Disability Medical screens 008-03010060

When MC/MCSS is keyed in the Super Key field, the Medical Assessment screen displays.

The Medical Assessment screen:

• records the customer's medical conditions or incapacity
• automatically populates verified medical conditions that have been assessed as part of:
• an Employment Services Assessment (ESAt)
• a Job Capacity Assessment (JCA), or
• a Government-contracted Doctor (GCD) assessment

Information on the screen includes:

• details from medical certificates
• medical assessments from ESAt, JCA and GCD
• manifest indicators
• Impairment Ratings for Disability Support Pension (DSP)
• other medical information, including:
• the commencement and expiry dates of medical certificates, and
• if a Temporary Incapacity exemption from mutual obligation requirements has been granted or not

Where a Temporary Incapacity exemption is granted, the exemption is also displayed on the Activity and Exemption Summary (AEX) screen.

Use the Medical Assessment screen to:

• enter medical certificate details manually within a new claim activity
• modify and view details of medical conditions and medical certificates associated with a customer's incapacity for work
• modify or override Impairment Rating for the medical condition. Only authorised Service Officers can change medical conditions after accepting the ESAt, JCA. Record the reason for any overriding of recommendations

The Medical Assessment screen has column headings displaying the following:

• Action: view, change or delete details by selecting the appropriate icon:
• Expand, see below for details on the Expand Icon
• Edit, or
• Delete
• Event Date: events dates display in order, the latest event date will display first
• Assigning Professional: details recorded under fields:
• Specialist Name
• Area Code
• Phone Number
• Professional Medicare/AHPRA
• Impairment Table Version Date
• Channel Code: for indication of whether the details were sourced from a Job Capacity Assessment (JCA) or other source
• Referral Reason Code
• Hours/Week: recorded as work capacity
• Incapacity Exempt Indicator: records whether a customer with mutual obligation requirements can be granted a Temporary Incapacity exemption for a medical certificate. This field is:
• coded as N, if an incapacity exemption is not granted. This could be because the customer is not incapacitated for all work, or the incapacity for work is not temporary
• blank for disability/medical condition details not recorded from medical certificates
• Incapacity Exempt Reason Code
• Incapacity Start Date
• Incapacity End Date
• Pending Further Assessment
• Acceptance Date
• Referral Number
• Record Status Code

Select Expand icon to view more details on the Medical Assessment screen.

The following fields display under Medical Condition:

• Medical Condition Code: abbreviation of the customer's medical condition. Only one code can be recorded and displayed
• Incapacity type by code
• Impairment Table
• Impairment Rating: displays the total Impairment Rating for the permanent medical conditions
• Status

The following fields display under Manifest Condition:

• Manifest Disability Code
• Mnfst Elig Ind
• Status

The following fields display under Medical Condition Override (Edit/Delete is only available with override access):

• Change Reason Code
• Override Source Code
• Status

Key 'MCSS' or 'MC' in the Super key field, the system will go to the Medical Assessment screen:

• The medical assessment with the most recent End Date will display first
• Select Expand icon on one of the existing lines. This displays the:
• Medical Condition
• Manifest Condition, and
• Medical Condition Override

To update, select the Edit icon on one of the existing lines to view/update the Medical Condition:

• The Change Medical Condition window will display
• Once updated, select Save
• Complete the Receipt Date and Channel. Select Save

To delete, select the Delete icon on the line that requires deletion:

• The Delete Medical Condition window will display
• Select Yes if confirming deletion
• Complete the Receipt Date and Channel. Select Save

For information on applying temporary exemptions for DSP customers with participation requirements see Pre-screening and booking participation interviews for Disability Support Pension (DSP) customers.

Assess medical certificates before recording the details.

Suitably skilled Service Officers are to select 'Medical Certificate' from the Task Selector.

See:

• Assessing and coding medical evidence for temporary incapacity exemptions, or
• Exempting a job seeker from mutual obligation requirements for serious illness

Staff must be SO5 or above to override information on the Medical Condition Details (MC) screen from:

• an Employment Services Assessment (ESAt)
• a Job Capacity Assessment (JCA), or
• a Government-contracted Doctor (GCD)

The fields will be unprotected and can be changed. See Overriding Medical Conditions and Work Capacity recommendations in a Job Capacity Assessment (JCA).

The event date can be one of the following:

• the date from which a claim for disability assistance is payable
• the date the medical practitioner conducted the medical assessment
• the same as the unfit for work from date when coding a renewal and the new medical certificate provides continuous coverage
• when using data sourced from an Employment Services Assessment (ESAt) and Job Capacity Assessment (JCA), or Governement - contracted Doctor (GCD) the event date will default to the Report Accepted Date

The Assigning Professional field records the health professional providing the medical evidence, for example, the treating doctor.

