Exceptional Cases (EC)
Some of our clients have health care needs that are not covered in the Schedule of Fees. We assess these as Exceptional Cases to make sure they get the community nursing (CN) services they need.
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Exceptional Case requirements
Effective 1 July 2021, prior approval must be sought from DVA through the EC process and EC approval given before the commencement of care outside of the Schedule of Fees.
Where urgent circumstances apply in regard to the commencement of care, the CN provider can contact DVA via secure email to outline these special circumstances. At DVA’s discretion, one off approval can be granted for up to ten working days to provide EC care without a comprehensive EC application. DVA will provide this approval in writing. Where this approval is granted, the CN provider is required to submit the EC application within two business days for assessment and processing by DVA.
Application submission is via DVA secure email
Please contact exceptional.cases [at] dva.gov.au to set up secure email facilities and refer to the DVA sensitive emails webpage for further information.
Refer to Attachment A – Exceptional Case process in the Notes for Community Nursing Providers for further information.Back to top
Exceptional Case applications
Complete D1004 - Application for Exceptional Case Status form.
Attach all required documents as detailed in the EC form.
Complete the relevant attachment if required:
- D1004A - Attachment 1 — Dementia / Short Term Memory Loss/ Confusion
- D1004B - Attachment 2 — Mental Health (Depression/ Anxiety/ Posttraumatic Stress Disorder/ Alcohol and Substance Misuse)
- D1004C - Attachment 3 — Palliative Care (End of Life/ Metastatic Cancer/ Non-Malignant Palliative Care)
- D1004D - Attachment 4 — Wound Care
Where possible, please submit the EC application and any attachments electronically. If this form is completed manually, email a scanned copy of the original signed EC application form and EC attachments as photocopies of these are not accepted.
Applications are to be submitted via secure email to exceptional.cases [at] dva.gov.au.Back to top
Variations or Interruptions to care
You need to let us know when there is a variation or interruption to a client's care. To do this use the relevant D1307 Exceptional Case – Variation or D9384 Exceptional Case – Interruption to Care form. Refer to the Notes for Community Nursing Providers for further information.Back to top
Request for reimbursement of nursing consumables
You may apply for funding for nursing consumables that cost more than $1000 by completing the D9297 Exceptional Case — Request for Reimbursement of Nursing Consumables over $1,000 form. We have more information about this in our Notes for Community Nursing Providers.Back to top