initial Case Conference

It will be the DVA location Director or Assistant Director responsible for Rehabilitation and Compensation claims who has the responsibility to liaise with the Assistant Director DVA Community Nursing Policy, Clinical, and to convene an initial case conference. This should include the ADF and DVA stakeholders identified below and aim to clarify responsibilities and processes.

Key Stakeholders

The key stakeholders are:

  • ADFRP or Rehabilitation for Reservists Program Rehabilitation Consultant or Regional Rehabilitation Manager;
  • Assistant Director DVA Community Nursing Policy (Clinical);
  • DVA location Director or Assistant Director responsible for Rehabilitation and Compensation claims;
  • DVA location Community Nursing Contract Manager;
  • DVA location Rehabilitation Coordinator; and
  • if appropriate, or if already in place, current service providers, e.g. ADFRP or Rehabilitation for Reservist Program Service Providers or Community Nursing Service Providers.
Purpose of the case conference

The purpose of the case conference is to clarify:

  • ADF separation status and dates;
  • current treatment pathway – if the client is at the pre-separation stage, can the provision of a DVA Health Card (Gold or White) be expedited;
  • current health status, and obtain current health assessments including a full 'whole of person' rehabilitation assessment (including medical, vocational and psychosocial);
  • current treatment regimes and location, eg hospital, rehabilitation centre or home;
  • how long this arrangement is expected to continue;
  • who is, or who will be, providing primary (medical, psychological, allied health and nursing) care;
    (Note: Discussions should include consideration of appointing a service provider who is a member of the national Panel of DVA Contracted Community Nursing Services Providers [40].
  • timing for new assessment/s for transfer of care from ADF providers to DVA providers, including, medical, nursing and rehabilitation; and
  • timing for involvement of client and family and/or any significant others to:
  • build positive working relationships;
  • manage stakeholder expectations; and
  • formulate agreed management pathways (medical, nursing, psychosocial and when or if appropriate vocational).
Client, client's family and/or any significant others involvement

It may be appropriate at the initial stages to include the client, their family and/or any significant others.  However, each case must be considered on its own merit, following consultation with the ADF lead or principal medical practitioner regarding the readiness of the client and family to be able to participate and contribute. It is important to note that consent of the member is required prior to any meeting or communication which includes family members or significant others.

In most cases, this initial case conference will focus on clarifying administrative and process matters rather than care planning. It is important to clarify DVA and ADF responsibilities at this stage as any client involvement prior to this happening could lead to confusion and frustration. This will allow for the carefully timed inclusion of the client and introduction to their case management staff who have a clear understanding of their respective roles and responsibilities.

3. Guidelines for treatment and care provision arrangements

The following guidelines should be followed:

  • ADF to provide medical treatment as required whilst client is a serving member and request support from DVA for those services they are unable to provide (once liability has been determined);
  • DVA location to issue DVA Health Card (Gold or White Card) as soon as possible to minimise delays when transitioning client into the community and to DVA responsibility;
  • while the client remains a serving member, where possible, the choice of any service provider should be a service provider from a panel of DVA contracted service providers or DVA preferred service providers to ensure the transfer to DVA service provision is as seamless and efficient as possible;
  • following the provision of a Gold or White Card and the client's transition to DVA responsibility, the appointed DVA Contracted Community Nursing Service Provider must arrange to undertake a new and comprehensive assessment of the client's needs in accordance with the DVA Guidelines for the Provision of Community Nursing Services;
  • based on the outcomes of that assessment the DVA contracted Community Nursing Service Provider will need to submit an Exceptional Case Unit (ECU) application, as the care needs for this client group will fall beyond the routine DVA Community Nursing Program Schedule of Fees; and
  • clear communication pathways between Rehabilitation and Compensation staff and DVA's Community Nursing Program are to be established and maintained, to ensure continuity of care and access to entitlements.

4. Post Transition monitoring and management

Regular case conferencing and monitoring is to occur to ensure any changes in the client's condition are reassessed and treatment and care adjusted accordingly as soon as practicable.

The DVA Rehabilitation Coordinator will:

  • confirm during the development of the client's Rehabilitation Program, timelines for reporting, ie weekly or even daily if the case requires, for the first three months, from the rehab service provider;
  • closely monitor these progress reports;
  • be responsive to sudden onset or acute changes in client needs;
  • communicate with the DVA location community nursing contract manager and Assistant Director DVA Community Nursing Policy (Clinical) to exchange case status information from a rehabilitation and community nursing program standpoint;
  • convene case conferences when and where appropriate; and
  • participate in case conferences when convened by DVA Community Nursing Program.