• For medical certificates the treating doctor who completed the certificate is recorded
• For customers granted DSP under the manifest eligibility guidelines because they are getting a Department of Veterans' Affairs (DVA) Disability Compensation Payment at Special Rate (Totally and Permanently Incapacitated (TPI)). DVA is recorded is as the Assigning Professional
• For customers where a JCA and/or GCD are accepted, the field will automatically record Assigning Professional as JCA Job Capacity Assessor (Auto) and GCD Government Contracted Doctors respectively

The Specialist Name field records the assigning professional's name, JCA assessor or Sonic HealthPlus.

The Area Code and Phone Number field records the assigning health professional's phone number.

The Professionals Medicare/AHPRA field records the assigning health professional registration number and can be left blank if not provided.

The 'Channel Code.' identifies the initial source of the data on the Medical Assessment (MC/MCSS) screen and is a display only field. Values for this field are:

• JCA - Data added from Job Capacity Assessment (JCA)
• ESA - Data added from Employment Services Assessment (ESAt)
• GCD - Data added from Disability Medical Assessment (DMA)
• SAR - Data added automatically from Better Assessment started pre 1 July 2006
• SAM - Data added manually from Better Assessment started pre 1 July 2006
• CNV - 1 July 2006 Conversion (from PDI screen - not involving the conversion of an impairment rating)
• CNI - 1 July 2006 Conversion (from PDI screen - involving the conversion of an impairment rating)
• CSO - Data added manually by user

Displays the reason for the referral to ESAt, JCA and GCD.

This is required as the reason for the referral may affect what information:

• is supplied, and
• can be used in the customer's assessment

Records hours of work the customer is able to do per week during the period of the medical certificate.

Records whether the medical certificate can be used to:

• authorise exemption from their mutual obligation requirements, and
• pay Pharmaceutical Allowance (PhA)

Values for this field are:

• Y - Yes
• N - No
• S - Serious Illness

To determine this, see Assessing and coding medical evidence for temporary medical conditions.

If it is determined the customer is Not Exempt, select an appropriate non-exemption reason. Values for this field are:

• DAM - Drug and/or alcohol dependency/misuse
• IES - Insufficient evidence supplied
• ATP - Has capacity to participate in suitable program
• WEH - Able to work or study 8+ hours per week
• NTI - Incapacity is not temporary
• OTH - Other

Records the medical certificate start and end date.

These dates determine the incapacity exemption period. This should be the shorter of:

• the duration stated on the medical certificate, or
• 13 weeks from the start date of the medical certificate

Note: for customers granted a Temporary Incapacity exemption (Serious Illness), the exemption period is the duration stated on the medical certificate. Initially this is up to 12 months. Consider a further period of exemption, up to 6 months where the same serious illness condition persists.

If coding a renewal and the start date of the new medical certificate is before the end date of the current one:

• code the Unfit to Work From/Incapacity Start Date field as the current end date + 1
• do not overlap the dates

Information sourced from a JCA report

• If the Channel code is recorded as 'JCA', and there is no pending medical certificate:
• the medical condition will be listed on this screen
• the customer's work capacity will appear on the Work Capacity (WC) screen
• This information is only shown if it is relevant to the job seeker's circumstances
• Do not use this to make a determination about a job seeker's capacity for work when assessing mutual obligation requirements based on the ESAt reports

This field:

• only needs coding if the medical certificate has already been coded as 'Y' on Pending further assessment
• must be updated once the Assessor's report is returned, to make sure the 'Pending further assessment' status is finalised
• must contain a valid date before entering a value in the Incapacity Exempt Reason Code field

Lists all medical condition recorded, with an option to:

• edit existing medical conditions, or
• add a new medical condition

Records the lasting effects of each medical condition. Values for this field are:

• PRM - Permanent
• TMP - Temporary
• REC - Recurring. This value cannot be used if the information is taken from the Job Capacity Assessment (JCA), it can only be coded manually
• DTS - DTS > 2YRS - Permanent DTS (auto populated from a JCA only)
• PND - NONDTS - Permanent Non DTS (auto populated from a JCA only)

Records the Impairment Table Value provided by the Assessor for each medical condition.

Records the Impairment Rating for a medical condition. The Impairment Rating is a value recorded by an Assessor in the JCA report. It specifies the severity of impairment that a customer may have for a particular medical condition.

The value coded in this field must be one of the following: 0, 5, 10, 15, 20, 25, 30, 35, 40, 45, 50, 55, 60, 65, 70, 75, 80, 85, 90, 95, NA (Not Available).

