Home Modifications

POLICY

The TAC can pay for the reasonable cost of reasonably required modifications to a home for a client residing in Australia with prior written approval. The TAC requires clinical justification for home modifications based on access and function within the home related to the transport accident injuries.

Transport Accident Act 1986: s.60(4) and s.60(4A)

BACKGROUND

The TAC recognises that some clients, as a consequence of injuries sustained in a transport accident may require home modifications in order to access their homes.

The TAC can pay for home modifications following:

  • advice on all housing/residential options from a registered occupational therapist or a Framework occupational therapist
  • prior written approval of the scope of the modifications by the TAC, including costings.

The TAC will consider all reasonable options when addressing a request for home modifications including installation and provision of equipment, home automation, structural alterations and relocation.

The TAC will also have regard to the following rules and regulations when considering requests for home modifications:

  • Building Code of Australia
  • Australian standards for disability and access
  • Liveable Housing Design Guide
  • Domestic Building Contracts Act 1995
  • Building Act 1993
  • Project Development and Construction Management Act 1994
  • Any other legislation or regulation relevant to the home to be modified, e.g. council planning scheme or heritage rules.

DEFINITIONS

In this policy:

  • Home is where a client resides, e.g. house, home unit or flat
  • Home automation refers to the integration of electronic equipment into the home to automate tasks, such as using an electric tablet device to operate light switches in the home
  • Home modification refers to an alteration made to a client's home
  • Major home modification refers to an alteration made to a client's home of $25,000 or greater
  • Minor home modification refers to an alteration made to a client's home of $24,999.99 or less
  • Relocation costs refer to the following expenses regarded as being incidental to moving from one home to another when the client's existing home is not suitable to be modified:
    • Relocation costs for a client who is relocating to a new home and which relate to a house sale - the reasonable costs include real estate agent fees, stamp duty, advertising costs, legal services, bank fees limited to the relocation process, furniture removal, interim accommodation support and the cost of an assessment and report to locate an appropriate home by an appropriately qualified third party approved by the TAC, e.g. registered occupational therapist, building modifications project manager, a Framework occupational therapist, etc.
    • Relocation costs for a client who is relocating from a rental property to another rental property - the reasonable costs include, any fee involved for breaking a tenancy agreement early because of the transport accident injury, furniture removal and the cost of an assessment and report to locate an appropriate rental property by an appropriately qualified third party approved by the TAC, e.g. registered occupational therapist, building modification project manager, a Framework occupational therapist, etc.
  • Rental property refers to a home lived in by a client whereby rent is paid to a private owner, the Ministry of Housing or a Statutory organisation
  • Semi-detachable portable unit refers to a building that can be positioned on vacant land/space close to the main residence and can be relocated if required.

GUIDELINES

How is eligibility for home modifications determined?

Eligibility for home modifications is determined by the client's need to reasonably access and complete functional activities within his/her home as a result of the transport accident injuries.

In considering eligibility, the TAC may consider the following:

  • Whether the home in which the client resides is structurally suitable for modification.
  • The nature of the client's injuries as a result of the transport accident.
  • How those injuries restrict, or are likely to restrict the client's ability:
    • to enter and leave the home in which he/she resides
    • to move about the home for necessary purposes.
  • The extent of the modifications that will be needed to address those restrictions or likely restrictions.
  • Any complex, unique or unusual circumstances associated with those modifications such as a remote, and isolated location which may be dangerous for the client taking into consideration his/her transport accident injury.
  • Whether the cost of those modifications is likely to exceed the value of the home in which the client resides.

What home modifications can the TAC pay for a person who has sustained permanent loss or severe restriction in physical functioning/mobility due to the transport accident injuries?

Following prior written approval, the TAC can pay the reasonable cost of home modifications for a client residing in Australia, which he/she reasonably requires, due to the transport accident injuries based on the completion of:

  • an assessment and report in relation to home modification needs, in a TAC approved form, by a registered occupational therapist or a Framework occupational therapist, and
  • for major home modifications, a report prepared by a building modifications Project Manager appointed by the TAC.

The reports from the registered occupational therapist or Framework occupational therapist, and building modification Project Manager must take into account:

  • clinical justification for the modifications considering all reasonable options available
  • Australian standards for disability and access
  • current building regulations, and
  • consultation with the client and/or his/her authorised representative.

The TAC considers reasonable home modifications as those that allow the client access to the following areas of the home that would need to be reasonably used by the client:

  • The physical dwelling.
  • A bathroom.
  • A bedroom.
  • A living/dining area.
  • A kitchen or basic cooking facilities (for clients who fully or partially prepare their own food or beverages).

Other examples of modifications that can be considered include:

  • structural modifications, e.g. door-widening and bathroom modification. Where possible, existing materials will be re-used and replacement of items, where appropriate, will be with equivalent materials.
  • changes to fittings or layout, e.g. installation of rails, installation of portable ramps and provision of equipment. See also the Equipment policy.

