Determining when an Employment Services Assessment (ESAt) is required 001-02330040

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Description

1

Reassessment of work capacity

George is a 59 year old job seeker who has been receiving JobSeeker Payment (JSP) for 5 years.

During this period, George has had 2 casual jobs that lasted about 3 weeks each. Both positions were in the seasonal picking area and George was unable to continue due to a 'broken down body'. George has never seen a medical practitioner about the physical problems as, in George's opinion, it is just due to ageing and there is nothing a medical practitioner could do.

George's previous work history has been as a labourer. George started at 13 and worked for 40 years on farms and in the building construction industry. George has no specific work qualifications and limited education although literacy skills are listed as 'fine'.

George has never had an Employment Services Assessment (ESAt) or Job Capacity Assessment (JCA) whilst receiving payment.

George tells the Service Officer during a recent contact that they cannot do what they used to do anymore. George has always worked and now no one wants to offer employment. However, George thinks undertaking light work for a few hours a day, would require a rest when body aches starts or else it is hard to move the next day.

The Service Officer runs the Job Seeker Snapshot. The outcomes of the Job Seeker Snapshot determine that George requires an ESAt because:

• George has disclosed some possibly serious health issues that are likely to affect the ability to work and look for work
• there is no current and valid assessment of the customer's work capacity

The Service Officer discusses the benefit of an ESAt and provision of medical evidence to possibly reduce his work capacity.

2

Claiming YDS

Jessica is a 20 year old student who has lodged a Youth Allowance (YA) (student) claim.

Jessica currently studies full-time and has never received income support payments prior to this claim. Jessica advises on the claim of a medical condition that will impact on the ability to work for more than 2 years. Jessica would like to test eligibility for Youth Disability Supplement (YDS).

Jessica has never had an ESAt or JCA. Jessica clearly states there is no intention to claim Disability Support Pension (DSP) as there is an intention to work after finishing studies and hopes to be able to achieve this.

Jessica will need an ESAt to determine eligibility for YDS. Jessica's capacity to work will be assessed. YDS is payable to YA and ABSTUDY customers under 22 years old who are assessed as having a Partial Capacity to Work (PCW).

A PCW exists if the customer has a physical, intellectual or psychiatric impairment that prevents them from working for 30 hours or more per week, or being trained for such work, independent of a program of assistance within the next 2 years. Jessica is encouraged to provide current medical evidence to support the ESAt request.

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Description

1

There is a current and valid assessment on the customer record

Tom has recently stopped working and been granted JobSeeker Payment (JSP).

When receiving JSP less than 12 months ago, an ESAt was triggered by Tom's earlier time in prison.

Tom has not been to prison since the assessment and no other changes in circumstances have occurred to trigger an ESAt. Tom is already referred to a Workforce Australia provider. A new ESAt is not required. The previous assessment is current and remains valid.

2

The medical condition triggering the ESAt is clearly temporary and likely to persist for less than 2 years

Jack is receiving JSP and has fractured a leg. Jack is scheduled for surgery and is expected to make a full recovery. The recovery time may be longer than 3 months.

The Job Seeker Snapshot triggered an ESAt referral because of Jack's injury. As Jack's injury appears to be temporary, an ESAt is not required.

Jack may be granted a temporary incapacity exemption if a medical certificate is lodged showing that Jack is temporarily incapacitated for all work during this period.

If Jack lodges further medical certificates, the situation should be reviewed. If Jack has long-term limitations because of this injury, an ESAt referral may be appropriate to assess the ongoing work capacity and support requirements.

3

ESAt triggered by Job Seeker Snapshot responses

Mark, a 20 year old job seeker, claims Youth Allowance after losing a job of 2 years duration. Mark has been employed in the role since successfully completing year 12 and leaving school.

When the Job Seeker Snapshot is run as part of the Participation workflow in Process Direct, Mark identifies as Indigenous. This response automatically triggers that an ESAt is required, although Mark does not appear to have any significant barriers to employment.

The Service Officer identifies that Mark does not have significant barriers to employment or participation and does not require an ESAt referral. This determination is to be documented on the customer record.

The Service Officer should indicate at the end of the Participation workflow in Process Direct that an ESAt is not required, and the Job Seeker Snapshot status becomes active as soon as it is completed.

Mark is immediately referred to a Workforce Australia provider for assistance with finding employment.

4

Personal Factors indicating the job seeker does not have significant barriers requiring assessment

The ESAt flag can be withdrawn if only one of the following personal factors has triggered the ESAt referral:

• Severe Stress
• Pregnancy
• Dental
• Sleep problems/insomnia
• Regular family/caring responsibilities
• Transport convenience
• Level of schooling with further training
• Gambling addiction
• Relationship breakdown
• Self-esteem/motivation/presentation issues
• Working history

5

Other circumstances where it would not be beneficial to refer for an ESAt

There are some circumstances where it would not be beneficial to refer for an ESAt, for example:

• The customer is in hospital or undertaking a rehabilitation program
• DSP customers who have had an ESAt/JCA (regardless of the age and referral recommendation) and want to be referred to IEA
• Customers (except for DSP customers) seeking a re-referral to IEA within 13 weeks of their exit. These customers can be re-referred to IEA regardless of the exit reason or age of the most recent ESAt/JCA, provided the last assessment recommended Disability Employment Services (DES) or IEA

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Questions and Answers

1

When should a Job Seeker Snapshot ESAt referral flag be withdrawn?

Answer: ESAt referrals triggered by the Job Seeker Snapshot are not always required. Service Officers have the delegation to override an ESAt flag by reapplying a previous assessment or withdrawing the ESAt flag.

