Treating doctor – information for providers
Use of the treating doctor for DVA compensation claim assessments
Key points at a glance
- The term ‘treating doctor’ refers to both GPs and non-GP specialists
- A treating doctor is a practitioner with an established relationship with a veteran who has seen them at least twice in the last 24 months
- DVA prefers the use of the treating doctor for compensation assessments
If you're a member of the veteran community, go to Treating doctor – information for veterans.
DVA’s definition of a treating doctor
A treating doctor is a medical practitioner (or practice) involved in the management of a veteran’s condition(s) prior to claim lodgement and has established a clinical relationship with the patient. This is demonstrated through continuity of care, and is based on the MyMedicare criteria.
For GPs: this means 2 or more face-to-face appointments with the practice within the past 24 months, or one face-to-face visit for practices in remote locations (MM6 and 7).
For non-GP specialists: a medical practitioner who has provided or is currently providing clinical treatment of the veteran’s claimed condition. This may be demonstrated by 2 or more appointments within the past 24 months.
Why DVA prefers the treating doctor
For compensation assessments, DVA needs medical information that is clinically sound and relevant to the veteran’s claimed condition. In many cases, the most useful information comes from the doctor who already knows the veteran, their medical history and the treatment being provided.
Where possible, DVA prefers information for compensation claims to come from the veteran’s treating doctor. This can support:
- clinical information based on an established therapeutic relationship and existing records
- better continuity between the compensation process and the veteran’s ongoing treatment
- less duplication of appointments, investigations and history taking where appropriate
- more efficient follow-up where the claims process identifies additional care needs
Use of the treating doctor is preferred, but not compulsory
While DVA prefers that compensation claims are completed by a veteran’s treating doctor, veterans can generally choose who to see for their compensation assessment.
This approach acknowledges that some veterans may not have access to a treating doctor who is willing to complete the assessment or may not have a treating doctor who meets the definition, such as those veterans who have recently transitioned from the ADF.
In some circumstances, based on the specific features of the claim, DVA may still need to seek additional information from the treating doctor or via an Independent Medical Assessment.
Provider FAQs
DVA prefers reports from a veteran’s treating doctor because, in most cases, they are best placed to provide clinically relevant information about the veteran’s condition, treatment and progress over time. A practitioner with an established therapeutic relationship can often draw on existing clinical knowledge and records to provide the information required for compensation assessment.
This approach can reduce unnecessary duplication of appointments, investigations and history taking, while also supporting continuity between the compensation process and the veteran’s ongoing care. It may also assist with timely follow-up where the assessment process identifies additional treatment or management needs. Doctors do not need to be a specialist in military or veteran health to complete DVA compensation paperwork; what is required is a good clinical assessment.
We use this definition for GPs because it is already widely known and understood by GPs. It is important to note that while we have used the MyMedicare definition, DVA does not require registration with MyMedicare.
While non-GP specialists are not covered by MyMedicare, it is likely that a treating Specialist will meet the same criteria of having 2 appointments within the prior 24 months. Some specialists, e.g. psychiatrists, may conduct many of their appointments via telehealth and this is accommodated for in the DVA definition.
For the purposes of meeting the definition, Garrison Health is considered a medical practice and would satisfy the criteria of a treating doctor if the member has been assessed two or more times within a 24-month period (which would be expected). However, serving members may nominate another provider to complete their assessment.
Serving members should be aware that the MRCA legislation requires that all Liability and Permanent Impairment determinations are provided to Chief of the Defence Force regardless of who completes the assessment.
Yes, veterans can generally choose the medical practitioner to complete their liability and permanent impairment assessments. There may also be occasions, based on the features of the claim, when an Independent Medical Assessment will need be arranged.
DVA prefers reports from a veteran’s regular treating doctor because we believe this provides the best care for the veteran and the best information for a compensation claim. However, we recognise that not all veterans have a regular treating doctor, and not all doctors want to complete DVA reports. We will not refuse a report solely because the doctor does not meet the DVA definition of a treating doctor. However, in some cases DVA will not pay for or accept reports from certain providers, for example, where there is an established history of unsatisfactory reports, integrity concerns or the appointment type is not suitable for the information required.
No. While DVA has used the MyMedicare definition for GPs, the definition is not linked to MyMedicare registration. Any medical practitioner can complete a Request for Information from DVA as part of a liability or permanent impairment assessment process, irrespective of their registration with MyMedicare.
No. A veteran can continue with a MyMedicare enrolment with their regular GP and also have DVA assessments undertaken via another provider. Veterans are encouraged not to change their preferred MyMedicare provider purely for claim assessment purposes.