6.6 How to determine if a psychosocial activity is reasonable

1. Likely to achieve progress towards an agreed rehabilitation goal in the client’s rehabilitation assessment and/or plan?
 

For example:
What is the demonstrated relationship between the activity and achievement of the client’s rehabilitation goals? 

(a) any written report in respect of the person under subsection 46(3);

(a) any written assessment given under subsection 36(8);

2. Likely to be effective?
 

For example:
What is the evidence that supports this activity as being likely to be effective?

NB: If there is no evidence (other than anecdotal), rehabilitation providers need to provide their professional opinion as to why a certain intervention is likely to be effective.

(a) any written report in respect of the person under subsection 46(3); and

(b) any reduction in the future liability of the Commonwealth to pay or provide compensation if the program is undertaken;

(a) any written assessment given under subsection 36(8); and

(b) any reduction in the future liability to pay compensation if the program is undertaken;

3. Appropriate for the client given their medical restrictions, both physical and psychological?
 

For example:
What is the evidence that supports this activity is appropriate for the client, both physically and psychologically given their condition?

(a) any written report in respect of the person under subsection 46(3);

(a) any written assessment given under subsection 36(8);

4. Unlikely to compromise the client’s personal safety, including their psychological safety?
 

For example:
What risk is posed to the client from participating in this activity – both physically and psychologically?

If the activity has a moderate to high level of risk, can an alternate (lower risk) activity still provide the same level of meaningful activity to the client, taking into account their prior work history and life experience?

NB: Lower risk activities should always be explored with the client.

If there are no meaningful lower risk activity options, what risk mitigation strategies been put in place by the activity/service provider?

(a) any written report in respect of the person under subsection 46(3);

(a) any written assessment given under subsection 36(8);

5. Likely to improve (or at least not impair) the client’s ability to function independently, including returning to work if feasible?
 

For example:
How will participation directly support the client’s ability to improve their ability to independently function – either physically or psychologically?

(a) any written report in respect of the person under subsection 46(3); and

(d) any improvement in the person's opportunity to be engaged in work after completing the program;

(a) any written assessment given under subsection 36(8); and

(d) any improvement in the employee's opportunity to be employed after completing the program;

6. Time-limited rather than a long-term or ongoing activity?
 

For example:
Is the time commitment & length of the proposed activity comparative with other activity options or service models from other providers? 

If this program varies in time or length from other programs – how?  Is this variation of any specific benefit to the client?

(c) the cost of the program;

(c) the cost of the program;

7. Cost-effective in relation to other equally effective interventions or arrangements?
 

For example:
What is the cost of this program? 

Is there a more cost effective program that achieves the same outcome for the client? 

NB: it is expected the rehabilitation provider will have explored costs of at least one other similar program.

c) the cost of the program;

(f) the relative merits of any alternative and appropriate rehabilitation program;

(c) the cost of the program;

(g) the relative merits of any alternative and appropriate rehabilitation program

8. In line with community standards and expectations?
 

For example:
Would such an activity program be considered as reasonably ‘standard’ for the clients rehabilitation goals?

If not, what is the rationale for recommending this activity? 

(f) the relative merits of any alternative and appropriate rehabilitation program;

(g) the relative merits of any alternative and appropriate rehabilitation program;

9. In line with the client’s preferences?
 

For example:
Does the preferred activity meet the client’s preferences?

Will the client be willing to consider an alternate program if this could achieve the same or better outcomes for them (as it is identified as having stronger evidence of effectiveness or is more in line with community standards, or is more cost effective).

If the client is unwilling to consider an alternate program, are they aware of why funding may not be supported for their preferred choice? 

(e) the person's attitude to the program; 

(e) the likely psychological effect on the employee of not providing the program;

(f) the employee's attitude to the program;

10. Reasonable after considering any other relevant matters?
 

For example:
Is there other client or related information which is relevant to determining the preferred program activity to be suitable for funding? (eg: work history, medical history, client aspirations/interests; transport considerations; geographical location of activities etc.)

NB: as a general principle DVA is not responsible for meeting travel costs associated with attendance at psychosocial rehabilitation activities. This is with acknowledgement that part of learning to self-manage is to become independent in organising and paying for travel. If travel costs are likely to be prohibitive, providers must explore alternate activity options that reduce or remove the barrier to accessing the program. If no other option exists, and after discussion with their team leader, rehabilitation coordinators can contact rehabilitation@dva.gov.au for policy advice.

(g) any other matter the rehabilitation authority considers relevant.

(h) any other relevant matter.