It is a mandatory field for all DSP new claims where:

• a Diagnosed, Reasonably Treated and Stabilised medical condition is recorded, and
• no Manifest Code has been recorded

Manifest information is in the Manifest Disability Code and Mnfst Elig Ind fields.

Use the fields for manifest information when assessing qualification for Disability Support Pension (DSP) and Special Benefit (SpB).

A JCA is not required if a Medical Assessment Team (MAT) has assessed the customer as being manifestly assessed for DSP, while a manifest code will be required if there is no impairment rating coded.

If a manifest condition has been recorded and the Medical Assessment screen is updated for any reason (including from a JCA), the existing manifest code will default into the Manifest Disability Code field for the new date of event. To remove a manifest code if the customer's condition has changed and they can no longer be manifestly assessed, delete the defaulted manifest code.

The Mnfst Elig Ind field is a protected field, derived from the manifest code. If the value of the manifest code qualifies the customer for DSP, the Mnfst Elig Ind field auto populates with 'Y'.

When coding manifest eligibility for customers granted because they are getting a Department of Veterans' Affairs (DVA) Disability Compensation Payment at Special Rate (Totally and Permanently Incapacitated (TPI)) the TPI indicator must appear on the Veterans' Affairs Pension (DVA) screen.

The value in this field will only change from JCA where an override of the JCA data has occurred for appeal cases.

Values for this field are:

• CSO - Customer Service Officer (Auto Conversion September 2010)
• JCA - Job Capacity Assessment (Auto Only)
• ODM - Original Decision Maker
• ARO - Authorised Review Officer
• SST - Social Security Appeals Tribunal (AAT first review)
• AAT - Administrative Appeals Tribunal (AAT second review)
• NSO - National Support Office

When data from an accepted report is overridden by Services Australia a reason for overriding this data must be provided. Select appropriate code from dropdown menu.

The DMM screen is an enquiry only screen. It shows the Service Officer more screens to view or input details about medical conditions and capacity for work.

To access the screens from the DMM screen, key the screen code and press Enter. The chosen screen displays. For example, code MCSS in the Nxt field and press Enter.

The MCSS screen shows a summary of the medical conditions and certificates recorded on a customer's record.

The MCSS screen is primarily an enquiry screen. The only action available is the selection of the:

• event date
• medical condition, or
• medical certificate

This is

• to view the related details page on the Medical Conditions Details (MC) screen, and
• including the expanded explanation for the disability/medical condition codes

The following is displayed on the MCSS screen:

• Event date field: the event date for the related page on the MC screen. Events dates display in order using the medical certificate and is generally the Unfit to work (or study) from date. The latest event date displays first. Medical conditions without medical certificate details display by the date of event. The latest date of event displays first
• Medical cond(s) field: the first medical condition code as coded on the MC screen. It displays only one code. If there are multiple medical conditions, a '+' indicator displays. This indicate there are more medical conditions coded on the MC screen
• Man Code field: the Manifest Code from the MC screen if there is one
• Imp Rate field: the total Impairment Rating for the permanent medical conditions coded on the MC screen
• Channel field: indicates if the data from the related page on the MC screen has been updated because of a Job Capacity Assessment (JCA)
• Unfit to Work From and Unfit to Work To fields: the dates the customer is unfit for work as per the medical certificate
• Incap exempt field: This field records whether a customer with mutual obligation requirements can be granted a Temporary Incapacity exemption for a medical certificate. This field is:
• coded as N, if an incapacity exemption is not granted. This could be because the customer is not incapacitated for all work, or the incapacity for work is not temporary
• blank for disability/medical condition details not recorded from medical certificates

The MC screen records a customer's medical conditions or incapacity. The screen automatically populates the verified medical conditions that have been assessed as part of:

• an Employment Services Assessment (ESAt)
• a Job Capacity Assessment (JCA), or
• a Government-contracted Doctor (GCD)

Use the MC screen to:

• enter medical certificate details manually
• modify and view details of medical conditions and medical certificates associated with a customer's incapacity for work

Access to the MC screen is via the Medical Conditions Summary (MCSS) screen.

Type 'MCSS' or 'MC' in the Nxt field.

Either:

• Select Continue if a new MC screen is required, or
• 'S'elect one of the existing lines from the MCSS screen to view/update details of that occurrence of the MC screen

For information on applying temporary exemptions for DSP customers with participation requirements see Pre-screening and booking participation interviews for Disability Support Pension (DSP) customers.

Before coding a medical certificate:

• assess and code medical evidence for temporary incapacity exemptions, or
• exempt a job seeker from mutual obligation requirements for serious illness

Assess the medical certificate before recording the details.

