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Program 1.2: Veterans' Disability Support

Description

To deliver disability pensions, allowances and special purpose assistance to eligible veterans and members of the Defence Force or Peacekeeping Force under the Veterans' Entitlements Act 1986 (VEA) and related legislation. The program provides compensation to eligible veterans (including Australian merchant mariners) and members of the Defence Force or Peacekeeping Force for the tangible effects of war or defence service. Eligible persons receive disability pensions and ancillary benefits.

Delivery

Deliver disability pensions and related allowances to veterans under the VEA and related legislation by:

  • processing new claims for the disability pension
  • processing applications for assessments of disability pension rates
  • processing applications for Loss of Earnings and Recreation Allowance
  • processing repayments of medical transport and maintenance deductions
  • processing applications for Vehicle Assistance.

Disability claims

There were 14,505 primary disability claims (applications for disability pensions, applications for increases in disability pension and assessment/reviews) received in 2016–17, compared to 13,615 claims in 2015–16.

In 2016–17, 15,713 compensation conditions were determined with an acceptance rate of 59.2 percent, compared to 12,981 compensation conditions determined in 2015–16 with an acceptance rate of 62.2 percent. In addition, 1,615 applications for increases in disability pension were determined with an acceptance rate of 58.9 percent, compared to 1,467 applications in 2015–16 with an acceptance rate of 57.9 percent. The number of cases on hand at 30 June 2017 was 2,447, compared to 3,323 at 30 June 2016.

The forecast reduction in the number of disability pensioners continued, with a drop of 3.7 percent, from 92,374 at 30 June 2016 to 88,974 at 30 June 2017.

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Most frequently claimed conditions and acceptance rates

In determining the majority of liability cases, the Department refers to the Repatriation Medical Authority SOPs for the relevant condition. Table 5 details the 15 most frequently claimed conditions under the VEA, based on SOPs usage, in 2016–17. The 15 most frequently used SOPs cover 59.5 percent of the conditions determined under the VEA.

Table 5—Top 15 claimed conditions under the VEA (based on Statements of Principles) 2016–17
Disability Number
accepted
Acceptance
rate (%)
Number
not accepted
Total
Osteoarthritis 1,428 70 617 2,045
Sensorineural hearing loss 1,278 98 27 1,305
Tinnitus 1,223 98 27 1,250
Lumbar spondylosis 774 79 211 985
Posttraumatic stress disorder 389 70 165 554
Depressive disorder 262 55 211 473
Solar keratosis 469 99 4 473
Non-melanotic malignant neoplasm of the skin 435 98 8 443
Alcohol dependence 185 54 157 342
Cervical spondylosis 79 25 233 312
Rotator cuff syndrome 67 26 189 256
Sprain/strain 163 68 77 240
Fracture 144 61 91 235
Hypertension 55 24 174 229
Ischaemic heart disease 117 55 95 212
Totals 7,068 76 2,286 9,354

VEA = Veterans' Entitlements Act 1986

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Time taken to process

The mean time taken to process VEA compensation cases (including disability pension cases, applications for increases in disability pension and war widow(er)'s pension cases) in 2016–17 was 72 days, the same as in 2015–16, against a target of 75 days.

In addition, the median time taken to process VEA disability pension claims (including applications for increases in disability pension) in 2016–17 was 59 days, against a target of 100 days.

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Price

The unit cost in 2016–17 is reported as the program staff and administrative expenses (departmental) per disability pensioner. The average cost per disability pensioner in 2016–17 was $486, compared to $427 in 2015–16.

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Quality

DVA continues to work on improving performance by reinforcing policy and procedures and refining and improving staff training. Under the Improving Processing Systems Program, DVA is building a single R&C processing system. This system will include processing of VEA disability pension claims and is expected to improve the quality of transactions.

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Merit reviews

Three levels of merit review activity are open to clients under the VEA. These are:

  • section 31—where a reviewable decision is reviewed by a delegate not involved in the original decision-making process
  • section 135—where the VRB reviews a decision and a report is then prepared by DVA under section 137 of the VEA
  • section 175—where a client who is still dissatisfied with the VRB decision can appeal to the Administrative Appeals Tribunal (AAT) on certain grounds. Following receipt of an appeal by the AAT, DVA prepares a report under section 37 of the Administrative Appeals Tribunal Act 1975 (AAT Act).

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Section 31 reviews

There were 999 section 31 reviews decided in 2016–17, compared to 1,116 in 2015–16. The mean time taken to process in 2016–17 was 31 days, against a target of 40 days, compared to 18 days in 2015–16.

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VRB reports

In 2016–17, 72 percent of reports for the VRB were prepared against a target of 42 days, compared to 93 percent in 2015–16. The number of outstanding reports was 178 at 30 June 2017, compared to 165 at 30 June 2016.

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AAT Act reports

In 2016–17, 78 percent of reports for the AAT were prepared against a target of 28 days, compared to 83 percent in 2015–16.

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Finalised activity

Merit review finalised activity consists of cases completed by DVA review officers under section 31 of the VEA, and the preparation of documentation for the VRB in accordance with section 137 of the VEA and for the AAT in accordance with section 37 of the AAT Act. The total number of finalised review activities in 2016–17 was 2,861, compared to 3,247 in 2015–16.

Table 6 shows a breakdown of activity in the three levels of merit reviews under the VEA for the past three years.

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Table 6—Merit review activity under the VEA 2014–15 to 2016–17
Activity 2014–15 2015–16 2016–17
Section 31
Applications received 1,205 1,129 1,030
Days taken to process 15 18 31
Decisions 1,202 1,116 999
Affirmed 817 837 769
Varied 362 255 212
Withdrawn 23 24 18
On hand 62 75 106
Section 137 (VRB)
Applications received 2,058 1,939 1,815
Proportion of reports completed within target time frame (%) 87 93 72
Reports prepared1 2,044 2,016 1,802
On hand 242 165 178
Section 37 (AAT)
Applications received 271 195 165
Proportion of reports completed within target time frame (%) 88 83 78
Reports completed 262 206 139
On hand 32 21 47

AAT = Administrative Appeals Tribunal, VEA = Veterans' Entitlements Act 1986, VRB = Veterans' Review Board

  1. Includes reports not progressed to the VRB because the applicants withdrew their appeals.

Note: Additional detail on decisions varied by the VRB is available in the Commissions' annual reports.

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