Directorate of ADF Rehabilitation Services

Frequently Asked Questions

1. What is the relevant Defence Instruction that addresses the ADF Rehabilitation Program?

2. Who is eligible for rehabilitation under the ADF Rehabilitation Program?

3. What are the three goals of the ADF Rehabilitation Program?

4. How is a rehabilitation assessment initiated/triggered?

5. Does an assessment automatically lead to a Rehabilitation Plan?

6. What is the role of the member?

7. What is the role of the Rehabilitation Coordinator?

8. What is the role of the Program Case Manager (PCM)?

9. What is the role of the Unit Rehabilitation Liaison Officer (URLO)?

10. What is the role of the Workplace Rehabilitation Representative (WRR)?

11. How are privacy and in-confidence issues managed within the ADF Rehabilitation Program?

12. What are member's entitlements on re-considerations of rehabilitation determinations?

13. How does the ADF Rehabilitation Program interact with the Medical Employment Classification Review (MECR) process?

14. Will CO's be informed when one of their members submits a request for Rehabilitation Assessment?

15. How does a member make a compensation claim?

16. The member is due to medically discharge soon and I am wondering if there is any opportunity for the rehab plan to be extended post discharge for 1 mth (or until claim is accepted) to provide that additional support.

17. When we are indicating date of injury (DOI) can you advise if you want to know the original injury date or most recent aggravation date?

Program Case Manager- PCM's

PCM1: When should we send you the paperwork? What about accounts?

PCM2 : What goal should I be recording on the Plan?

PCM3: What should we put down in "PCM services" (part 6) of the Plan?

PCM4: I think this member should be referred to a specialist / needs a gym membership / isn't having appropriate medical treatment / should see Dr X, etc. Should I put this down in the plan?

PCM5: What should the process be for ergonomic recommendations?

PCM6: We sent you guys a plan for Corporal Bloggs ages ago. We haven't heard anything back. What's happening, and what do we do in the interim?

PCM7: How do I organise Vocational Assessments and Functional Capacity Evaluations?

PCM8: I sent in my account ages ago and I haven't been paid yet. What's going on?

PCM9: Do I need to attend the assessment the member has with the MO?

PCM10: This member's all fine. Do I need to develop a plan?

PCM11: I contacted the URLO/WRR/member/MO and they're not available until next Wednesday. I am concerned this will impact on timelines.

PCM12: It's not just that they're not available - but I just can't get on to the URLO/WRR/member/MO. What do I do?

1. What is the relevant Defence Instruction that addresses the ADF Rehabilitation Program?

DI(G) PERS 16-22 The Australian Defence Force Rehabilitation Program.

2. Who is eligible for rehabilitation under the ADF Rehabilitation Program?

DI(G) PERS 16-1 Health Care to Australian Defence Force Personnel defines the health care entitlements of serving personnel. Health care, in this context, encompasses a spectrum of services that extends from emergency care through to the provision of rehabilitation. A member must be eligible for health care in accordance with DI(G) PERS 16-1 Health Care to Australian Defence Force Personnel to be eligible for rehabilitation services within the ADFRP. Eligibility conditions are also prescribed in annex A to DI(G) PERS 16-22.

3. What are the three goals of the ADF Rehabilitation Program?

The three goals of the ADF Rehabilitation Program (in priority order) are: (1) (Goal 1) Fit for duty in the pre injury/illness work environment. (2) (Goal 2) Fit for alternative duty in the ADF. (3) (Goal 3) Transition out of the ADF.

4. How is a rehabilitation assessment initiated/triggered?

The requirement for a Rehabilitation Assessment is triggered when: (1) the treating medical officer recommends an assessment due to the nature of the injury or illness, or (2) the member requests an assessment, or (3) the member's commander requests an assessment, or (4) the treating medical officer places the member on medical restrictions, absence due to illness, or absence due to convalescence, for a period greater than 28 days, or (5) the Rehabilitation Coordinator receives advice from the Department of Veterans' Affairs (DVA) that a needs assessment has identified the requirement for a rehabilitation assessment to be conducted.

5. Does an assessment automatically lead to a Rehabilitation Plan?

No. A Rehabilitation Plan is developed only where the need for rehabilitation is identified through the assessment.

6. What is the role of the member?

ADF members have a responsibility under the Occupational Health and Safety (Commonwealth Employment) Act 1991 to report any change of circumstances that may impact on their performance in the workplace. Members are to actively participate in a Rehabilitation Assessment and Rehabilitation Plan when required. Failure on a member's part to so participate can result in various sanctions: disciplinary; administrative; and/or prejudice compensation outcomes. Members who consider their injury or illness is related to their ADF service are entitled to lodge a compensation claim. The ADFRP supports the lodging of compensation claims as soon as possible after the date of injury or the date on which the illness becomes apparent. This should also include completing an AC 563.

