Streamlined Access to Incapacity Payments is a 2017/18 Budget measure which aims to:
The policy intends to provide increased support to clients who are testing their ability to return to work, or who are concerned that they may experience financial stress if they need to leave their employment because of their accepted mental health condition(s). This policy is guided by evidence surrounding the health benefits of good work [2], which stresses that employment is as much part of a person’s recovery from injury, as it is a positive outcome of rehabilitation. Many of DVA’s rehabilitation success stories [3] highlight how important employment has been in helping veterans get their life back on track after a service related injury or disease.
To be eligible for the additional assistance the client must:
Once approved, Streamlined Access to Incapacity Payments is valid for one year from the date the client commences employment.
Streamlined Access to Incapacity Payments is designed to support clients who are in the process of accepting an offer of employment and preparing to return to work. The policy can provide clients with confidence they can attempt a return to employment with full rehabilitation support, and if they not successful, their incapacity payments can be reinstated.
It is expected that Rehabilitation Providers and clients will work together to ensure that there is a good match between the client’s needs, skills, expectations and experience and the job that they have been offered. This will provide the client with the best possible opportunity to be successful in returning to sustainable employment. While this is a business as usual approach for any client who is participating in a vocational rehabilitation plan, it is recognised that mental health issues have the potential to create greater difficulties for clients, resulting in hesitancy regarding their return to employment. Issues that should be worked through before returning to work include (but are not limited to):
It is expected that if any of these issues are concerning the client prior to commencing new employment, the client and the Rehabilitation Provider will work together to develop management strategies. Undertaking this process may help to resolve whether a particular job is a suitable option, or whether it may be better for the client to be looking for an alternate role or employer.
In addition to potential difficulties, the range of benefits should also be discussed, including:
Streamlined Access to Incapacity Payments should be considered for specific clients:
Through this policy, clients who meet the criteria can access rehabilitation support through the continuation of their rehabilitation plan for up to 12 months once they have secured employment. This will enable them to access the support of a Rehabilitation Provider to manage any issues they are experiencing in the workplace and in the event that they need to cease or reduce their hours due to their accepted mental health condition, their incapacity payments will recommence.
There are many individual differences in the way that mental health conditions impact on a person’s life. For example, having a particular diagnosed condition may manifest in an episodic flare of mental health symptoms for some clients which impacts on their ability to manage in a workplace. In contrast, another client with the same condition, who has developed a range of strategies and skills to manage their symptoms effectively may not require a break from their employment.
Rather than this policy applying to all clients with mental health conditions, consideration must be given to if a client’s accepted mental health condition is contributing to their incapacity. The flags outlined below are intended to guide Rehabilitation Providers to identify issues that may place a client at risk of managing and sustaining their return to work due to their mental health conditions:
Where the Rehabilitation Provider and/or the client identify any of the above flags that are likely to make the client vulnerable in an employment setting, then they are expected to discuss this with the DVA Rehabilitation Coordinator, to determine suitability for streamlined access to incapacity payments.
Early identification of these flags and pro-active management of issues is more likely to result in the client better handling their situation and recovering sooner. Identifying these issues quickly can also enable whole-of-person rehabilitation support to be provided, which may help the client to overcome some of their concerns about managing their work role.
The Incapacity delegate must be informed when considering and approving Streamlined Access to Incapacity Payments, as they need to be aware of the implications. As part of this process Rehabilitation Coordinators will need to check that the person’s accepted mental health condition is contributing to their incapacity. Approval for Streamlined Access to Incapacity Payments is recorded in the rehabilitation claim in R&C ISH, and also creates a flag in the Incapacity claim screen for the incapacity payment delegate.
Streamlined Access to Incapacity Payments allows a veteran to utilise rehabilitation support for up to 12 months following their return to work. During this 12 month period, it is expected the Rehabilitation Provider will maintain regular contact, which is agreed upon with the client to allow proactive identification and resolution of emerging issues while ensuring the client has adequate space and time to focus on their new employment. For example, one client may want weekly calls and another client may need only 3 monthly calls from the provider, but also be willing to the call the provider themselves if they need assistance.
Additional rehabilitation activities can be approved during the 12 month monitoring timeframe to assist the client to maintain employment. It is still important to close any existing goals that have been met, and set new activities under an appropriate goal related to monitoring employment. Activities appropriate for this monitoring period might include:
If the client needs to cease their employment or reduce their hours because of their accepted conditions, they are not required to submit a new claim for incapacity payments. Once notified, the Rehabilitation Coordinator will liaise with the client’s incapacity claims manager to ensure that incapacity payments are reactivated.
