A whole-of-person approach to return to work
In many cases, a vocational rehabilitation program will include psychosocial rehabilitation and medical management rehabilitation activities as part of a whole of person approach to helping a person return to sustainable employment. This will be particularly important where a person has been out of the workforce for some time as work absence tends to perpetuate itself, with the barriers to a person returning to work increasing, the longer that they are disconnected from the workforce. Psychosocial and medical management rehabilitation activities can assist with overcoming these barriers to rehabilitation and return to work by assisting a person to develop a sense of hope for the future and to learn to self-manage their conditions as effectively as possible.
Where a person’s long-term goal is to return to work, particularly after a long-term absence from employment, a vocational rehabilitation plan should be opened. Any medical management or psychosocial activities should be recorded under the return-to-work plan, as they will assist in helping the person to prepare for a return to work, and therefore to reach their rehabilitation goal.
Volunteer work may also be considered as an approved activity to assist a person to build confidence and update their skills and experience as part of working towards a goal of returning to paid employment.
The costs of psychosocial and medical management rehabilitation activities should be paid and recorded in R&C ISH as a rehabilitation or third-party cost under the vocational rehabilitation plan.
Interactions between incapacity payments and rehabilitation
It is essential that there is good communication between a person’s Rehabilitation Coordinator and their incapacity delegate at all times. However, this is even more important where a person who has been out of work for some time is working towards a return to work goal and may be particularly vulnerable to negative messages about their ability to return to employment. For this reason, it is important that the focus remains on what the person can do, rather than what they cannot do. This is consistent with initiatives being undertaken by organisations such as Comcare, which are trialling GP certificates detailing a person’s "capacity for work" rather than their "incapacity for work".
Client working towards a return-to-work goal
If a client is actively and fully participating in a rehabilitation plan which has the overall goal of return to employment, then there is no requirement that the person continue to provide medical certificates of their capacity for employment and incapacity delegates should not actively seek this information from the person. Rather, when medical evidence of the person’s ongoing capacity for work is required, the rehabilitation provider should obtain this from the treating doctor.
Clients should also not be asked to continue to provide evidence of their capacity for employment, whenever they are working towards a goal of returning to employment, even if they are focusing on medical management and psychosocial rehabilitation activities as a starting point to overcome barriers to return to work. Incapacity payments are made on the basis of finite periods in-line with either medical certification or the rehabilitation plan start and end dates. The end date of the formal determination for incapacity payments should therefore align with the end date of the person’s medical certificate or rehabilitation plan.
This authority to pay incapacity benefits against the rehabilitation plan start and end dates will only apply as long as the person is participating fully and actively in their approved rehabilitation activities. The incapacity delegate and the Rehabilitation delegate will need to work together, to ensure that when a rehabilitation plan is extended, the incapacity determination is applied from the end date of the old plan to the end date of the new plan.
Rehabilitation plan length
A client’s vocational rehabilitation plan should remain open for as long as DVA is providing support to assist the client to reach their rehabilitation goals. The plan should therefore remain open until:
- all rehabilitation goals have been achieved;
- a return to an optimum level of functioning has been achieved and the client does not require any further support or services; and
- a sustainable return to work has been achieved, and the client has been able to maintain optimum hours/duties for a period of at least 3 months.
Where a client is undertaking tertiary study or retraining courses, their vocational rehabilitation plan should remain open for the whole period of the study. This ensures that the client has access to support from their rehabilitation provider whenever they need it. However, it is important that the Rehabilitation Coordinator and the provider have discussed and agreed:
- how often the provider will make contact with the client;
- how often the provider will supply progress reports; and/or
- the level of funding that will be allocated for case management activities.
It is important that a flexible approach is applied, and that these arrangements can be varied if the client’s needs change.
If a client is undertaking an apprenticeship lasting 3-4 years, a more flexible approach can be taken. This is because the employer will also be monitoring whether the client is meeting the expectations of their role. In this case, a Rehabilitation Coordinator may decide, for example, that a rehabilitation provider will continue to manage the client’s rehabilitation plan for a period of 12 months. The level of involvement from the provider is likely to change as the plan progresses whereby there would be intensive involvement in the beginning to ensure the activity is progressing well and the client is coping, and then move to more of a monitoring role.
After twelve months, for the majority of clients, it may be more appropriate to move to the plan being managed “in-house”, if this is considered to be appropriate by the delegate. This means the client will still need to provide evidence each semester that they are meeting the requirements of their apprenticeship, but there is no requirement for the involvement of a rehabilitation provider. A Rehabilitation Coordinator will need to make a judgement about case management arrangements, with an awareness of each client’s individual circumstances. If there is evidence the client would benefit from the continued involvement of a rehabilitation provider, then this can continue.
Addressing concerns with vocational rehabilitation progress
If there are issues with the person’s compliance with their rehabilitation obligations, or their capacity for rehabilitation and return to work, then the person’s rehabilitation provider should be asked to investigate this further. Appropriate investigation could include discussing issues and concerns with the person’s treating doctor or organising for the client to undertake a functional capacity evaluation with their rehabilitation service provider.
Where the client has been participating in a return-to-work rehabilitation plan with a vocational focus for more than six months, and there has been no success securing employment, the ‘Job Seeking Questionnaire’ can be used by Rehabilitation Coordinators, to seek more detailed information from providers. This questionnaire may assist in identifying any barriers to the client securing employment and any further assistance the client may require. The questionnaire is D9283 on the DVA forms portal. Where this questionnaire is completed, it must be uploaded as an attachment to the client's R&C ISH case.
DVA staff are also strongly encouraged to utilise the department’s advisers, particularly the DVA Psychology Adviser and the DVA Rehabilitation Advisers, to discuss specific cases, and to help determine a way forward for individual clients.
If it is agreed that a medical review by an independent specialist is required, then a discussion will need to occur between the incapacity delegate and the rehabilitation coordinator to decide who should liaise with both the specialist and the client about this. It is essential that a client-centric approach is taken, and that all communication with a client reinforces the department’s support in helping them achieve their return-to-work goal.
Finding a client non-compliant with their rehabilitation program should always be used as an option of last resort. Further information about making a decision to suspend compensation benefits can be found in section 13.3.2 in this library
Client undertaking a non-return to work rehabilitation plan
Where a person is not working towards an eventual return-to-work goal, then they will be on a non-return to work plan. In this case, the client will be expected to provide medical certificates of their capacity for employment. The person’s incapacity delegate is responsible for ensuring that these certificates are provided and that a new determination is made for each period of incapacity.