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Factsheet HSV23 - Occupational Therapy Services

Purpose

This Factsheet describes how you can access occupational therapy services.

What is occupational therapy?

Occupational therapy can assist you with maintaining your independence in daily living activities, returning to work, and / or optimising your ability to manage psychological issues.

In order to achieve these functional outcomes, an occupational therapist may prescribe appropriate rehabilitation aids. This may include suitable assistive technology, home modifications to improve safe access, short term focussed treatment programs e.g. hand therapy, functional mobility retraining or cognitive retraining, and / or mental health treatment focussing on reaching the best possible functional outcome.

Who is eligible?

If you have a Department of Veterans' Affiars (DVA) Health Card/Veteran Card - All Conditions (Gold) or Totally & Permanently Incapacitated (Gold), DVA will pay for clinically required occupational therapy services, available through DVA arrangements. For more information please see Factsheets HSV59 — Eligibility for the DVA Health Card/Veteran Card — All Conditions (Gold) or Totally & Permanently Incapacitated (Gold) and HSV60 — Using the DVA Health Card/Veteran Card — All Conditions (Gold) or Totally & Permanently Incapacitated (Gold).

If you have a DVA Health Card/Veteran Card - Specific Conditions (White), DVA will fund clincially required occupational therapy services, available through DVA arrangements, if they are required because of an accepted war or service caused injury or disease. For more information please see Factsheet HSV61 — DVA Health Card/Veteran Card — Specific Conditions (White).

If you are an allied veteran, you are eligible for clinically required treatment of war caused disabilities accepted by your country of enlistment. Please see Factsheet HSV62 — Commonwealth and Other Allied Veterans Living in Australia for information about the services available.

How do I access this service?

You must be referred to an occupational therapist who has a Medicare provider number. A referral can be issued by a general practitioner (GP). In certain circumstances, a referral may also be issued by a medical specialist, or a health professional as part of a hospital discharge.

A referral is valid for up to 12 sessions of allied health treatment or one year, whichever ends first. This ‘treatment cycle’ aims to promote quality clinical care so that you have the best possible prospects for living a healthy life.

At the end of a treatment cycle, your occupational therapist will send a report to your usual GP. Your GP will use this report to review your progress and assess if further occupational therapy is clinically required, or whether other treatment options are needed. Your GP will provide a new referral to the occupational therapist, if it is needed.

For more information about referrals to an allied health service, visit Allied health treatment cycle.

What happens when I visit the Occupational Therapist?

Please check with your occupational therapist prior to your consultation or receiving treatment that the occupational therapist accepts DVA Card arrangements, and present your Gold or White Card at the beginning of a consultation or before you receive treatment.

The occupational therapist will assess your clinical need for occupational therapy services and provide treatment if clinically required. The occupational therapist will provide you with a copy of the treatment record for your reference.

Do I need to sign a treatment record?

Service providers can submit treatment records electronically. If this is not possible, you may be required to sign a record of treatment at the completion of each visit to ensure your treatment is covered by DVA. Before you sign, please check that the treatment record shows:

  • your name
  • your DVA file number
  • the date of treatment
  • the item number for the service provided, and
  • your accepted disability or condition for which you required occupational therapy services and/or supplies (if you are a White Card holder).

If you are unable to sign, a member of your family, or someone else who attends the appointment with you, may sign on your behalf. The occupational therapist must note that you are unable to sign.

Are there limits to the number of services I can receive?

Your occupational therapist will determine the type, number and frequency of services you require according to your assessed clinical need.

You should advise your treating occupational therapist if another occupational therapist has provided you with treatment during the previous 12 months. This will prevent your current occupational therapist from experiencing difficulties in claiming payment for services provided to you.

Do I need to pay for treatment?

You should confirm prior to your appointment that the occupational therapist will accept your DVA Gold or White card for full payment of their services and will bill DVA directly for any care provided to you under DVA arrangements. This will ensure you do not incur any out of pocket expenses.

Can I choose to be treated as a Medicare or private patient?

Yes, you can choose to be treated as a Medicare or private patient. However, if you choose one of these options, DVA will not pay for any services that have been paid in part or full by Medicare, private health insurance or a third party compensation benefit.

More Information

DVA General Enquiries

Phone: 1800 555 254 *

Email: GeneralEnquiries@dva.gov.au

DVA Website: www.dva.gov.au

Factsheet Website: www.dva.gov.au/factsheets

* Calls from mobile phones and pay phones may incur additional charges.

Related Factsheets

Disclaimer

The information contained in this Factsheet is general in nature and does not take into account individual circumstances. You should not make important decisions, such as those that affect your financial or lifestyle position on the basis of information contained in this Factsheet. Where you are required to lodge a written claim for a benefit, you must take full responsibility for your decisions prior to the written claim being determined. You should seek confirmation in writing of any oral advice you receive from DVA.

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17 October 2019