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Accelerated Access to Rehabilitation Pilot

Frequently Asked Questions

The Department of Veterans’ Affairs (DVA) will be commencing a new initiative that will enable approximately 100 DVA clients with entitlements under the Military Rehabilitation and Compensation Act 2004 (MRCA) to be referred for a whole-of-person rehabilitation assessment and development of a rehabilitation plan before their claim for liability is accepted. In some circumstances, such as when a person has urgent rehabilitation needs, or is judged to be “at risk” because of their health conditions, a limited range of rehabilitation activities may also commence prior to the claim for liability being finalised.

Timing

The pilot will run for approximately six months and will be evaluated at the end of this period.

Background

Participation in the pilot is voluntary. For those participating in this initiative, it will mean that once liability is accepted, the client can immediately implement the rehabilitation plan which has been developed, rather than having to wait for liability to be accepted.

Early intervention has shown to significantly improve the probability of returning to work, can prevent long-term dependence on benefits, and improve overall quality of life. Accelerated access for rehabilitation generates momentum for the client to set their rehabilitation goals, focus on their future and assist them with their transition to civilian life.  

Background and Eligibility

Why is the pilot being undertaken?

Early intervention is regarded as a best practice approach to rehabilitation. Early access to rehabilitation helps to facilitate participation in employment and community, improved quality of life and a focus on recovering wellbeing from the earliest opportunity. 

There is a growing body of evidence which shows that the longer a person is out of work, or disengaged from their community, friends or family, the greater the time it takes for them to return to employment and lead a productive and meaningful life.

Assessing a claim for liability can take time, and for complex claims, where for example, a diagnosis is not finalised, this can take even longer. This may result in a delay in the individual being able to think about and define their rehabilitation goals, focus on the future and transition to civilian life.

What benefit will the pilot have for the client?

Clients who choose to participate in this pilot will be assessed for rehabilitation once their claim for liability is lodged, and they can develop their rehabilitation plan.

This pilot brings forward the clients’ rehabilitation assessment and rehabilitation planning. This will enable them to commence implementing the activities outlined in their rehabilitation plan once their claim for liability of an injury or illness, is accepted. Usually, the rehabilitation assessment and planning takes place after liability is accepted, so it is expected that this pilot will see clients being able to access services earlier.

Important Information

It is essential that veterans and their families understand that participation in the accelerated access to rehabilitation program does not influence the result of their claim for liability.  That is, participation does not automatically result in liability being accepted.

Who is eligible for the pilot?

Participation in the scheme is voluntary and available for clients lodging a claim for certain conditions under the MRCA. Veterans who wish to participate in the pilot must:

  • have lodged a claim for initial liability for either one or more specified conditions;
  • be regarded as being likely to benefit from participation in an accelerated access to rehabilitation program; and
  • provide their consent to participate in the accelerated access to rehabilitation program.

It is important that veterans understand that the accelerated access to rehabilitation program provides an opportunity for veterans to identify and discuss their rehabilitation goals earlier and if appropriate, commence a limited number of specific rehabilitation activities. The veteran’s motivation and willingness to participate will therefore be paramount. If either the Rehabilitation Coordinator or the Rehabilitation Consultant question whether the client should participate, then both parties should discuss and consider whether the second criterion has in fact been met: is the client “likely to benefit from participation in an early access to rehabilitation program”.

What informed the eligibility criteria which were chosen?

The 20 specified physical health conditions are most commonly related to service in the ADF and claimed by veterans. This means that it is more likely that veterans with these conditions may have their claims for liability accepted. The 5 specified mental health conditions were those covered by the Non-Liability Health Care Arrangements prior to 1 July 2017.

Changes for Providers

What will change for rehabilitation consultants?

Overall, there is no change in processes for rehabilitation consultants, except that the rehabilitation plan assessment and development of the plan will commence at an earlier point.  However, rehabilitation consultants will be required to carefully manage client expectations and provide assistance to refer the client to an appropriate organisation should their claim for liability be denied.  Further information about managing client expectations and client referrals is addressed in more detail later in this document and in the policy guidelines.

The pilot brings forward the clients’ rehabilitation assessment and rehabilitation planning. This will enable the client to commence implementing the activities outlined in their rehabilitation plan once their claim for liability of an injury or illness, is accepted.

Usually, the rehabilitation assessment and planning takes place after liability is accepted, so it is expected that this pilot will see the client being able to access services earlier. The evaluation of the pilot will examine whether this helps to improve rehabilitation outcomes.

Who will advise as to whether a client is suitable for the pilot?

