The role of DVA in providing assistance to Reservists
MAJGEN Liz Cosson (Retd)
Deputy Secretary/Chief Operating Officer, Department of Veterans’ Affairs
The DVA budget for 2017/18 is $11.3 billion of which $5.9 billion is allocated to income support and compensation and $4.9 billion is allocated to Health services. There are an estimated 320,000 veterans of whom about 50% are DVA clients, and of some of these clients are Reservists. As you would be aware, DVA administers a range of legislation that also affects eligibility. Today my focus will be on the services and support provided for Reservists under the Military Rehabilitation and Compensation Act 2004 (MRCA). All members of the Navy, Army and Air Force Reserves with service on or after 1 July 2004 are covered under the MRCA, whether they are on part-time service or continuous full-time service.
DVA Support entitlements
Under the Military Rehabilitation and Compensation Act 2004 (MRCA) Reservists are entitled to the same support as full-time ADF, if they suffer injury, disease or death that was:
- Sustained while travelling between a member’s place of residence and place of employment, including Reserve parades, camps etc; or
- Materially contributed to or aggravated by Reserve service.
This support includes:
- Compensation and income support payments
- Gold card eligibility
- Compensation for dependants
- Rehabilitation services through Defence or DVA
Range of Services and Support to Reservists
In general terms, all ADF members can receive the same range of benefits and support. However, eligibility is dependent on the type of Reserve service. The Government, through DVA, provides a range of services and support to Reservists who have suffered a loss that is directly related to an accepted service injury or illness. These Services and support include:
- permanent impairment payments
- incapacity payments
- household services
- attendant care
- aids and modifications
- access to VVCS
- access to the Military Rehabilitation and Compensation Act 2004 (MRCA) Education and Training Scheme; and
- vocational rehabilitation.
The MRCA also provides a range of benefits, depending on particular circumstances and needs of the person. Where compensation is payable, a needs assessment is conducted so that the Reservist receives all the benefits to which they are entitled. Compensation for dependants may also be provided in the event of a Reservist’s death. Regardless of the circumstances of the Reservist’s death, compensation for funeral costs may also be available.
Compensation and Income Support
The MRCA covers all ADF service (including Reserve) from 1 July 2004. Reserve service prior to this is covered by the SRCA. Reservists are covered for injury, disease or death: sustained while travelling between a member’s place of residence and place of employment, including Reserve parades, camps, etc; to which Reserve service on or after 1 July 2004 has made a material contribution or that was aggravated by Reserve service.
Under the MRCA, all ADF members can receive the same range of compensation and income support, including permanent impairment compensation and incapacity payments. The only difference for Reservists relates to the calculation of incapacity payments. This is to ensure that Reservists receive incapacity payments that fairly reflect the earnings they have lost.
Incapacity payments are provided as compensation for loss of salary due to an incapacity for work or service because of accepted injury or disease. Incapacity payments normally cease at Age Pension age.
Incapacity payments for all ADF members are based on the difference between the person’s normal earnings (NE) before the injury or disease occurred and his or her actual earnings. For a Reservist, NE is based on:
- a choice of either their full time ADF wage, or their full time civilian income and their part-time Reserve income — if the Reservist was rendering continuous full-time service (CFTS) at the time of the injury or contraction of the disease; or
- a combination of their civilian income and their part-time Reserve income — if the Reservist was injured or contracted the disease whilst performing part-time service.
Where the full-time ADF wage is taken into consideration and the person has discharged, a remuneration loading is added to NE to compensate for the non-salary benefits enjoyed by serving CFTS reservists.
Eligibility for the DVA Gold Card
Former members of the Australian Defence Force (ADF), Reservists and Cadets who have conditions for which liability has been accepted under the MRCA are eligible for a Gold Card if they:
- have permanent impairment from accepted conditions assessed at or above 60 points; or
- have a permanent impairment from accepted conditions assessed at 30 points or above, and the person is receiving any amount of Service Pension; or
- meet the criteria for the Special Rate Disability Pension (SRDP) even if they have not chosen that pension.
Compensation for Dependants of Reservists
Compensation for dependants under the MRCA may be provided in the event of a Reservist’s death where:
- the death is accepted as related to service on or after 1 July 2004;
- the Reservist was entitled to the Special Rate Disability Pension under the MRCA at some point before his or her death; or
- the Reservist was entitled to the maximum rate of permanent impairment compensation immediately before his or her death.
Rehabilitation services available to Reservists through DVA
Defence has the responsibility for providing rehabilitation support for Reservists through the Rehabilitation for Reservists (R4R) Program. However, DVA has the flexibility to organise a transfer of rehabilitation authority, where it may be more beneficial to a Reservist. For this to occur, DVA must have accepted liability for a service-related injury or disease and agreement must be reached by all parties.
DVA may also provide the following assistance to Reservists while they continue to receive rehabilitation support from Defence:
- vehicle modifications;
- household services;
- attendant care services; and
- adaptive equipment in some cases, where alterations that may not be able to be provided through the R4R program.
For Reservists, both the ADF and DVA provide medical treatment. To access DVA support and compensation, the Reservist must lodge a claim. If they wish to do so. Those Reservists covered under MRCA can submit their claim through MyService. Once liability has been determined, compensation can then be paid.The MRCA also provides payment of medical costs for an accepted injury or disease for part-time Reservists when they are not undertaking Reserve service and for former Reservists. In some instances, treatment is provided for all conditions, whether accepted as service-related or not.