The TAC may consider paying for home modifications as a multi-step process. Initial home modifications may be undertaken to provide reasonable access to assist the client to enter and leave the home to allow discharge from hospital, while the remainder of recommended reasonable home modifications may be undertaken after discharge from hospital.

What can the TAC pay for if an injury is not permanent or stable?

The TAC can pay for the reasonable cost of minor modifications or the provision of equipment and/or aids to enable a client to access his/her home, based on the recommendation of a registered occupational therapist, a Framework occupational therapist or an approved qualified third party, agreed to by the TAC. See also the Equipment policy.

What factors impact on the reasonable cost of home modifications?

A registered occupational therapist, Framework occupational therapist and/or building modifications Project Manager appointed by the TAC will assess and make recommendations regarding the suitability of a home to be modified having regard for the following factors:

Client related

  • The nature of the client's injury as a result of the transport accident.
  • How these injuries restrict the client's ability to enter and leave the home in which the person resides; and to move about the home for necessary purposes and complete functional activities.
  • The extent of the modification needed to address those restrictions.
  • Ownership of the property.
  • Length of lease of a rental property (usually a minimum of 12 months).
  • Anticipated period of occupancy in the dwelling to be modified.
  • The scale of the proposed modifications when considered in conjunction with alternative residential options and the value of the existing dwelling.

Building related

  • The structural suitability of the home to be modified including size, age, design, surrounding terrain and condition of the dwelling.
  • Whether the cost of home modifications is likely to exceed the value of the home in which the client resides.
  • Building materials required for the modifications.
  • Local planning regulations/building permits.
  • Ability of the TAC to negotiate any necessary agreement or consent with the owners or the Body Corporate. Other negotiation may need to take place with the Department of Housing or the Senior Master's Office.
  • Any complex, unique or unlikely circumstance associated with those modifications
  • Relevant National Trust building regulations.
  • Relevant Australian Standards, including Australian Standards for disability and access
  • Permission of the owner, the Department of Housing or the body corporate to temporarily or permanently modify the dwelling.

In cases of late claim acceptance the TAC will consider these factors to reimburse the cost of home modifications if already completed.

What are the options, if for any reason the home the client owns cannot be reasonably modified?

Relocation or semi-detachable portable unit option
The TAC can either:

  • contribute a reasonable amount to the purchase cost of a semi detachable portable unit, or
  • the reasonable relocation costs to relocate to another home that is suitable for the client or that is capable of being reasonably modified.

Reasonable relocation costs can include real estate agent fees, stamp duty, advertising costs, legal services, bank fees limited to the relocation process, furniture removal, interim accommodation support, etc.

The Transport Accident Act 1986 states that where the cost of the modifications is likely to exceed the value of the existing home the option of relocating to a more suitable home must be considered. The TAC can also pay for minor modifications to enable access to the home to which the client is relocating.

Transport Accident Act 1986: s.60(4)(b)(ii)

What are the options, if for any reason the client's rental property cannot be reasonably modified?

Rental property option
The TAC can contribute a reasonable amount towards the relocation costs to relocate the client to another rental property that is suitable for the client or that is capable of being reasonably modified. If a suitable rental property cannot be located, the TAC can contribute a reasonable amount toward the modification of a new home.

The TAC may require a registered occupational therapist or a Framework occupational therapist to review the selected property before a client commits to renting a property in order to identify if the property is appropriate for the client and the modifications.

When is it reasonable to pay interim accommodation?

The TAC pays interim accommodation support as part of relocation or home modification cost for the duration of time that the client is unable to access their existing or new home due to modifications taking place. Examples of interim accommodation support payable by the TAC include a short-term stay in an accessible property, hotel, motel or serviced apartment.

The client and family must vacate the property and move into interim accommodation during the construction period. This allows the builder to maintain a safe working environment and to protect the safety of the client and family.

The examples below highlight when it is reasonable and not reasonable to pay interim accommodation costs.

Example 1

A client cannot be discharged to the city apartment he/she owns because the treating team at the rehabilitation facility have advised the client would be in danger of further injury because of the number of staircases in the pre-accident home. The client's home is assessed as unsuitable for home modifications and upon recommendation of the treating team the client places his/her home on the market. In order to be discharged, the client and his/her family move into a suitable short-term facility approved by the TAC. It takes the client 3 months to sell his apartment and purchase a ground floor apartment in the city. The TAC agrees to fund relocation costs including interim accommodation support because of the client's circumstances.

Example 2

The TAC has previously paid for modifications to a client's home. The client decides to sell the modified home and move into another home which also requires modification before the Capital Services Agreement term has expired. The client asks the TAC to pay for interim accommodation support whilst waiting on the completion of modifications to his/her subsequent home.The TAC denies the request as not being reasonable because the client was already living in a suitably modified home.

