Job Capacity Assessments (JCA) 008-06110000

When deciding the appropriate format of a JCA, the assessor must consider the customer's:

• medical information
• medical condition, and
• personal circumstances

Available formats include face to face, video conference, phone, and file assessment.

The assessor records their format recommendation in the MAT/SA479 when recommending a referral for JCA.

Opportunity also exists for the assessor to vary the original format in select circumstances. See:

• Table 2 > Step 4 Change format assessment
• Non-attendance at Job Capacity Assessments (JCA) appointments

The assessor must consider how an assessment with no customer contact and/or treating health professional (THP) contact may impact on the assessment. See Table 3 for more details about contacting a THP.

To consider details for a:

• face to face assessment, see Item 2
• video conference (VC), see Item 3
• phone assessment, see Item 4

JCA by file can by recommended/considered where:

• other interview formats have been carefully considered (face to face, video conference or telephone)
• it is clear these formats are inappropriate for the individual circumstance of the claim
• the customer has a scheduled appointment and consents to a change in format to file, and
• the customer/nominee has not attended a scheduled appointment, see Non-attendance at Job Capacity Assessments (JCA) appointments

For details to consider for a file assessment, see Table 2

.

An assessment conducted by face to face interview is the most appropriate format in the following circumstances:

• When the customer and/or nominee requests a face to face assessment
• When the customer has a communication, hearing or speech disorder, and the assessment cannot be conducted by phone
• A specialist assessment is required
• Customer reported information is required to complete the JCA because of the nature of the condition, or the functional impact. This may include, but not limited to, intellectual or cognitive impairment, or where significant variation exists in the evidence available
• When the assessor deems the assessment would benefit from visual confirmation. For example, where a physical specialist assessment is required

Before recommending a face to face assessment consider:

• the customer's remote location
• assessor availability
• significant travel time, such as more than 90 minutes each way, would be required by the customer to access the nearest office. This also needs to consider the customer's medical conditions and impact on their ability to travel

If the customer/nominee requests an interview format that Services Australia cannot support, see Table 4.

Is a face to face assessment appropriate?

• Yes, continue with the recommendation of a face to face assessment. Procedure ends here
• No, go to Item 3, video conference

Before considering an assessment by VC the customer must meet all of the following criteria:

• Access to a device that enables Microsoft Teams
• Reliable internet connection, and
• Registered for myGov and subscribed to online letters

If the customer and/or nominee:

• does not have access to the required technology to accurately complete the assessment, a VC is inappropriate
• does have access to the required technology, check if any of the following circumstances apply:
• the customer and/or nominee has requested a VC assessment
• the customer has a communication, hearing or speech disorder, and the assessment cannot be conducted face to face or by phone
• where a visual format supports the assessment of the customer's impairment with consideration to the nature of their condition
• a specialist assessment is required that cannot be conducted face to face
• customer reported information is required to complete the JCA because of the:
  nature of the condition, or
  functional impact. This includes, but is not limited to intellectual or cognitive impairment or when significant variation exists in the evidence available

Consider a VC when:

• medical vulnerabilities impact the customer's ability to access a service centre
• if the customer:
• has a communication, hearing or speech disorder, and an appropriate interpreter is not available in the customer's local area
• is in rural or remote areas and has access to the required technology
• and/or nominee has requested it

Remote customers

Where the customer cannot reliably access the required technology for VC, the assessor must consider an alternative assessment format including:

• phone assessment, through remote agent or personal device, or
• face to face engagement during remote servicing community trip, where applicable

If the customer/nominee requests an interview format the agency cannot support, see Table 4.

If a VC assessment is:

• appropriate, continue with the recommendation of VC format of assessment. Procedure ends here
• inappropriate, see Item 4 phone format

An assessment by phone is the most appropriate format in the following circumstances:

• The customer and/or nominee has requested a phone assessment
• Customer reported information is required for the assessment
• The customer must give more details as well as the medical evidence, or before contacting their treating health Professional (THP)
• The evidence on hand does not clearly indicate, or differences exist in the type and extent of the functional impairment
• Enough doubt exists as to the currency or relevance of the evidence, and:
• contact with the customer will help to decide the nature of the evidence, or
• if other sources of evidence are available
• The customer has vulnerabilities for example, recent history of self-harm, when the customer would benefit from contact, but face to face or file assessment is not suitable for their circumstances

Note: where the customer and/or nominee have requested a phone assessment, the assessor must make all attempts to meet this request.

