Coding the Adult Disability Assessment Tool (ADAT) 009-05020010

The ADAT has been designed specifically for use in the assessment of an adult care receiver's functional ability, emotional state, behaviour and special care needs, to determine their carer's entitlements to CP and/or CA.

The ADAT consists of responses to a:

• carer questionnaire, and
• Treating Health Professional (THP) questionnaire (completed by an approved THP)

These questionnaires include questions about the amount of help the care receiver needs to undertake basic activities of daily living such as:

• mobility
• communication
• hygiene
• eating, and
• management in a range of cognitive and behavioural areas

This may include supervising and prompting the care receiver to undertake these daily activities. The responses from the questionnaires are used to calculate a score indicating the level of care needed because of that person's disability or medical condition.

The ADAT does not assess higher activities of daily living such as managing finances, housework, cooking, shopping, laundry or gardening.

The Treating Health Professional (THP) questionnaire is in the Carer Payment and/or Carer Allowance Medical Report for a person 16 years or over form (SA332a). The THP can complete the form if the care receiver is aged at least 15 years and 6 months. The questions in the SA332a are not about specific disabilities or medical conditions. The purpose is to determine the level of care needed by the adult.

If an adult care receiver satisfies the re-use provisions they medically qualify their carer for both CP and/or CA without the need for a new ADAT assessment.

If an adult care receiver has a terminal illness, and the THP medical report (Carer Payment and/or Carer Allowance Medical Report for a person 16 years or over form (SA332a)) indicates they are not expected to live more than 3 months, the care receiver is medically eligible to qualify their carer for both CP and/or CA without the need for an ADAT assessment.

If an adult does not meet the re-use provisions and does not have a certified terminal illness, an ADAT will be needed.

Information previously gathered under ADAT or terminal condition assessment for CP and/or CA (adult) may be re-used for CP and/or CA claims.

Re-use provisions do not apply to medical reviews, or where a carer has provided a new medical report and new carer questionnaire and these forms are an accurate reflection of the care receiver’s care needs.

The re-use provisions are automatically assessed if a carer claims online, ACC or First Contact Service Offer (FCSO) workflow is run. See ADAT and reclaim provisions and ADAT and re-use provisions.

Even if the reuse provisions apply, the previous ADAT must reflect the current care needs and the carer meets the daily care and constant care requirements. Clarification of the provision of care should only be sought if there are circumstances indicating the carer is not providing constant or daily care.

If a medical report or carer questionnaire has been lodged when the re-use or reclaim provisions may apply, see Process.

An adult care receiver (aged 16 years or over) who is likely to suffer from their disability permanently or for an extended period may qualify 2 or more carers for separate Carer Payments if the care receiver achieves a qualifying ADAT score.

If the THP score is:

• less than 8 or the total score is less than 20, the care receiver does not medically qualify their carer for either CP or CA
• at least 8 and the total score is at least 20, the care receiver will medically qualify their carer for CP if the care receiver has a dependent child who is either under 6 or over 6 and CA is payable for that child
• at least 10 and the total score is at least 25, the care receiver medically qualifies their carer for CP
• at least 12 and the total score is at least 30, the care receiver medically qualifies their carer for CP and CA
• 32 or more and the total score is 80 or more, the care receiver medically qualifies more than 1 carer for CP, but only qualifies one carer for CA

Terminal Illness

If an adult care receiver is certified as being in the final phase of a terminal illness,  only that part of the THP questionnaire Carer Payment and/or Carer Allowance Medical Report for a person 16 years or over form (SA332a) is to be completed. The care receiver is automatically assessed as having a qualifying ADAT score of 30.
However, if 2 or more carers wish to claim CP for a care receiver who has been certified as being in the final phase of a terminal illness:

• the care receiver must be reassessed using another SA332a, and
• achieve the qualifying score for two carers (THP score of at least 32, with a total ADAT score of at least 80)

If a carer lodges multiple medical reports, the most recent medical report is used for the CP/CA assessment. However, the following factors must be considered if multiple medical reports are lodged, as some older medical reports can be used for the CP/CA assessment.

For carers who lodge multiple medical reports, check the following:

• is each medical report an accurate reflection of the care receiver’s care needs
• the date of each medical report
• the qualifications of the THP (they are on the approved THP list)
• the relevance of the THP qualification in relation to all of the care receiver’s conditions

Where multiple medical reports have been lodged, but only 1 medical report is being used for the assessment, only this report should be recorded.

If this occurs, the carer may not be qualified at claim but:

• subsequently become qualified and the early claim provisions apply
• ceases to be qualified (this happens if a subsequent medical report is lodged and there has been a reduction is in the care needs which precludes payment. In this case both medical reports were an accurate reflection of the care needs at the time they were completed)

Note: it is possible for the latest medical report to reflect the care receiver’s care needs from a date after the claim was submitted and for the claim to be granted from the date of lodgement.