7. What is the role of the Rehabilitation Coordinator?

Rehabilitation Coordinators are responsible for ensuring the coordination of the Rehabilitation Assessment and the Rehabilitation Plan once the rehabilitation process is triggered, and for the appointment of a Program Case Manager if required. Rehabilitation Coordinators may be authorised to exercise the powers and functions of the Rehabilitation Authority as delegated by the Service Chiefs.

8. What is the role of the Program Case Manager (PCM)?

A person or company accredited to provide return to work case management services and tasked by the Rehabilitation Coordinator under contract to Defence. These services include assistance to individual members in preparing Member's Health Statements and to commanders in preparing Workplace Disability Reports.

9. What is the role of the Unit Rehabilitation Liaison Officer (URLO)?

Provide liaison between the Program Case Manager and the member's Unit.

10. What is the role of the Workplace Rehabilitation Representative (WRR)?

Provide advice to the PCM on a member's workplace environment & immediate employment options.

11. How are privacy and in-confidence issues managed within the ADF Rehabilitation Program?

The PCM will explain privacy issues to the member and provide a Form PM543 - Medical Consent and Release Authority, which authorises the release of medical information. This medical information will be used by the PCM and RC to formulate and administer a Rehabilitation Plan, if required. The member is not obligated to complete the Medical Release Authority. In the case where a member does not wish to sign the authority, decisions regarding the member's ability to undertake a Rehabilitation Plan will need to be based on the available information.

12. What are member's entitlements on re-considerations of rehabilitation determinations?

If a member is dissatisfied with their Rehabilitation Plan, or with any decision that has been made to vary or cease it, they have the right to request a formal reconsideration or review. The avenues available for reconsideration or review depend on which legislation applies. The immediate action is to raise the matter through the chain of command.

13. How does the ADF Rehabilitation Program interact with the Medical Employment Classification Review (MECR) process?

The MECR process will proceed concurrently with the rehabilitation plan. A function of the rehabilitation plan will be to inform the MECR process of an individual's prognosis and progress towards the agreed goal under the Rehabilitation Plan.

14. Will CO's be informed when one of their members submits a request for Rehabilitation Assessment?

Yes. As part of the process the RC will notify the member's URLO, who in turn will be responsible for notifying the chain of command.

15. How does a member make a compensation claim?

During the Rehabilitation Assessment process, the PCM is to provide the member with information regarding compensation, claim procedures and contact details. The PCM is to also provide the member with a checklist for submitting a claim. To make a claim the member must complete the appropriate claim form/s. The claim form/s are available from the RC. The form/s are then forwarded to the local DVA office; the member can give the claim form to the PCM for submission to DVA, through the RC.

16. The member is due to medically discharge soon and I am wondering if there is any opportunity for the rehab plan to be extended post discharge for 1 mth (or until claim is accepted) to provide that additional support?

Unfortunately, there is no entitlement for the member to access ADFRP post discharge. However, what about requesting the member's commander to approach the Career Adviser to defer the discharge date?

17. When we are indicating date of injury (DOI) can you advise if you want to know the original injury date or most recent aggravation date?

The DOI is the most relevant one. If the condition is an old injury (to which is being self managed) but an aggravation causes a period of incapacity or impairment then it would be the aggravation. In short, the DOI should be the date of what caused the member to be referred.

PCM1: When should we send you the paperwork? What about accounts?

We would prefer that the paperwork for a case is sent to us as a package when the Plan has been developed. So send us the Part 2 member interview, Part 3 supervisor interview, Part 4 doctor's information, and the Part 5 plan all together at the same time. This reduces the risk of us losing information. When you send the plan to us, make sure you have obtained (or sought) the signatures of the stakeholders listed at the bottom of the Part 5 form. If you have difficulty obtaining signatures or people refuse to sign, that's fine, please let us know. Signature requests shouldn't be a means to delay things too much. Also as you have been (initially) contracted and have provided costings up to developing the plan, this is the preferred time to provide your itemised account. That way it is easy for us to distinguish between costings/invoicing relating to 1. assessment /plan development and 2. on-going plan management.

PCM2 : What goal should I be recording on the Plan?