The Rehabilitation Service Provider will:

  • in consultation with stakeholders develop a client centric rehabilitation plan around the client's needs as identified following the transition to DVA responsibility;
  • provide progress reports as agreed;
  • be responsive to sudden onset or acute changes in client needs and report such changes promptly to DVA Rehabilitation Coordinator; and
  • participate in case conferences when convened by DVA.

The DVA location community nursing contract manager and Assistant Director DVA Community Nursing Policy (Clinical) in consultation with the ECU will:

  • closely monitor DVA contracted community nursing service providers reports and reassessments and care; and
  • convene case conference when and where appropriate; or
  • participate in case conferences when convened by the DVA Rehabilitation Coordinator.

Note: Definitions of specific terms used in this topic are in section 4.6 [41] of this Guide.


Source URL (modified on 04/06/2019 - 3:22pm): https://clik.dva.gov.au/rehabilitation-policy-library/4-adf-rehabilitation-programs

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[15] https://clik.dva.gov.au/rehabilitation-policy-library/10-alterations-modifications-aids-appliances/108-provision-alterations-aids-appliances-and-services-serving-adf-clients
[16] https://clik.dva.gov.au/user/login?destination=comment/reply/21268%23comment-form
[17] https://clik.dva.gov.au/rehabilitation-library/4-adf-rehabilitation-program/44-interaction-ctas-goal-3-clients
[18] https://clik.dva.gov.au/user/login?destination=comment/reply/21267%23comment-form
[19] https://www.comlaw.gov.au/Series/C2004A01285/t_blank
[20] https://clik.dva.gov.au/rehabilitation-policy-library/4-adf-rehabilitation-programs/43-transferring-rehabilitation-authority-cdf-mrcc/431-section-10-transfer-rehabilitation-authority
[21] https://clik.dva.gov.au/rehabilitation-policy-library/4-adf-rehabilitation-programs/43-transferring-rehabilitation-authority-cdf-mrcc/432-section-393aa-transfer-rehabilitation-authority
[22] https://clik.dva.gov.au/chapter-7-maximum-rate-weeks-hours-used-calculations-and-part-week-calculations
[23] https://www.comlaw.gov.au/Series/C2004A01285
[24] https://clik.dva.gov.au/user/login?destination=comment/reply/21273%23comment-form
[25] https://clik.dva.gov.au/user/login?destination=comment/reply/21271%23comment-form
[26] https://clik.dva.gov.au/rehabilitation-library/4-adf-rehabilitation-program/44-interaction-ctas-goal-3-clients/442-eligibility-for-CTAS
[27] https://clik.dva.gov.au/user/login?destination=comment/reply/21274%23comment-form
[28] http://www.defence.gov.au/transitions/support/ctas/ctas.htm
[29] https://clik.dva.gov.au/user/login?destination=comment/reply/21262%23comment-form
[30] https://clik.dva.gov.au/military-compensation-mrca-manuals-and-resources-library/policy-manual/ch-8-treatment-injuries-and-diseases/85-transferring-cost-treatment-adf-dva
[31] https://clik.dva.gov.au/military-compensation-reference-library/needs-assessment-guide-overview
[32] https://clik.dva.gov.au/rehabilitation-policy-library/4-adf-rehabilitation-program/43-transitioning-adfrp-mrcc
[33] http://www.comlaw.gov.au/Series/C2004A01285
[34] https://clik.dva.gov.au/user/login?destination=comment/reply/21272%23comment-form
[35] https://clik.dva.gov.au/rehabilitation-library/4-adf-rehabilitation-program/46-treatment-and-service-provision-severely-injured-adf-clients-and-transitioning-adf-clients/461-adf-process
[36] https://clik.dva.gov.au/rehabilitation-library/4-adf-rehabilitation-program/46-treatment-and-service-provision-severely-injured-adf-clients-and-transitioning-adf-clients/462-transitioning-clients-adf-dva
[37] https://clik.dva.gov.au/user/login?destination=comment/reply/21264%23comment-form
[38] https://clik.dva.gov.au/rehabilitation-library/4-adf-rehabilitation-program/45-what-assistance-can-dva-provide-serving-members-including-reservists-adfrp
[39] https://clik.dva.gov.au/user/login?destination=comment/reply/21269%23comment-form
[40] http://www.dva.gov.au/providers/community-nursing/panel-dva-contracted-community-nursing-providers
[41] https://clik.dva.gov.au/rehabilitation-library/4-adf-rehabilitation-program/46-severely-injured-and-transitioning-adf-clients