The following are examples of when an ESAt flag should be withdrawn:

• there is a current and valid assessment on the customer record
• the medical condition triggering the ESAt is clearly temporary and likely to persist for less than 2 years, such as a broken leg or pneumonia

For details, see Table 2.

If an ESAt is not required:

• when running Job Seeker Snapshot, indicate on the 'results' screen that an ESAt referral for the job seeker is not required - this will make sure that an ESAt flag is not raised, or
• if an ESAt flag has already been raised, it may be withdrawn using the 'copy/withdraw' workflow on the Participation Summary

2

Why did the customer receive a letter inviting them to provide medical evidence?

Answer: If the job seeker completed the Job Seeker Snapshot online and Assessment Services were not able to contact them about booking an ESAt, an invitation to provide medical evidence letter is sent.

If the customer contacts about the letter, tell them:

You recently completed the Job Seeker Snapshot online, and told us you have an injury, illness or disability that might impact your ability to work.

Based on this, we have identified that you may need an Employment Services Assessment (ESAt). An ESAt will help us identify what type of employment service is best for you and determine what your current capacity to work is.

So you can get the best outcome from this assessment, we have asked you to provide medical evidence from your doctor or treating practitioner.

3

What medical evidence is required to support an ESAt that includes the assessment of medical conditions?

Answer:

• Where an ESAt referral is required to assess a job seeker's medical conditions, a request should not be made until current and relevant medical evidence has been provided, and recorded in the electronic Medical Information File Envelope (MIFE). If there is insufficient medical evidence to conduct an assessment, the job seeker should be asked to provide this as soon as possible
• Medical evidence includes newly provided medical information and current and relevant medical information already on the job seeker's record. This would generally be medical evidence from a medical practitioner provided within the past 2 years, including details about the diagnosis, prognosis, functional impact and treatment of a medical condition. Examples of medical evidence that may be suitable for an ESAt are:
  • Verification of Medical Conditions (SU684) form completed by the job seeker's medical practitioner, registered nurses and nurse practitioners, registered Aboriginal and Torres Strait Islander Health Practitioner
    - this form is designed to provide sufficient evidence to complete an ESAt, for job seekers who are not seeking a temporary incapacity exemption
  • Medical certificates
  • Letters from the job seeker's medical practitioner, mental health plans, specialist reports and hospital reports
  • Other written medical evidence that provides information about the diagnosis, prognosis, functional impact and treatment details of a medical condition
• If no new evidence is provided by the job seeker, the Service Officer must check the job seeker's record to see if there is enough existing evidence to support the request. Examples of when medical evidence exists on the job seeker's record:
  • Medical evidence that is submitted electronically (for example, SU683)
  • Medical reports and medical certificates recently provided and scanned on the job seeker's record

4

What is the process if the job seeker does not have medical evidence with them when an ESAt is triggered for medical reasons?

Answer: If the Job Seeker Snapshot flags an ESAt for medical reasons and there is no current and relevant medical evidence available, the following process must be followed:

• Discuss with the job seeker the requirement for medical evidence and the type of medical evidence to be provided (for example, Verification of Medical Conditions (SU684) form)
• Issue a Request for Information (RFI) letter listing the documents required
• Place the relevant JSR/UPD activity on hold for a timeframe agreed with the job seeker (no longer than 14 days)
• When the medical evidence is received, scan the documents

If the medical evidence is not returned within 14 days, Assessment Services will check if an ESAt referral is still required because of non-medical barriers that are likely to affect the job seeker's current services.

For example, a job seeker currently placed in Workforce Australia Online for Individuals is clearly having difficulty complying with mainstream job search requirements because of non-medical barriers such as homelessness or ex-offender status, and a referral to a physical provider may be more appropriate.

In this case, the Service Officer must clearly document that current and relevant medical evidence has not been provided, and an ESAt is required for identified non-medical barriers only.

If the job seeker does not provide medical evidence within 14 days and the only identified barriers are medical, withdraw the ESAt flag (Use reason: 'other-please provide detail') and complete the Job Seeker Snapshot.

The job seeker's payment must not be suspended because of a failure to provide medical evidence and they must not be advised that payment will be suspended.

They should always be strongly encouraged to provide evidence to make sure that we can assess suitable payments, mutual obligation requirements and services, but in the end it is the job seeker's choice whether they provide this information.

If the job seeker subsequently provides relevant medical evidence, re-run the Job Seeker Snapshot and make an ESAt request if required.

Never tell the job seeker to bring new evidence with them to the assessment, as there is a high risk that the job seeker will attend the appointment without suitable evidence. In this case, the Assessor will be unable to effectively conduct the assessment, and unnecessarily uses an appointment session which could be preventing the assessment of a job seeker who has already provided evidence.

5

What happens if an ESAt referral is made without medical evidence?

Answer: If an ESAt request is made without current and relevant medical evidence for conditions that significantly affect the job seeker's ability to work and if there is no indication to the Assessor that there are non-medical barriers requiring assessment, the Assessor may need to finalise the referral as 'unable to complete' (UTC).

If the report is finalised as UTC for any reason where the Job Seeker Snapshot status is pending, the JSR/UPD 'ESAREFRQ' activity will then be re-created to indicate further action to manage the Job Seeker Snapshot.

Unless there are non-medical barriers requiring assessment and likely to affect the job seeker's current servicing, the ESAt flag should generally be withdrawn on the grounds that the job seeker cannot provide medical evidence.

If the job seeker subsequently provides suitable evidence, the Job Seeker Snapshot can be re-run and a new ESAt request can be made if required.