Is a phone assessment appropriate?

• Yes, continue with the recommendation as a phone assessment. Procedure ends here
• No, consider if an assessment by file may be appropriate. See Table 2

An assessor must only complete/recommend a JCA by file when:

• They have carefully considered other interview formats (face to face, video conference or telephone), and
• It is clear these formats are inappropriate for the individual circumstance of the claim. Go to Step 2 for claim circumstances that may apply
• If the customer:
• resides in a remote and/or very remote location and has not attended a scheduled phone/face to face or VC appointment, see Non-attendance at Job Capacity Assessments(JCA) appointments
• agrees to a change in the original assessment format to a file assessment, go to Step 4
• has not attended a scheduled assessment and the customer meets the guidelines outlined in Non-attendance at Job Capacity Assessments (JCA) appointments
• meets any of the circumstances outlined in Step 2, or
• meets all of the guidelines outlined in Step 3

An assessor can recommend/conduct an assessment by file format in any of the following circumstances:

• A history of customer aggression exists or a Managed Service Plan (MSP), precluding contact by face to face, video conference, or phone
• The customer is deceased
• The customer's condition or circumstances prevent contact by phone, face to face, or video conference. For example, the customer is in prison or psychiatric confinement
• Engagement with an assessor to conduct an interview is likely to be detrimental to the customer's health and wellbeing because of the nature of their condition. For example, it is clearly documented on the record, in medical or other evidence, that contact would be detrimental
• When evidence exists the customer's medical condition impacts their ability to discuss their functional impairment or work capacity
• It is a sensitive escalated case, or
• It is the preferred format to implement a Merits Review through the Administrative Review Tribunal (ART), or court case

Note: where the customer has a correspondence nominee, assessors must consider their involvement in an assessment to support the customer to discuss their impairment.

Circumstances where an assessment by file format may also be appropriate, include where all of the below apply:

• The assessor has considered other formats, and they are inappropriate for the claim circumstances
• The medical evidence clearly demonstrates functional impacts with sufficient detail to confidently assess:
• impairment ratings
• continuing inability to work, and
• barriers and interventions for employment services, where indicated
• More customer reported details are not required to complete the JCA
• The assessor has no concerns with the quality, breadth, and currency of the available medical evidence relevant to the claim period.
  For example, it provides a comprehensive view of the condition and its impacts which includes:
• consistent evidence from multiple health professionals, and
• treatment history over a reasonable time period for the condition
• Contact with the customer, or visual confirmation, is not required to confirm the accuracy or currency of the evidence to their current circumstances
• The nature of the condition means the functional impacts and work capacity of the customer is unlikely to significantly improve in the next 2 years
• Medical evidence clearly indicates at least one severe condition meeting medical eligibility on a single Impairment Table
• The recommendation of the assessor is that medical eligibility is met, and
• No clear indication exists that the customer requires, wants, or would benefit from an employment services referral. For example, the customer has an active referral to an appropriate employment service provider which will not be impacted by the new JCA (work capacities affecting eligibility)

The assessor must consider how using a file assessment with no customer contact and/or treating health professional (THP) contact may impact on the assessment. For more details for contacting treating health professionals, see Table 3.

Is an assessment by file format considered appropriate?

• Yes, and the customer
• has a booked appointment, go to Step 4
• does not have a booked appointment or Disability Support Pension Medical Eligibility Assessment Recommendation (SA479) form completed - submit SA479 recommending file format of assessment. Procedure ends here
• does not have a booked appointment and an SA479 form has been completed - annotate the relevant DOC. For example, DSP Progress DOC and JCA Ref Required DOC indicating change in format recommendation. Procedure ends here
• No, reconsider assessment format and discuss with Assistant Director. Procedure ends here

Assessors undertaking the JCA may decide that file assessment is the appropriate format even when a face to face, video conference, or phone assessment is already booked.