Reinstatement of incapacity payments under this policy is not restricted to the client’s mental health condition(s) impacting their employment, however their accepted mental health condition must be a contributing factor. As long as the Rehabilitation Coordinator is satisfied that the reason for the change affecting their employment is genuine and that their accepted mental health condition has contributed to the change, the impact on their employment can be due to any of their accepted conditions, Clients who have not been previously accepted under Streamlined Access to Incapacity Payments will need to follow the normal procedures, which may include a new Incapacity Payments claim.
Streamlined Access to Incapacity Payments provides additional rehabilitation support for clients who are vulnerable to moving in and out of employment due to their accepted mental health conditions. It is also important that clients continue to access appropriate treatment and support from their treating health professionals, to ensure that any flare in symptoms can be managed as quickly as possible.
For this reason, DVA expects that a client who is accessing support through Streamlined Access to Incapacity Payments will visit their GP, psychiatrist, psychologist or other appropriate health provider when they begin to experience difficulties in managing their employment responsibilities. A medical certificate from any treating health professional, including their GP, will provide DVA with required assurance that the client’s mental health condition(s) is a main contributor to the client needing to reduce their hours of employment, or to cease their employment. This certificate must be provided to the client’s DVA Rehabilitation Coordinator.
Where the person remains in employment at a reduced number of hours, it is important that DVA has evidence of the client’s current rate of pay, as this will ensure that the correct rate of incapacity payments is paid, and will reduce the risk of overpayments. If the person has completely ceased employment, an employment separation certificate will be required before incapacity payments can be reinstated. If the client is having difficulty accessing these documents, the Rehabilitation Provider can assist and ensure that they are forwarded to the client’s DVA Rehabilitation Coordinator. The Rehabilitation Coordinator will then liaise with the client’s incapacity claims manager so that incapacity payments can recommence as quickly as possible.
There are no barriers to a client being able to participate in Streamlined Access to Incapacity Payments on more than one occasion, however, each incident cannot be extended beyond 12 months. For example, a client may commence employment two times and can access streamlined access to incapacity payments both times. But if the client remains in employment for 12 months and asks for an extension to the Streamlined Access to Incapacity Payments, then this cannot be granted and the client will need to re-claim for payments in the normal way.
If the client needs to cease their employment or reduce their hours, because of a reason that is not their accepted conditions, they cannot automatically have their incapacity payments reinstated.
Other reasons might include when the client;
In this case, if the client must choose if they wish to submit a new Incapacity Payments claim, which may or may not be accepted.
The expectations of clients accessing additional support through this policy are available at section [4]9.13 [4] of the Rehabilitation Policy Library. The general rights and obligations of clients undertaking rehabilitation can be found at section 13 [5] of the Rehabilitation Policy Library.
Clients accessing additional support through this policy have been identified as requiring additional support due to the episodic nature of their mental health conditions. In keeping with the intent of this policy, clients should be given every assistance in meeting their obligations before any action is taken to remove benefits. In all likelihood, non-compliance may be as a result of clients being involved in their new employment and not believing they require any assistance.
It is essential that if the plan is being closed due to non-compliance, that it is the Rehabilitation Coordinator that discusses this with the client, and informs them that the plan will be closed, and the consequences of this occurring. At no time must a Rehabilitation Provider progress a discussion regarding, or be asked to communicate closure of a plan due to non-compliance with rehabilitation obligations with a client. The policy regarding closure of a rehabilitation plan can be found at section 3.10 [6] of the Rehabilitation Policy Library.
At the end of the 12 month monitoring period, where the Rehabilitation Coordinator is satisfied that the client has returned to sustainable employment and all other goals are closed, the rehabilitation plan will be closed.
In situations where the client needs ongoing assistance, due to their mental health conditions or other conditions, and an appropriate goal is still active, then the rehabilitation plan can continue. However, the Streamlined Access to Incapacity Payments flag should be removed at the 12 month mark.
There is a 12 month maximum period to Streamlined Access to Incapacity Payments, and after this period, rehabilitation (and access to incapacity payments) reverts to BAU.
Clients approved for the Streamlined Access to Incapacity Payments are expected to be:
Participation in Streamlined Access to Incapacity Payments is voluntary and clients can decide that they would like to withdraw from their involvement at any time. However, clients who are participating will be expected to continue to be involved in activities on their rehabilitation plan that focus on building on their capacity to sustain long term employment.