While I realise that Reservists do not technically ‘discharge’, the post-discharge GP health assessment is available to all former serving personnel. This includes those who have left the permanent force and are now in the Reserves, and those who have left the Reserves.
There are no time restrictions for accessing this one-off assessment. DVA will fund the assessment through the usual DVA health card arrangements. If the person getting the assessment is not a DVA client, a Medicare rebate is available. Their GP can also choose to bulk bill the assessment at no cost to the veteran. However, if the GP charges a fee that is higher than the rebate, the veteran will need to pay for the gap. Any GP can give this assessment.
Non-liability health care is one of the most important initiatives DVA has developed in recent years.
Under this program, DVA can pay for treatment for any mental health condition – whatever the cause, not just service related – as long as they have served at least one day in the full-time ADF. The program also covers cancer (Malignant Neoplasm) and Pulmonary Tuberculosis.
There have been two major updates to this program since it was established in 2014. In 2016 eligibility was reduced from three years full-time service to 1 day, and this year it was expanded to cover all mental health conditions. Before that only the top five mental health conditions suffered by DVA clients were covered.
The key restriction on accessing non-liability health care is the requirement of serving one day in the full-time ADF, or have rendered continuous full time service – this means that many Reservists are ineligible for this important program – in fact a recent estimate from Defence is that 23,000 Reservists who have rendered service utilising Reserve Service Days (RSD) since 1 July 2004 remain ineligible for NLHC.
This situation is at odds with the access available to all Reservists under the Veterans’ and Veterans’ Families Counselling Service (VVCS) who have rendered Defence service such as involvement in domestic disaster relief operations and/or border protection operations or who have been involved in a training accident that resulted in serious injury to any person.
Further, the current NLHC eligibility arrangements are inconsistent with Defence’s recently-introduced Total Workforce Model that does not rely on any sharp distinction between Reserve and Permanent service. Successive Governments have used the ADF to support whole of government responses to natural disasters and that Reserve units often play a large role in such activities and are exposed to traumatic scenes.
While a considerable element, if not the majority, of the Air Force and Navy Reserve is comprised of former permanent ADF members, the Army Reserve, which is often called out for such events, has a large component of members who have never had permanent service.
Given that the new NLHC arrangements will provide life time access to NLHC to a recruit who leaves at the end of the first week of training because they qualify as he or she was a member of the permanent forces (albeit for a short time with no effective service), it seems inequitable that they would be eligible for cover but not a Reservist who had provided years of effective part-time service.To address this inequity, Defence and DVA are currently considering expanding non-liability health care to cover all Reservists with service since 1 July 2004.
I will now go into a little detail about DVA’s ‘Transformation’ – the work we have been doing over the last couple of years to overhaul the way DVA does business, and put veterans at the centre of everything we do.
As part of our transformation, we have undertaken a large amount of research, interviewing currently serving and former ADF members. Now I will be the first to admit that many of these veterans are more frustrated with DVA than they are with the ADF. However, if you look at the situations these people are in, you have to admit that we do not have any easy job ahead of us. The people that come to us looking for support are often broken, extremely vulnerable, and in need of immediate help. We currently cannot offer that immediate help, although that is our goal for the future. Of course, to implement this transformation we require the funding to do so.
Another important cost of military service is financial – not to the veteran, but to the government. To give you an example: I recently became aware of a 35 year-old DVA client. This client has a large variety of severe conditions, and has been receiving daily physiotherapy for the last six years, which is being used, in conjunction with morphine, to treat his chronic pain. DVA is paying for this, along with over 20 other accepted conditions. This person has been discharged for at least six years. The ADF had him for maybe ten years, DVA will be taking care of him for the rest of his life.
We must therefore accept the impact that Defence service has on some members who then later become clients of DVA. It should be noted that at this stage Defence does not contribute funds towards the costs of supporting and treating injured veterans.
DVA is nearly 100 years old. For nearly a century, our fundamental mission has been to support those who serve, or have served in Defence of our nation and commemorate their service and sacrifice. This remains core. DVA is currently in a period of significant change, and there are many reasons for this transformation:
Of our current clients, around 170,000 of are 65 years of age or above. Around 150,000 are widows or dependents over the age of 79. 450,000 have served since Vietnam and we know 1-in-3 of these. For those who have served since 1999, we only know 1-in-5. We are seeing more clients from modern conflicts, such as Iraq and Afghanistan, who have different needs and expectations and in 2020 our client numbers are expected to be 243,000.
While our dedication to our clients and the veteran community cannot be understated, our systems and business processes are complicated and stressful to navigate. Transforming DVA is about putting veterans at the centre of everything we do. Not claims-based. Not paper-based. Through this transformation, our clients will receive a better level of support based around their needs and expectations, rather than our complicated legislation and systems. Transforming DVA is a complex process – we have outdated ICT systems, complex legislation, hundreds of thousands of paper records, (which we are looking to digitize), and a geographically dispersed workforce. The Australian Government has acknowledged that a significant investment needs to be made in order to foster long-lasting, effective change.
Finally. DVA is committed to engaging with veterans, their families, current ADF and other members of the veteran community going forward with our transformation efforts.
We are still inviting these groups to give their ideas on what DVA does right and what it does wrong. We’ve engaged with over 500 clients and their family members since starting our transformation efforts, and that is going to continue. This is called ‘co-design’ and it is the reason why products like MyService are so successful – at every stage of the journey we are talking to the people who are actually going to be affected by our new initiatives to get their opinions, rather than assuming anything.