Remember the goals are aspirational so the plan goal should be looking to the best outcome. For example if it is not clear (eg member awaiting further review) then the initial goal should be Goal 1. Only when there is definitive medical information should you then be looking at Goals 2 or 3. So when developing a plan it may start out as Goal 1 then possibly be reviewed and amended to a Goal 2 or 3 when more is confirmed (eg MEC review board outcome).

PCM3: What should we put down in "PCM services" (part 6) of the Plan?

The Statement of Work document that outlines the contractual basis for services between PCMs and Defence contains a number of enclosures. Enclosure 2.1 provides for several different lines to be included as standard items in each plan. The first two ("Conduct informal weekly reviews" and "produce and email reports for monthly case reviews") can be bundled together if preferred and a maximum of 2 hours and 20 minutes per calendar month can be forecast for this combination. The statement of work also provides for a number of other circumstances - allowing you an additional 40 minutes per case per occasion (plus travel) if you are required to attend a case review as part of the local area's case management process (some have them, some don't), as well as an additional one hour per case per occasion (plus travel) if you are required to attend the workplace again due to an upgrade/downgrade of the person's hours (eg on a graduated return to work and increasing from modified to normal duties, or increasing hours, etc). So for a Goal 1 case, part 6 of the Plan form may contain lines looking something like this for a 2-month duration plan: * Ongoing case management (2 hrs 20 mins per month; 4 hrs 40 mins total, by hourly rate) * Participate in case reviews (as required; 40 minutes per occasion) * Participate in formal change of duties reviews (as required; 1 hour per occasion) * Travel (as required) Goals 2 and 3 may require additional lines for vocational and functional capacity evaluations.

PCM4: I think this member should be referred to a specialist / needs a gym membership / isn't having appropriate medical treatment / should see Dr X, etc. Should I put this down in the plan?

You will notice that the ADFRP has a fairly narrow focus, probably far less broad than the work you do for other organisations. The PCM's role is to 'walk with' the member until they reach the goal determined. Additional medical treatment, etc, is not the role of the PCM to organise. Part 5 of the Plan form allows you to record "concurrent services" which would normally be implemented by the Medical Officer (MO). However, it is the MO's call as to whether these things are appropriate. The only exception really is ergonomic items (see next question). Note that part of the narrow focus of the ADFRP is that we only really have funding for PCM services. Any other services, such as gym membership, other medical treatment, must come out of the medical budget, not the ADFRP.

PCM5: What should the process be for ergonomic recommendations?

The first part of the assessment process under the ADFRP is the 'situational assessment' in which you see the member in their current location, discuss their medical situation, and consider if you believe any modifications are required to the member's work set-up. If as a result of this situational assessment you believe that a member requires additional back support through a new or modified chair, or requires additional workplace ergonomic items, then you should discuss this with the member at this time. You should also discuss this with the workplace rehabiltiation representative (WRR - supervisor). OHS requires that workplaces have a responsibility to provide a safe working environment for their staff. This includes the provision of 'reasonable adjustment items' for the member. If a member needs a chair, monitor riser, whatever, due to their medical condition, then in the first instance you must discuss this with the WRR and inform the WRR that it will be up to the business unit to organise and obtain the recommended items. Defence has 'preferred provider' arrangements with some companies, so stationery items such as monitor risers, etc, will need to be obtained by the WRR through Corporate Express. The provision to the supervisor of the Corporate Express order number would assist here. As you can see, we are placing you as the PCM as the authority for determing whether ergonomic items are necessary and appropraite. We expect you to only recommend items if, medically, they are required. We do not expect you to acceed to 'shopping lists' put forward by staff, but to use your professional judgement to determine what is appropriate, and talk to the member about this. You will also need to discuss these requirements with the supervisor, as they will be paying for these items in most cases. If there are issues regarding the supply of recommended items, this needs to be resolved between the PCM, the supervisor, and the employee. The ADFRP is NOT funded to provide furniture or office consumables to workplaces. Our funding only pays for PCMs. These ergonomic items and their provision should be noted in the member interview (part 2) part of the paperwork. The provision of these items should also be listed in the 'concurrent service' section of the Plan. We are not specifically requiring that these ergonomic items need to be approved by the MO. Part of your role in continuing to manage the case after the plan is approved should be to ensure these items are obtained and the chairs, etc are appropriately adjusted for the member's use. However, if it becomes clear that these items will not be provided because the WRR does not take action, then this should not be a reason to continue to leave the case open indefinitely.

PCM6: We sent you guys a plan for Corporal Bloggs ages ago. We haven't heard anything back. What's happening, and what do we do in the interim?

