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3.8.4 Changes to a rehabilitation plan
There are two types of changes that can be made to a rehabilitation plan;
a rehabilitation plan amendment for minor changes, funding changes or a change in goals; or
a rehabilitation plan variation for a change in plan focus.
A rehabilitation plan amendment
At times it may be necessary to amend a rehabilitation plan in response to changes to a client's circumstances, or where the plan is not progressing as expected. To implement these changes, the Rehabilitation Plan Amendment form is used (DVA form 1336), which can be found on the DVA forms portal.
A plan amendment is not a formal determination point, and therefore a determination letter is not required. This also means that a plan amendment is not a reviewable decision.
The client and rehabilitation service provider are required to sign the plan amendment. The DVA Rehabilitation Coordinator must also sign the plan, using either a physical (wet) signature or an electronic signature.
A copy of the signed amendment must be provided to the client so that they have a record of all activities included on the plan. If there are barriers to a client signing the plan amendment, DVA delegates are asked to please refer to their procedure or further information.
Changes that would require a plan amendment may include:
- when any changes to the short or long term activities of a plan are required, but the overall focus or intent of plan are the same;
- if the time frames to complete activities of the plan need to be adjusted or extended;
- if the goals in the plan are changing, but the focus or intent are the same;
- if additional rehabilitation activities need to be included that do not change the overall focus of the plan; and/or
- where the approved funding for the plan activities requires an amendment;
- pregnancy, maternity leave or parental leave as described in Chapter 13.6 of this library.
Please refer to "a rehabilitation plan variation" in this section for information about changing the focus or intent of a rehabilitation plan.
Please see Goal Attainment Scaling instructions in section 15.3.4 of this library for "how to" steps for amending a rehabilitation plan.
Recording rehabilitation plan amendments
DVA Rehabilitation Coordinators are required to record any amended rehabilitation goals, activities, dates for activities and LSI and GAS scores in R&C ISH.
Interaction with incapacity payments
If the client is in receipt of incapacity payments, it is important for the Rehabilitation Coordinator to advise or provide evidence to the incapacity payment team or the client's incapacity delegate of any change in dates, as this may have an effect on the client's incapacity payment amounts and/or the duration of incapacity payments to the client. Please refer to section 9.4 of this library for more information about incapacity payments when a person is participating in a rehabilitation plan.
A rehabilitation plan variation
Variation of a rehabilitation plan
A Rehabilitation Plan Variation should be used where the overall focus of a plan changes, for example where a client moves from a non-return to work plan to a return to work plan or vice versa.
Where this occurs, the original plan should be varied by the creation of a new plan. In contrast, where the focus of the plan remains, but significant activities or costs are added or removed, the current plan should be amended.
Please note, the requirement to do a plan amendment may be due to a change in the client's circumstances which may warrant a subsequent needs assessment to ensure that we have an understanding of the client’s current circumstances.
Determination to vary a rehabilitation plan
DVA Rehabilitation Coordinators must issue a determination whenever a rehabilitation program is varied. Please note, the decision to vary a plan is one determination. While in essence the action of varying a plan may require that a new plan is opened (and therefore the previous plan is closed) this is considered a single plan approval determination rather than two separate determinations.
It is mandatory that R&C ISH standard letters are used when communicating with clients about the approval of their varied rehabilitation plan. Letters generated from R&C ISH will automatically attach to the client’s UIN folder in TRIM. A variation to a plan is a reviewable decision.
The determination letter together with a copy of the relevant rights and obligations document (either return to work or non-return to work) and the signed varied plan constitute a formal determination under section 37 of DRCA, section 53 of MRCA and under the VVRS Instrument. The determination letter should address the relevant points under either section 37 of DRCA, 51 of MRCA or the VVRS Instrument that have been considered. These points are outlined in section 3.8.3 of this library. Only points that are relevant to the decision need to be noted in the determination letter to vary a plan. For example, if a plan is varied because the focus of a plan is changing from return to work to non-return to work, so that the person can concentrate on accessing treatment and building their resilience, then the person’s current ability to engage in employment is a key reason for the plan being varied and should be highlighted in the letter.
The client and rehabilitation service provider are required to sign the plan variation. The DVA Rehabilitation Coordinator must also sign the plan, using either a physical (wet) signature or an electronic signature.
For further information about what needs to be provided to the client as part of making a determination to vary a rehabilitation plan, DVA delegates are asked to please refer to their procedures.
It is essential that any variations to a plan are based on an assessment by the rehabilitation provider, and that the client is consulted about the proposed variation. A copy of the varied plan must be provided to the client. If there are barriers to a client signing the plan amendment, DVA delegates are requested to please refer to their procedures for further information.