Calculating the total Disability Care Load Assessment Determination (DCLAD) (2020) score 009-05030010

The DCLAD (2020) requires all carers claiming CP (child) (excluding terminal care receivers) and CA (child) (excluding List of Recognised Disabilities (LoRD) care receivers) to achieve a qualifying rating of 'intense'.

A qualifying rating of 'intense' is achieved if the carer and care receiver achieve a score of:

• 'greater than zero' on the Treating Health Professional (THP) functional assessment
• '85 or greater' on the Care Needs Assessment (CNA)

Assessing the DCLAD (2020) involves 2 parts. The THP is required to complete the medical report and the carer completes a CNA. Both CP (child) and CA (child) are assessed using the same THP and CNA scores.

See Calculate the Treating Health Professional score for a child under 16 years on or after 1 July 2020 before continuing with this procedure. Note: this procedure only relates to calculating the total DCLAD score.

It is possible to assess multiple and combined claims at the same time when assessing the DCLAD (2020).

All claims for CP and/or CA (child) are checked for validation triggers. This identifies if there are inconsistencies in some of the responses provided in the THP and CNA questions relating to the child's behaviour and special care needs.

The system identifies if validation is required by determining if the sum total scores of the answers identified as inconsistent between the 2 question-sets would result in a change to the qualifying scores, and therefore result in a grant of payment which might be rejected or a rejection of payment which might be granted.

The Resources page contains a table that shows the validation question triggers.

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. This remains 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 must provide a DCLAD (2020) care load assessment and medical report. These groups of care receivers will appear on the CRGF screen

If a carer lodges multiple medical reports, usually 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 on some occasions the older medical report will be used for the CP/CA assessment.

For carers who lodge multiple medical reports, a Service Officer must 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 (are they 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:

• becomes qualified and the early claim provisions apply
• ceases to be qualified (this happens when 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. See the Resources section for examples of when multiple medical reports are lodged for the same claim.