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This chapter provides information about the Australian Defence Force Rehabilitation Program (ADFRP) and the Rehabilitation for Reservists Program.
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].
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:
irrespective of whether a member's injury or illness is related to work. | Provides rehabilitation services and early intervention treatment to:
for service related injuries only. |
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.
The principles of the ADF Rehabilitation Programs are:
The key components of ADFRP and R4R Programs are:
The three goals of ADF rehabilitation are, in priority order:
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.
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.
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.
The ADF may undertake a rehabilitation assessment in any of the following circumstances:
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.
The categories according to the Defence Instructions General (DIG) Pers 16-15
Category | Definition |
---|---|
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 |
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.
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:
Step 1 (b): Rehabilitation assessment is undertaken:
Step 1 (c): Rehabilitation Program developed and implemented around one of three possible goals
Step 1 (d): Rehabilitation Program Closed
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
At certain times throughout the case management process, DVA and Defence will need to exchange information about individual clients. These times may include:
*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].
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:
irrespective of whether a member's injury or illness is related to work. | Provides rehabilitation services and early intervention treatment to:
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:
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:
Including medical documentation in the referral ensures that Defence can explore:
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:
Protocols for referrals of reservists
The R4R Program provides rehabilitation assistance for all non-CFTS reservists which includes:
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:
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.
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:
Where the client provides consent, and they are available, the following documents should also be provided:
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:
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].
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:
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.
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:
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:
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:
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.
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:
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:
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:
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.
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.
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 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:
|
Benefit |
CTA Level 3 (18+ years, MED, RED, MIER) |
---|---|
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 |
For more information, refer to the Department of Defence's Career Transition Assistance Scheme [28] webpage.
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.
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:
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.
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:
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:
Please refer to section 10.8 of this Guide [15] for more information about how to provide aids to full time serving members.
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:
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.
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:
In accordance with priority of claims protocols, DVA must provide priority to non-CFTS reservists where there is:
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.
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.
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.
A case will be high profile if:
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:
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.
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.
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:
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:
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
ADF - DVA Notification
ADF - DVA Communication regarding Rehabilitation and Treatment Needs
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.
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.
Typically, clients categorised as requiring high level care:
Primary communication pathway entry point:
or
By the usual claims processes where:
* 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.
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.
The key stakeholders are:
The purpose of the case conference is to clarify:
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.
The following guidelines should be followed:
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:
The Rehabilitation Service Provider will:
The DVA location community nursing contract manager and Assistant Director DVA Community Nursing Policy (Clinical) in consultation with the ECU will:
Note: Definitions of specific terms used in this topic are in section 4.6 [41] of this Guide.
Links
[1] https://clik.dva.gov.au/user/login?destination=comment/reply/21270%23comment-form
[2] mailto:rehabilitation@dva.gov.au
[3] https://clik.dva.gov.au/user/login?destination=comment/reply/21276%23comment-form
[4] http://www.defence.gov.au/ADF-TotalWorkforceModel/ServiceSpectrum.asp
[5] https://clik.dva.gov.au/rehabilitation-policy-library/4-adf-rehabilitation-programs/41-overview-adf-rehabilitation-programs/411-adf-rehabilitation-framework
[6] https://clik.dva.gov.au/user/login?destination=comment/reply/21265%23comment-form
[7] https://clik.dva.gov.au/rehabilitation-policy-library/4-adf-rehabilitation-programs/41-overview-adf-rehabilitation-programs/413-adf-medical-employment-classification-system
[8] https://clik.dva.gov.au/user/login?destination=comment/reply/21266%23comment-form
[9] https://clik.dva.gov.au/rehabilitation-policy-library/4-adf-rehabilitation-programs/42-interaction-between-adf-rehabilitation-programs-and-dva/421-rehabilitation-referrals-adf-rehabilitation-programs
[10] https://clik.dva.gov.au/user/login?destination=comment/reply/21275%23comment-form
[11] https://clik.dva.gov.au/user/login?destination=comment/reply/21263%23comment-form
[12] http://www.dva.gov.au/site-information/privacy
[13] https://clik.dva.gov.au/rehabilitation-policy-library/4-adf-rehabilitation-programs/43-transferring-rehabilitation-authority-cdf-mrcc
[14] https://clik.dva.gov.au/rehabilitation-policy-library/4-adf-rehabilitation-programs/45-what-assistance-can-dva-provide-serving-members
[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