When using Customer First, the preferred method for recording medical certificates is to use the Medical Certificate guided procedure.

To add or change medical condition details, the following fields must be updated:

• Event date, see Item 1 in Table 3 on the Customer First tab
• Source, see Item 3 in Table 3 on the Customer First tab
• Reason, see Item 4 in Table 3 on the Customer First tab
• Assigning Professional Information, see Item 5 in Table 3 on the Customer First tab
• Medical Conditions, see Item 8 in Table 3 on the Customer First tab
• Type, see Item 9 in Table 3 on the Customer First tab
• Rating, see Item 11 in Table 3 on the Customer First tab
• Source (Src), see Item 12 in Table on the Customer First tab
• Date finalised, see Item 18 in Table 3 on the Customer First tab

Changing any field results in a second page being created. This displays first when accessing the Medical Condition Details (MC) screen. This means the most recent data is displayed first.

Staff must be SO5 or above to override information on the Medical Condition Details (MC) screen from:

• an Employment Services Assessment (ESAt)
• a Job Capacity Assessment (JCA), or
• a Government- contracted Doctor (GCD)

The fields will be unprotected and can be changed. The Source and Reason fields must also be updated as part of this process. See Overriding Medical Conditions and Work Capacity recommendations in a Job Capacity Assessment (JCA) report.

The event date is one of the following:

• the date from which a claim for disability assistance is payable
• the date the medical practitioner conducted the medical assessment
• the same as the unfit for work from date when coding a renewal and the new medical certificate provides continuous coverage
• when using data sourced from an Employment Services Assessment (ESAt), Job Capacity Assessment (JCA) or Government - contracted Doctor (GCD), the event date defaults to the Report Accepted Date
• the same date of event can apply to different pages unless the Channel code is 'CSO'

Manifest information is in the Manifest Code and Manifest Eligible Ind fields.

Use the fields for manifest information when assessing qualification for Disability Support Pension (DSP) and Special Benefit (SpB).

A JCA is not required if the customer has been manifestly assessed for DSP. A manifest code is required if there is no impairment rating coded.

If there is a manifest condition recorded and an update to the MC screen occurs for any reason (including from a JCA), the existing manifest code will default into the Manifest Code field for the new date of event. If the customer's condition has changed and they can no longer be manifestly assessed, delete the defaulted manifest code.

The Manifest Eligible Ind field is a protected field, derived from the manifest code. If the value of the manifest code qualifies the customer for DSP, the Manifest Eligible Ind field auto populates with a 'Y'.

When coding manifest eligibility for customers granted because they are getting a Department of Veterans' Affairs (DVA) Disability Compensation Payment at Special Rate (Totally and Permanently Incapacitated (TPI)) the TPI indicator must appear on the Veterans' Affairs Pension (DVA) screen.

The Source field is only visible if there is an accepted ESAt/JCA report.

The value in this field will only change from JCA where an override of the JCA data has occurred for appeal cases.

Values for this field are:

• CSO - Customer Service Officer (Auto Conversion September 2010)
• ESA - Employment Services Assessment
• GCD - Government Contracted Doctor
• JCA - Job Capacity Assessment (Auto Only)
• ODM - Original Decision Maker
• SME - Subject Matter Expert
• SSO - Senior Service Officer
• ARO - Authorised Review Officer
• SST - Social Security Appeals Tribunal (AAT first review)
• AAT - Administrative Appeals Tribunal (AAT second review)
• NSO - National Support Office

When data from an accepted report is overridden by Services Australia a reason for overriding this data must be provided. Use field help ('?') to view the reason codes to record.

The Assigning Professional field records the health professional providing the medical evidence, for example, the treating doctor.

• For medical certificates the treating doctor who completed the certificate is recorded
• For customers granted DSP under the manifest eligibility guidelines because they are gettting a Department of Veterans' Affairs (DVA) Disability Compensation Payment at Special Rate (Totally and Permanently Incapacitated (TPI)), DVA is recorded is as the Assigning Professional
• For customers where JCA and GCD are accepted, the field will automatically record Assigning Professional as JCA Job Capacity Assessor (Auto) and GCD Government Contracted Doctors respectively

The Name field records the assigning professional's name, JCA assessor or Sonic HealthPlus.

The Telephone field records the assigning professional's phone number.

The Professionals Medicare/AHPRA field records the treating health professional registration number and can be left blank if not provided.