What standard of interim accommodation support can the TAC pay for?

In considering what constitutes reasonable interim accommodation support, the TAC will have regard to whether the interim accommodation:

  • meets the post-accident medical and rehabilitation needs of the client
  • enables the client/family to stay within the pre-accident community to be close to health services, schools, shops and the transportation accessed before the transport accident
  • ensures the client/family is close to support networks such as relatives and friends
  • cost is not excessive in view of the client's pre and post-accident living situation (in principle the interim accommodation should equal the standard of housing the client lived in before the transport accident).

The TAC also understands rental accommodation may be scarce, and where the client is accommodated in an area or housing that costs more than was expected, the TAC can pay a proportion of the increased cost because it is required in order to meet the immediate accommodation needs of the client.

Prior approval must be obtained from the TAC for interim accommodation support costs.

What can the TAC pay for if a client chooses to build a new home or move into another home?

If a client chooses to build a new home, the TAC can pay the reasonable cost difference between building the home and the cost of the disability specific costs. For example, the TAC can pay the cost difference between a standard bathroom and a disability accessible bathroom, if required.

If a client chooses to move into another home, he/she needs to take into consideration his/her transport accident injury requirements. The TAC does not consider it reasonable that a client with significant functional limitations move to a home where substantial modifications need to be undertaken to allow the client to reasonably access the home.

The TAC requires a registered occupational therapist or a Framework occupational therapist to review the selected property before a client commits to purchasing it in order to identify if the selected property is appropriate for the client's needs and relevant modifications.

Can the TAC pay for home modifications for a secondary home which the client concurrently resides in?

For a dependent child where a parent who is not the primary carer, or who has joint custody or agreed regular overnight access visits of a child client in an agreement ratified by the Family Court or agreed to in writing by both parents, the TAC can consider paying for the reasonable cost of minor home modifications to a secondary residence to provide access, e.g. ramps, rails, doorway widening and minor bathroom modifications.

If modifications to a secondary residence are requested, the TAC will consider:

  • the nature and extent of home modifications to the primary residence or any other previous home modifications approved by the TAC
  • the anticipated amount of time that the client is expected to spend in the secondary residence
  • the suitability of the home to be modified.

Can the client use the home modification process to include other, non-transport accident-related modifications, and have these incorporated into the planning and construction process?

Where significant modifications are necessary because of the transport accident injuries, reasonable additional work requested by the client can be considered by the TAC and the building modifications Project Manager and can be incorporated into the planning and construction process for non-transport accident-related modifications.

However, where any additional works result in modification costs over and above those that would otherwise have been incurred, these must be met by the client.

A client is responsible for paying the cost of any client requested works, the subsequent project management fees and resulting interim accommodation costs. Clients are required to sign a separate building contract with the builder.

Further costs could potentially result from:

  • project manager fees for the additional work
  • architect's or draftperson's fees for the additional work
  • plans and building permits required by Council
  • labour costs
  • building material costs, and
  • any other associated costs related to the additional modification/work.

Example

The TAC pay for the construction of widening the deck at a client's home to allow wheelchair access. The client may request that the deck be extended to include a barbecue area. Whilst the request can be accommodated in the overall planning and construction process, the client will have to pay any the additional costs to cover the extension.

Can the TAC pay for more than one home modification?

When considering a request to pay for a subsequent home modification, the TAC must have regard to the appropriateness of the next home for modifications. The TAC will also take into account the:

  • amount of time the client occupied his/her previous residence (at least 8 years in accordance with the Capital Services Agreement)
  • cost and extent of all prior home modifications funded by the TAC
  • financial impact on the client as a consequence of selling his/her previously modified home.

The TAC can pay for more than one home modification in the life of a claim if:

  • a client who was a minor leaves the family home to live independently
  • a client is required to move location to access employment
  • a client is required to move location to access services more readily
  • deterioration occurs in the client's health as a result of the transport accident injuries
  • other circumstances occur which are consistent with community standards.

Whilst the TAC also acknowledges a client's choice and the need to change residences from time to time, the TAC does not consider it reasonable that a client with significant functional limitations move to a home where substantial modifications need to be undertaken.

The TAC requires a registered occupational therapist or a Framework occupational therapist to review the selected property before a client commits to purchasing a property in order to identify if the property is appropriate for the client and the modifications.

Transport Accident Act 1986 : s.60(4B)

Can the TAC pay for air-conditioning/evaporative cooling and heating?

The TAC can pay for the reasonable cost of air-conditioning/evaporative cooling and heating for a client with impaired thermoregulation. See also the Equipment policy.

Can the TAC pay for home automation?

The TAC can consider paying the reasonable cost of necessary home automation equipment or modifications where the client reasonably requires this due to his/her transport accident injuries and where the home automation will clinically increase the client's independence and functional activities.