As the client will be concurrently managing their employment obligations while adjusting to changes to routine and demand on their time that they may not be used to, it is important that the rehabilitation activities are not too onerous and that participation these can be realistically achieved. A rehabilitation plan for a participating client would be expected to be less complex and include fewer activities relative to other clients. Any achieved goals need to be closed, and an appropriate monitoring of employment goal needs to be created for any activities relating to this period. Scheduled Rehabilitation Provider contact needs to be agreed upon, and can be more or less frequent, depending on the clients’ needs.
If a client withdraws from Streamlined Access to Incapacity Payments, the Rehabilitation Provider is expected to provide a rehabilitation closure report for the Rehabilitation Coordinator explaining that the client has chosen to withdraw, however, successful return to work (if still appropriate) can still be used as the reason for closure.
DVA’s expectations of Rehabilitation Providers who are working with clients accessing streamlined access to incapacity payments include:
As outlined in section 3.8.5 [7], progress reports are a key reporting tool which reports progress and planned actions against goals. However, during the employment monitoring phase, if no other goals are still active, Rehabilitation Coordinators and Rehabilitation Providers can agree to reduce the frequency or cease these reports. Providers are still required to communicate any issues or developments as they happen.
It is essential that a client receiving support through Streamlined Access to Incapacity Payments is not deemed with an ability to earn while their extended rehabilitation plan remains open. To do so would create barriers to the person’s incapacity payments being reinstated as quickly and as easily as possible. Clients participating in this policy will be identified on the claim in the rehabilitation and incapacity payments screens on R&C ISH.
It is important that the client’s Rehabilitation Coordinator and the client’s incapacity delegate communicate regularly and that the incapacity delegate is immediately notified when a client needs to reduce, pause or cease their employment due to an increase in the symptoms, or impact of their accepted mental health condition(s). This will prevent any unnecessary delays in incapacity payments being recommenced.
Rehabilitation Coordinators are expected to ensure that value for money is being achieved during the extended rehabilitation program and that the Rehabilitation Provider is actively engaged and providing meaningful support to the client. If a Rehabilitation Coordinator has any concerns about the Rehabilitation Provider’s recommendation that a specific client be provided with an extended rehabilitation plan, then it is strongly suggested that they discuss the case with a DVA Rehabilitation Adviser, to help determine a way forward.
Rehabilitation Coordinators are expected to ensure that a whole-of-person rehabilitation approach is maintained during the extended rehabilitation program. If a client needs to reduce their hours or work, access sick leave or cease employment, their rehabilitation plan may move to focusing on medical management and/or psychosocial rehabilitation activities once their acute symptoms have diminished. This helps to ensure that the client will continue to work towards overcoming barriers to their recovery, which includes barriers to them remaining in employment.
This means for example, that it would be reasonable for an exercise program, healthy cooking course, dietician support or similar activities to be included on the extended rehabilitation plan, if a client’s physical health and weight gain is impacting on their ability to sustain employment. Another example is that time limited anger management, stress management, mindfulness, meditation or yoga courses may be included on a rehabilitation plan to assist clients to develop strategies to manage stress in their workplace. Likewise, time limited drama courses, public speaking or other similar courses could be included on the rehabilitation plan if the client is having difficulty in communicating in a work place. A flexible approach will be required, with each case to be considered on its merits, being mindful that non-accepted conditions are also likely to impact on the client’s ability to sustain employment. As the client starts to recover, and their symptoms reduce, then vocational rehabilitation activities can recommence.
Links
[1] https://clik.dva.gov.au/user/login?destination=comment/reply/81627%23comment-form
[2] https://clik.dva.gov.au/rehabilitation-policy-library/9-vocational-rehabilitation/91-what-vocational-rehabilitation
[3] https://www.dva.gov.au/health-and-wellbeing/rehabilitation/rehabilitation-success-stories
[4] https://clik.dva.gov.au/rehabilitation-policy-library/9-vocational-rehabilitation/913-streamlined-access-incapacity-payments
[5] https://clik.dva.gov.au/rehabilitation-policy-library/13-rights-and-obligations
[6] https://clik.dva.gov.au/rehabilitation-policy-library/3-rehabilitation-process/310-plan-closure-process
[7] https://clik.dva.gov.au/rehabilitation-policy-library/3-rehabilitation-process/38-dva-rehabilitation-reporting-documents/385-progress-reports