The Channel field identifies the initial source of the data on the Medical Condition Details (MC) screen and is a display only field. It will display one of the following values:

• JCA - Data added from Job Capacity Assessment (JCA)
• ESA - Data added from Employment Services Assessment (ESAt) or where an ESAt has been upgraded to a JCA
• GCD - Data added from Disability Medical Assessment (DMA)
• SAR - Data added automatically from Better Assessment started pre 1 July 2006
• SAM - Data added manually from Better Assessment started pre 1 July 2006
• CNV - 1 July 2006 Conversion (from PDI screen - not involving the conversion of an impairment rating)
• CNI - 1 July 2006 Conversion (from PDI screen - involving the conversion of an impairment rating)
• CSO - Data added manually by user

The Job Capacity Assessment (JCA) Acceptance Date field will display the date a JCA report was returned to Services Australia.

The JCA Referral Reason field will display the reason for the JCA referral.

This is required as the reason for the JCA referral may affect what information:

• is supplied, and
• can be used in the customer's assessment

For a list of referral reasons, see Job Capacity Assessment (JCA) referral or Request an Employment Services Assessment (ESAt).

Record up to 4 medical conditions, with an option to add more if needed.

Records the lasting effects of each medical condition. The valid values for this field are:

• PRM - Permanent
• TMP - Temporary
• REC - Recurring. This value cannot be used if the information is taken from the Job Capacity Assessment (JCA), it can only be coded manually
• DTS - DTS > 2YRS - Permanent DTS (auto populated from a JCA only)
• PND - NONDTS - Permanent Non DTS (auto populated from a JCA only)

Records the Impairment Table Value provided by the Assessor for each medical condition.

Records the Impairment Rating for a medical condition. The Impairment Rating is a value recorded by an Assessor in the JCA report. It specifies the severity of impairment that a customer may have for a particular medical condition.

The value coded in this field must be one of the following: 0, 5, 10, 15, 20, 25, 30, 35, 40, 45, 50, 55, 60, 65, 70, 75, 80, 85, 90, 95, NA (Not Available).

It is a mandatory field for all DSP new claims where:

• a Diagnosed, Reasonably Treated and Stabilised medical condition is recorded, and
• no Manifest Code has been recorded

Records the source of any changes to the:

• Medical condition
• Type
• Impairment Table, or
• Impairment Rating sections

Relevant codes are CSO, ESA, JCA or GCD.

This is an additional field used to code more medical conditions if a customer has more than 3 medical conditions.

If a 'Y' is coded in this field, code the collated impairment ratings for the remaining permanent medical conditions in the Other Collated Ratings fields.

This screen is protected from manual updates if the medical details on the MC screen are taken from a JCA.

This is an optional field, when a Disability Support Pension (DSP) customer has more than 4 permanent medical conditions.

Where the customer has more than 4 permanent medical conditions, code the collated total impairment ratings of any other permanent medical conditions in this field.

This screen is protected from manual updates if the medical details on the MC screen are taken from a JCA.

Records hours of work the customer is able to do per week during the period of the medical certificate.

Records the medical certificate start and end date.

These dates determine the incapacity exemption period. This should be the shorter of:

• the duration stated on the medical certificate, or
• 13 weeks from the start date of the medical certificate

Note: for customers granted a Temporary Incapacity exemption (Serious Illness), the exemption period is the duration stated on the medical certificate. Initially this is up to 12 months. Consider a further period of exemption, up to 6 months where the same serious illness condition persists.

If coding a renewal and the start date of the new medical certificate is before the end date of the current one:

• code the Unfit to Work From field as the current end date + 1
• do not overlap the dates

Information sourced from a JCA report

• If the Channel field is recorded as 'JCA', and there is no pending medical certificate:
• the medical condition will be listed on this screen
• the customer's work capacity will appear on the WC screen
• This information is only shown if it is relevant to the job seeker's circumstances
• Do not use this to make a determination about a job seeker's capacity for work when assessing mutual obligation requirements based on ESAt reports

Records whether the medical certificate can be used to:

• authorise exemption from their mutual obligation requirements, and
• pay Pharmaceutical Allowance (PhA)

This screen will not display if the code in the Channel field is recorded as 'JCA'.

Codes that appear in this field are:

• Y - Exemption has been granted
• S - Customer meets criteria for serious illness exemption
• N - Exemption has not been granted. When an exemption is not granted Service Officer will need to provide a reason
• P - Assessment is pending the outcome of a JCA referral. Note: this code can no longer be recorded

To determine this, see Assessing and coding medical evidence for temporary incapacity exemptions.

This field:

• only needs to be coded if the medical certificate has already been coded as 'pending further assessment'
• must be updated once the Assessor's report is returned, to make sure that the 'pending further assessment' status is finalised
• must contain a valid date before any value can be entered in the Incap Exempt field