The DVA Rehabilitation Co-ordinator will identify whether the client may suitable for the pilot and will then ask the client whether they would like to participate. The DVA Co-ordinator will first assess the information from the client’s pre-liability needs assessment or their social worker initiated psychosocial assessment to determine if the client may be suitable for participation in the pilot.

Will DVA Co-ordinators continue to refer clients even if initial liability is pending?

Yes. DVA Co-Ordinators will continue to have the discretion to refer clients for a rehabilitation assessment prior to DVA accepting their claim for liability, as long as they are satisfied that the person is likely to benefit from participation in accelerated access to rehabilitation.

What other services will clients have access to?

Participation in the accelerated access to rehabilitation pilot will not impact in any way on a client’s ability to access the Non-Liability Health Care (NLHC) arrangements. This means that veterans can access treatment for a range of conditions without the need to establish a link to their ADF service.

Referencing these conditions helps to ensure that veterans with commonly occurring mental health conditions are able to get support through either a DVA rehabilitation program, or a community based rehabilitation program.

What happens when liability is accepted by DVA?

Once liability has been accepted, the client will then be able to commence implementing the plan they have already developed.

What happens if the claim for liability is disallowed?

Should the client have their liability claim disallowed, then the rehabilitation provider will be required to refer the client to another government or community based provider with the appropriate skills, qualifications and experience to support them with the services identified in the rehabilitation plan. 

The rehabilitation provider must not close the client’s rehabilitation case until all referrals to the relevant services have been completed and if possible, a hand-over has occurred. In such circumstances, DVA will cover case management costs including the rehabilitation assessment and development of the rehabilitation plan, and other agreed transition costs, until the client has been referred to another provider.

The rehabilitation company I work with provides services on behalf of other government or community based organisations – can I continue with the client if their claim is denied?

Yes - If your rehabilitation company is able to arrange alternative funding for the services required by the client.

Whose responsibility is it to manage the expectations of the client?

The DVA Rehabilitation Co-Ordinator and Rehabilitation Consultant need to carefully manage the expectations of the client, especially when developing the activities in the rehabilitation plan including the associated cost. 

The Rehabilitation Plan may need to be referred to a different provider

Rehabilitation Consultants must keep in mind that DVA can support a broad range of rehabilitation activities, however the same activities may not necessarily be covered by community based rehabilitation programs.

Therefore, it will be essential that the veteran and their family clearly understand the services provided by DVA may be different than those provided by another government agency or community based organisation, should their liability claim be disallowed and a referral to a different provider becomes necessary.

The pilot does not influence the outcome of the liability claim

It is also important that the veteran and their family understand that an early referral for a rehabilitation assessment and development of a rehabilitation plan does not influence whether DVA will accept their claim for liability of an injury or illness.

How may urgent needs be addressed during the pilot?

At present, as soon as a client lodges a claim for liability under the MRCA, they are contacted by a social worker who conducts a psychosocial assessment. When any urgent needs are identified that place the client “at risk”, such as financial or housing vulnerability, risk of suicide or self-harm, drug or alcohol use or other issues, a referral is made to a community based provider. This helps to ensure that the person receives urgent assistance while their claim for liability is being determined.

During the accelerated access to rehabilitation pilot, the social worker will make a decision about whether the person may benefit from receiving support from DVA instead. They will discuss the client’s needs with a DVA rehabilitation team, who will make a decision about whether the client is eligible to participate in the pilot, or whether they may need to prioritise treatment or other needs first.  Once a referral to a rehabilitation provider has been made and it is identified that the client has urgent needs, the provider should, with consent from the veteran, discuss the best way of supporting the veteran during the pre-liability period with the rehabilitation pilot program manager.

What will be evaluated at the completion of the pilot after 6 months?

After the pilot is complete, an evaluation will occur. This will help DVA to ascertain whether veterans benefited from having earlier access to rehabilitation supports. A range of data for all participants will be evaluated from the pilot. These include, but not be limited to:

  • the average time for veterans on the pilot to access rehabilitation services following the submission of a claim for liability;
  • the percentage of rehabilitation cases closed within six months of claim for liability because the client has reached their rehabilitation goals,  for clients participating in the pilot, compared to a control group;
  • the percentage of clients who received rehabilitation services through the accelerated access to rehabilitation pilot whose claims for liability were disallowed; and
  • outcomes of Goal Attainment Scaling scores between pilot participants and an equivalent number of veterans who did not participate in the pilot.

Where can you find further information?

More information is available about the Accelerated Access Pilot on the DVA website and the Rehabilitation Policy Guidelines.

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