We have been bombarded with paperwork here. Our first priority has been to get cases actually referred to PCMs so that some professional assistance can be provided to them. This has meant that examination of rehabilitation plans has not occurred as expeditiously as we would have liked. Our aim in the longer term is to ensure that all paperwork and plans sent to us are dealt with within a week. At this stage, we are well off this mark. We have put in place measures to ensure we deal with work more speedily in future, however delays will continue for some time yet. Because of the narrow focus of the plans and the program, 99% of plans will be uncontroversial and so the delay in signing-off a plan should not cause too many issues. In these cases, please assume that we will approve the plan and you can go ahead and continue to manage the person, including undertaking case monitoring, case reviews, travel, chasing ergonomic items, etc. However, where there are more fundamental determinations to be made - for example that the person should be Goal 2 or Goal 3 and requires assessments to occur, these cannot occur until we actually determine that the person is appropriately a Goal 2 or Goal 3.

PCM7: How do I organise Vocational Assessments and Functional Capacity Evaluations?

If a person is determined to be a Goal 2 or Goal 3 following our approval of the Plan, Vocational Assessments and Functional Capacity Evaluations may need to occur. Depending on the status of other processes (such as MECRB occurring), these assessments may already have taken place or have been organised. You will need to find out from the MO or medical section what the status of this is. Our understanding of Vocational Assessments at this stage is that if a member is to be a Goal 2, the VA would be undertaken by Defence's in-house Psychological Services. In Goal 3 cases, the PCM organisation (remember, not the actual provider) would organise the VA. Frankly, we are not too sure regarding the situation with FCEs however as a general rule if services are provided by Defence in-house, then we must utilise these services.

PCM8: I sent in my account ages ago and I haven't been paid yet. What's going on?

Yes, we are currently a little behind with accounts. We are currently going through these and hope to have the backlog sorted in the near future. Our goal again would be to process these within a week of receipt. Be aware that after we approve the accounts, they still need to be entered into the Department's account paying systems so payment will not be immediate, and that Defence has a '30-day' payment policy. ** Also, eventually we hope to be able to pay you using a Defence credit card, which is a Diner's Club card. So, to get this process started, would you please let us know if you are currently able to accept payments this way, and if not, are you able to make the necessary arrangements to become a Diner's Club merchant?

PCM9: Do I need to attend the assessment the member has with the MO?

The PCM manual indicates that yes you should. HOWEVER, on this occasion only we are saying you should disregard the manual on this point! WE have clarified with Canberra that this is not required. You do not need to attend the assessment with the member. What you need to do is to complete Parts 2 and 3 of the program (member and WRR interview), and then contact the MO to arrange an appointment for the assessment of the member. You should let the member know when this appointment is to occur. You should then forward the paperwork to the MO for them to complete Part 4. The emphasis is to progress the case, and get the plan happening.

PCM10: This member's all fine. Do I need to develop a plan?

Let's say your case is a member who was referred because they had 28 days of restrictions due to a strained muscle and they couldn't do physical training, but by the time you're called in to the case the member has recovered and they have no restrictions whatsoever. No ongoing support is required as they will be a Goal 1 and they have already achieved the Goal 1 outcome. You will still need to talk to the stakeholders (member, WRR, MO) to get Parts 2, 3 and 4 completed, to confirm that this is the case. When it comes to the actual plan documentation, identify the person as Goal 1, state the reasons for this, and you can then basically write "not applicable" on all the other sections. In this case and in this case only, don't worry about getting signatures - only put your own, and then submit it to us, together with a completed closure form. The reason for this bureaucratic process is that we need to actually approve the person as being the appropriate Goal before it can be closed. The only way to identify the Goal is through the plan paperwork, hence the need for this to be completed.

PCM11: I contacted the URLO/WRR/member/MO and they're not available until next Wednesday. I am concerned this will impact on timelines.

Your role as a PCM is to move the case forward and develop a plan. At a minimum this requires you to meet with the member, meet with the WRR, and arrange for the member to be seen by the MO. If these stakeholders are not available and no substitutes are available, then this could seriously hold-up the process. However, we are only holding you accountable for delays within your control and we understand that there are circumstances where you will not be able to meet the timelines described in the Statement of Work.

PCM12: It's not just that they're not available - but I just can't get on to the URLO/WRR/member/MO. What do I do?

Again, the emphasis is getting the case moving. In such a situation, it may be necessary for you to contact the member directly rather than through the URLO, and obtain the supervisor's details from the member. If it is necessary to do this, please ensure that the URLO is advised - either via phone message or preferably email. This way key stakeholders are aware that an assessment is occurring. If you need additional contact details for members, or you're having trouble, please contact us.

23 September, 2008