Application for Exceptional Case Status
Applications for Exceptional Case Status must be completed on the 'Application for Exceptional Case Status' form with Attachments where required.
The Exceptional Case Unit (ECU) requires the original signed exceptional case status forms to be able to assess exceptional case status. Photocopies of the exceptional case status forms are not acceptable as they may be difficult to read and interpret.
Relevant attachments should be completed with an application, interruption to care, or variation, if required:
- Attachment 1 — Dementia / Short Term Memory Loss/ Confusion (D1004A) (PDF 256 KB)
- Attachment 2 — Mental Health (Depression/ Anxiety/ Posttraumatic Stress Disorder/ Alcohol and Substance Misuse) (D1004B) (PDF 501 KB)
- Attachment 3 — Palliative Care (End of Life/ Metastatic Cancer/ Non-Malignant Palliative Care) (D1004C) (PDF 358 KB)
- Attachment 4 — Wound Care (D1004D) (PDF 797 KB)
Application for additional travel for exceptional case status or schedule fees
(For claim periods commencing in 2018. Reimbursement for additional travel for periods commencing on or after 1 January 2019 to be claimed through the Schedule of Fees).
Variation or Interruption to Care
Second worker
(For claim periods commencing in 2018. Reimbursement for second workers for periods commencing on or after 1 January 2019 to be claimed through the Schedule of Fees).
Palliative Care
(For claim periods commencing in 2018. Reimbursement for overnight care for periods commencing on or after 1 January 2019 to be claimed through the Schedule of Fees).
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