Supporting Veterans’ compensation claims: a guide for GPs
As a GP, you can play a crucial role in helping veterans navigate the complexities of compensation claims. This process can be particularly challenging for those dealing with significant impairment or mental health conditions and is often exacerbated by the transition to civilian life. By understanding the steps involved and the required documentation, you can positively assist your patients' access to essential support and wellbeing.
Understanding eligibility and the claims process
Some veterans will have not submitted their claims prior to discharge. It's important to also remember that veterans can develop new conditions post-service, which may be eligible for coverage in addition to deterioration in previously accepted conditions. Your role as a GP involves accurate diagnosis, suitable management, thorough documentation, and supporting veterans through the claims process. For mental health conditions, the Non-Liability Mental Health Care (NLMHC) program covers various treatment costs, but a formal diagnosis and application for acceptance by the Department of Veterans' Affairs (DVA) is key to optimise compensation.
The claims process involves the veteran submitting the initial claim supported by their GP completing the diagnosis form (D9287) or you can provide the same information using your practice letter templates.
Following this submission DVA may, if required, directly request further information from the veteran’s GP. This information will be through the completion of a form outlining a clear, specific diagnosis and date of onset. As the GP, you may also be asked to consider contributing factors and any aggravation over time and provide investigation results or relevant reports.
The impairment forms will ask you for information about the condition's impact on physical, mental, and psychosocial function, as well as on the veteran’s daily life and work capacity.
Further specialist medical reviews may be sought and funded by DVA to complement the information provided by the GP.
Billing and remuneration
Billing for your services through DVA ensures you are appropriately compensated for your time and expertise.
When considering consultations with veterans, remember any previously accepted white card conditions and mental health consultations covered under NLMHC. For these consultations you can choose suitable consultation rebate item numbers and bill directly to DVA (without a gap payment applied). Do not forget to add the incentive payment item numbers, the veteran access payments (VAP), relevant for your geographical area.
For non-mental health conditions, standard MBS item numbers and billing practices apply until the claim is accepted.
Once a veteran has applied for recognition of a condition, if DVA requests additional information or forms, such as those related to impairment or incapacity assessments, you will be provided with a Transaction Reference Number (TRN). The TRN is used on any invoices relating to time and effort spent to complete the requested documentation. This would include time spent with the veteran in addition to any time spent completing paperwork outside a consultation.
DVA has item numbers and associated values to be utilised for these invoices; they are also able to accept suitable invoices for remuneration of time and effort.
Ongoing care and support
Your role extends beyond the initial diagnosis and compensation process. Regular veteran health checks (where eligible), referrals to relevant services like Open Arms, and utilising the VETERANS Lens in consultations can significantly improve outcomes. By staying informed and proactive, you can provide comprehensive care and support to veterans to optimise their health and wellbeing.
Key takeaways for GPs
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Understanding these key aspects, you can better support veterans in accessing the compensation and care they need and deserve. Remember, your expertise and dedication make a significant difference in the lives of those who have served our country.
To improve your understanding of how to support veteran patient compensation claims, enrol in our upcoming webinar: Supporting Veterans’ compensation claims and GP billing
VETs HeLP is an initiative funded by the Australian Government through the Department of Veterans’ Affairs.
Catherine is a GP in Geelong, Victoria. She has been involved in a wide variety of Medical Education opportunities, these include GP training, lecturing in Medicine at Deakin University, and providing clinical consultancy for the Deakin Indigenous Health team. Over recent years Catherine has moved into planning and facilitating the professional development of Medical Educators and GP Supervisors as well as learning (like everyone else) to do all of this online. Catherine strives to ensure her education events are engaging and innovative, with a dose of appropriate fun.
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