Does the customer meet the file format guidelines identified in Step 2 or Step 3?

• Yes, the assessor must attempt to contact the customer/or nominee before, or at, the scheduled appointment time to discuss the proposed use of a file format. Go to Step 4
• No, the assessment must continue in the original planned assessment format. Procedure ends here

When contact with the customer and/or nominee is successful, the assessor should:

• advise that all required details are available to complete the assessment
• offer the option to complete the JCA without their participation
• if appropriate, advise of a referral to a Disability Medical Assessment (DMA) and to expect contact by Sonic HealthPlus to book the DMA appointment
• confirm if the customer needs, wants, or will benefit from an employment services referral. For example, the customer has an active referral to an appropriate employment services provider which will not be impacted by the new JCA (work capacities affecting eligibility)

Does the customer and/or nominee agree to changing the format of the assessment to file format?

• Yes, the assessor can continue with the assessment using file format, and:
• Change the format of JCA report in ESSWeb to file format. Information sharing statement (CISS) must be Yes
• The assessor must document the discussion in the Assessment Summary to make sure a contact record is available
• Note must include: 'Customer was contacted, and mode of assessment was varied following customer consent. Customer advised of information sharing statement.'
• Procedure ends here
• No, the assessment must continue in the original planned assessment format
• The assessor must document the discussion in the Assessment Summary to make sure a contact record is available
• Procedure ends here

It is mandatory for the assessor to identify if THP contact is required to support an assessment despite the format used.

This requirement also includes when customer participation in their assessment was considered appropriate (face to face, video conference or phone), but the customer, or nominee, did not attend their scheduled appointments and was unreachable.

Some examples of when the assessor should attempt THP contact, include:

• To clarify:
• medical evidence or functional impairments
• ambiguities in the medical evidence
• inconsistencies between the medical evidence and customer reported information
• To confirm treatment status. For example, where surgery was considered, but waitlists or customer decision on having it were unclear/could have changed and the medical evidence is from before the date of claim
• To support the file assessment where customer participation in their assessment was considered appropriate (through face to face, video conference or phone), but the customer did not attend an appointment and was unreachable
• For any other reason, the assessor deems appropriate

Would contacting the THP be beneficial for the assessment?

• Yes, go to Step 2
• No, procedure ends here

The assessor should make 2 outbound call attempts to contact the THP. The assessor must document the contact attempts in the JCA report.

An assessor must attempt to call the THP:

• on the current phone number listed for the THP and/or medical practice
• at different times of day and when the THP is likely to be available
• over more than one day

If contact with the THP was:

• successful:
• Record the details of the conversation in the relevant section of the JCA report, and
• Create a reference in the 'References' section of the JCA report in ESSWeb. Procedure ends here
• unsuccessful, the assessor must document the following in the Assessment Summary:
• Date, time and outcome of each contact attempt, and
• Reason THP contact was required. For example, verification of functional impairments

If Services Australia cannot support the recommended assessment format, an assessor or administration officer in Assessment Services must make 2 attempts to contact the customer and/or nominee.

This includes use of pre-call notification (SMS) where the customer subscribes to electronic messaging

The assessor or administration officer must attempt to call:

• on every current phone number, the agency has recorded for the customer and correspondence nominee (if they have one)
• at different times of day and when the customer is likely to be available
• over more than one day

The assessor or administration officer in Assessment Services must annotate on the JCA ref required DOC in Process Direct with the:

• date
• time, and
• outcome of these contact attempts

If contact with the customer and/or nominee is:

• successful:
• offer an appropriate alternative format
• annotate the relevant DOC, for example, DSP Progress of Claim DOC with conversation details
• book assessment in Process Direct
• procedure ends here
• unsuccessful, and the customer:
• does not have a medical condition that would impede a phone assessment, future book the appointment at least 5 working days in advance as a phone assessment
• has a medical condition that would impede a phone interview for example, a hearing impairment, future book the appointment at least 5 working days in advance as a video conference assessment