The TAC will only consider written requests for home automation from a registered occupational therapist or Framework occupational therapist with knowledge and experience in home automation.

In considering requests for home automation, the TAC will have regard to:

  • Clinical justification, considering all available alternative options
  • Whether the home automation is likely to increase the client's independence, e.g. a reduction in the need for an attendant carer
  • Australian standards for disability and access.

When is a Capital Services Agreement required?

A client or his/her representative is required to sign a TAC Capital Service Agreement (CSA) when the cost of the home modifications exceed the Capital Service Agreement Limit. The Capital Services Agreement includes:

  • subsequent modifications
  • changes of ownership, and
  • frequency of modifications and changes of ownership.

Transport Accident Act 1986 reference: s.60(5) and s.60(6)

The CSA outlines that a client should stay in the modified home for at least 8 years unless exceptional circumstances arise. The CSA must be signed before the building works for home modifications can commence.

When is a Building Contract required?

For all minor home modifications a client or his/her representative is required to sign a domestic building contract with the builder.

For all major home modifications, the owner of the home and the client will be required to sign an Acknowledgement form authorising the TAC to sign and enter the building contract with the builder, on behalf of the owner.

The building contract outlines the work to be undertaken, the owner, the client's and the builder's rights and responsibilities, any special conditions and payment. The building contract also documents the start and end dates for the building works. The building contract must be signed before the works begin.

Can the TAC pay for rectification, maintenance, repair or replacement costs for completed home modifications?

Faulty workmanship

For both major and minor home modifications, faulty workmanship is the responsibility of the tradesperson or company and not the TAC.

For minor modifications the client should contact the builder to discuss rectification.

For major modifications the client should contact the TAC to discuss rectification.

Equipment installed as part of home modifications

The TAC can consider requests to pay for the reasonable cost of repairs/maintenance to equipment, e.g. ramps, rails, etc. installed as part of home modifications that is not covered in the building contract.

General wear and tear

The home owner is responsible for paying for the total cost of repair/replacement caused by general wear and tear, as this is a cost the home owner would incur regardless of transport accident injuries. e.g. non-slip flooring wears out over 15 years due to general wear and tear and not due to transport accident related reasons.

The home owner should also contact their home and contents insurer.

Maintenance

The home owner is responsible for paying for the total cost of the maintenance where this is a cost he/she would have incurred regardless of transport accident injuries, e.g. paying for an annual clean of air-conditioning ducts.

The client should also refer to their CSA for details of their reposibility for maintenance costs.

Repairs to damage caused by transport accident related equipment

The TAC can consider requests to pay for the reasonable cost of repairs for damage caused by transport accident related equipment, e.g. repairing wall damage caused by wheelchair-use.

In relation to home modifications what will the TAC not fund?

The TAC will not fund:

  • home modifications for a person other than the injured client
  • home modifications unrelated to the client's needs arising from the transport accident
  • home modifications required as a result of a condition that existed before a transport accident or that are not a direct result of a transport accident
  • home modifications where the owner, a body corporate or other responsible authority has not given permission for the modifications
  • home modifications which exceed the Capital Service Agreement Limit or where the Capital Service Agreement (CSA) is not signed by the owner and/or the client or his/her guardian
  • home modifications where a building contract has not been signed
  • home automation equipment or modifications that do not not clinically increase the client's independence and functional activities
  • contribution to, or the purchase price of a residence
  • upgrades of any materials requested for home modifications
  • maintenance/repair of home modifications that are not related to the client's transport accident injury
  • maintenance/repair of home modifications caused by faulty workmanship
  • new items where the original items are suitable for recycling
  • furnishings
  • rent, with the exception of short-term rent whilst home modifications are underway
  • items or labour not included in the final contract for modifications agreed to by the TAC, unless prior approval has been obtained from the TAC
  • the unreasonable cost of home modifications
  • relocation costs when a client's home can be reasonably modified
  • home modifications to a dwelling that is not structurally suitable to be modified
  • home modifications received by the injured person outside the Commonwealth of Australia
  • services provided more than 2 years prior to the request for funding except where the request for payment is made within 3 years of the transport accident. Refer to the Time Limit to Apply for the Payment of Medical and Like Expenses policy.

View TAC Home modifications - Client information sheet

TAC Home modifications - Client information sheet

Summary:

This information sheet outlines who can apply for TAC-funded home modifications to ensure safety and accessibility. It also explains the home modification assessment and planning process.

View Home modifications assessment form (for Provider use only)

Home modifications assessment form (for Provider use only)

Summary:

This comprehensive form is for completion by occupational therapists (OTs) providing assessment services for clients who are applying for TAC-funded home modifications to ensure safety and accessibility.

Please note, there are seperate forms for Hospital based OTs and for Community based OTs.