Calculating the Treating Health Professional score for a child under 16 years on or after 1 July 2010 009-05010040

The DCLAD is used to assess the care provided and care required for a child care receiver (under 16 years). The DCLAD contains the List of Recognised Disabilities (LoRD), a carer questionnaire and a THP questionnaire. If a child’s medical condition or disability is not on the LoRD, they will be assessed using the DCLAD.

These questionnaires consider the:

• level of care required by the child and the level of care provided by the carer
• total care load of the carer
• child’s functional ability, language, self care, social and community skills
• impact of behaviour and special care needs on the care load

The DCLAD is not aimed at specific disabilities, medical conditions or age groups.

All child care receivers must achieve a qualifying rating of ‘intense’ where both the carer and care receiver have a score of:

• 'greater than zero' on the medical report completed by the THP
• '85 or greater' on the Care Needs Assessment (CNA) completed by the carer

These provisions allow qualifying THP medical reports and CNAs previously supplied to be used for a subsequent claim.

The system assesses these provisions when a carer claims online, when using Assisted Customer Claim (ACC), or when running First Contact Service Offer (FCSO).

The medical report is a questionnaire completed by the THP currently involved in the treatment of the child. A combination of the following forms is issued at Next Steps for online claims, Assisted Customer Claim (ACC) or First Contact Service Offer (FCSO):

• SA422 - Carer Payment and Carer Allowance Medical Report (for a child under 16 years)
  This is a system generated form. The manual (printable PDF) version is the SA431. Used to assess eligibility for CP and CA if a functional assessment is required
• SA397 - Carer Payment Medical Report including functional assessment (for a child under 16 years)
  This is a system generated form. The manual (printable PDF) version is the SA427. Used to assess eligibility for CP (child) if a functional assessment or Special Disability Trust beneficiary status is required. It must be completed by the child’s THP
• SA333TDR - Carer Allowance Medical Report (for a child under 16 years)
  This is a system generated form. The manual (printable PDF) version is the SA426. Used to assess eligibility for a CA (child) and must be completed by the child’s THP

In conjunction with 1 of the following:

• SA410 - Claim for Carer Payment, or
• SA409 - Claim for Carer Allowance, or
• SA411 - Claim for Carer Payment and Carer Allowance, and
• SA414 - Income and Assets (for Carer Payment)
• SA489 - Carer Allowance adjusted taxable income details (SA489)

Or via the review process with:

• SA421 - Review of Carer Payment - Care Needs Assessment, (for a child under 16 years)
  This is a system generated form. The manual (printable PDF) version is the SA424
• SA416 – Review of Carer Payment and Carer Allowance - Care Needs Assessment for a child under 16 years
  This is a system generated form, The manual (printable PDF) version is the SA417

View forms generated by FCSO on the History Summary (HS) screen.

If the care receiver has a recognised disability, the THP does not have to complete the THP functional assessment questions included on the SA333TDR/SA426. This is because a care receiver with a recognised disability will automatically medically qualify their carer for CA. It also means that the Functional Assessment is not required. See Assessing a recognised disability for Carer Allowance (CA) (child).

THP medical reports include the (LoRD) for CA (child) only claims, or CP and CA child combined claims. The CP (child) only THP medical report will contain the functional assessment questions but will not require the LoRD questions to be included in the report.

The THP medical report:

• forms part of the process of assessing a child care receiver's ability and objectively determining their level of disability
• helps to measure the level of functional ability or disability of a young person against standards appropriate to their age in the areas of communication, feeding, self-care, social and community skills and mobility
• takes into account the care receiver's specific needs. The carer and THP must complete separate questionnaires about the care receiver's functional ability, behaviour and special care needs
• is designed to identify the level of disability regardless of the actual disability/condition, and
• was developed in consultation with peak disability representatives, consumer groups and childhood disability specialists from many medical and allied health professional backgrounds

The medical score is assessed by the DCLAD 2020 from the answers provided by the one of the following forms, SA422*/SA431, SA397*/SA427, SA333TDR*/SA426. Once they are coded on the carer’s record the system will calculate the THP score. The overall score, comprising of the THP and CNA score, is used to determine if the care receiver qualifies a carer for both CP and CA or CA only.

If the THP indicates the absence of a significant level of disability, the child will not attract a fortnightly payment of CP and/or CA. However, the child may qualify for a CA Health Care Card only.

The Receptive language skills to the Gross Mobility questions on the medical report must all be answered, as it is possible to receive a negative score from these questions.

Add a new THP with the same date of effect if the carer provides 2 THP reports.

THPs include:

• legally qualified Medical practitioners, including Specialists
• registered nurses
• occupational therapists
• physiotherapists
• registered psychologists
• speech pathologists
• Aboriginal health workers, in a geographically remote area

Diagnosis of a terminal condition is restricted to medical practitioners.

The details of the medical practitioner who has diagnosed the recognised disability must be provided in writing, if any of the following medical reports, SA422*, SA431, SA397*, SA427, SA333TDR*, SA426 has not been completed by a medical practitioner.

Note: * denotes system generated version of that form

Carers who are current or suspended on 30 June 2010 and were:

• granted CP (child) under the DCLAD (2009) or CA (child) under the Child Disability Assessment Determination (CDAD) (2001) will maintain qualification and payability under their existing provisions. This remains until they are selected for review under DCLAD 2020 or lose qualification on or after 1 July 2010. This group of care receivers will not appear on the Carer Payment Grandfathered (CRGF) screen
• granted CP (child) due to caring for a Profoundly Disabled Child (PDC), or two children who require the equivalent care of a PDC, will maintain qualification and payability under PDC provisions until they are selected for review under DCLAD 2020 or lose qualification on or after 1 July 2010. Carers in this group who reclaim CP (child) for the same care receiver from 1 July 2010 to 17 August 2020 will be required to provide a DCLAD (2020) care load assessment and medical report. These groups of care receivers will appear on the  CRGF  screen