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5.1 What is Medical Management Rehabilitation

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Last amended 
17 July 2020

Medical management rehabilitation is assistance to help clients understand, access and navigate the civilian health system. This may involve encouraging or supporting clients to attend and participate in medical and allied health services specifically aimed at treating their physical and/or mental health conditions. The aim of medical management rehabilitation is that clients will be able to independently access treatment and support for their accepted conditions.

Normally these activities would be coordinated by the person's treating medical practitioner. However where the person, because of their specific injury or condition, is struggling to pursue treatment in a consistent way, a rehabilitation service provider can be engaged to coordinate a medical management rehabilitation plan. This may involve the rehabilitation service provider facilitating attendance at necessary appointments and assisting the person to manage their medical conditions more effectively by accessing appropriate treatment and support from health professionals or organisations.

A medical management rehabilitation plan may include psychosocial rehabilitation or vocational rehabilitation interventions as a part of a whole of person approach to helping the person to achieve their rehabilitation goals. Goal Attainment Scaling is mandatory when developing a whole-of-person rehabilitation plan that includes medical management. Information about Goal Attainment Scaling can be found in chapter 15 of the Rehabilitation Guide.

A medical management rehabilitation plan cannot be used to pay for treatment. This includes the cost of nursing or other similar medical care. Similarly, a medical management rehabilitation plan cannot be used to pay for attendant care or household services.

Rehabilitation Coordinators must contact rehabilitation@dva.gov.au as soon as they become aware of difficulties in meeting a client's care and treatment needs. The rehabilitation policy section and the Community Nursing Program will then work together to ensure that coordinated assessments can be organised and an appropriate level of services can be provided to meet the client's assessed needs, in line with the legislation and the department's usual contractual arrangements.

Management of medical treatment needs

A medical management rehabilitation plan may be indicated in cases of severe injury, complex multiple injuries or where a person requires support to coordinate their medical treatment program or clinical self-care activities. Support for clients with psychological illness should be given particular consideration.

The Safety, Rehabilitation and Compensation (Defence-related Claims) Act 1988 (DRCA) and the Military Rehabilitation and Compensation Act 2004 (MRCA) include provisions to engage a rehabilitation service provider to help the client access and coordinate their treatment needs.

A rehabilitation service provider can be contracted to connect with the client and the client's various medical and allied health practitioners and to support them navigate through their medical appointments, treatment regimes, medical information, self care needs, requirement for aids/appliances and other related activities.

Medical management rehabilitation is provided as an adjunct to medical treatment. It cannot be used to provide treatment or to meet the costs of medical care, including nursing care. The role of the rehabilitation provider is not to provide medical advice, but to support the client to remain on-track, in continuing to access treatment.

Such a rehabilitation intervention can involve an intensive case management approach, including regular contact and follow-up with the client and their treating practitioner or team of practitioners, by a rehabilitation provider with appropriate skills and experience in working with clients in this way. The intervention can be developed as part of a stand-alone rehabilitation plan, or incorporated into a more integrated whole of person rehabilitation plan which could also address the client's psychosocial and vocational needs. Where this occurs, the medical management and psychosocial rehabilitation interventions can be paid as third party costs under the person's non return to work or return to work (vocational rehabilitation) plan.

Medical management rehabilitation can also help to support a client to seek further information about medical guidelines and restrictions relevant to their accepted conditions, which will assist in promoting effective management of their medical needs in their home, community or workplace.