Occupational therapists are trained to help people take part in everyday activities and live a more independent life after injury or illness. Services provided by an occupational therapist may include:

• Assessing and reporting on a person’s daily living support needs.
• Working out what the person can do and identifying areas where support may be needed.
• Developing goals, strategies or a treatment program to improve functional ability including supporting the use of assistive technology, retraining techniques and other environmental modifications to support independence.

Occupational therapists can complete assessments and make recommendations in relation to:

• Support to manage personal, domestic and community activities of daily living, such as attendant care
• Assistive technology
• Home services
• Home modifications
• Vehicle modifications
• Driving assessment
• Driving programs/lessons
• Vocational and return to work plans
• Transport and travel training
• Support and monitoring for clients engaged in community group programs or a supported employment service.

The TAC can pay the reasonable cost of occupational therapy provided to TAC clients which is required as a result of transport accident injuries.

Where a pre-existing condition has become aggravated as a result of a transport accident, the TAC will consider funding treatment for that condition. The level of treatment that the TAC can consider funding will depend on the extent to which the transport accident has exacerbated the pre-existing condition.

For accidents that occurred prior to 14 February 2018 a medical excess may apply.

Clients with a severe injury

If the client has a severe injury, the discussion, referral and approval of services may form part of the client planning process between the client, the client's treating team and the TAC.

If the client already has an individualised funding package, occupational therapy services may be included as part of that.

The TAC will pay for the reasonable cost of occupational therapy. This includes intervention, assessment and recommendations to:

• establish what supports and services a TAC client may require because of their injury/illness.
• prescribe adaptive and/or alternative techniques to make it easier for a TAC client to perform activities, e.g. breaking strenuous tasks into smaller more manageable tasks.
• prescribe assistive technology that will facilitate and/or maximise a TAC client's independence and participation, e.g. installing a rail in a bathroom.
• prescribe exercises to maximise a TAC client's function and promote the recovery or rehabilitation from their injury
• attend multidisciplinary consultations and team meetings
• complete and issue Certificates of Capacity for TAC clients.

The TAC can pay for an occupational therapist’s travel to and from a client, where reasonable and clinically justified. This must be pre-approved by the TAC. Travel time is paid between the occupational therapist’s practice address and client's residence.

The TAC will pay for treatment and services according to the Occupational therapy fee schedule. If a provider’s fee is higher than the TAC rate, the client may need to pay a gap fee to cover the difference. Information about how the TAC pays for services can be found on the Paying for treatment and services page.

• Directly to the service provider, when the client has given the service their TAC claim number.
• The client can pay for the service and then using myTAC, send a copy of their receipt to TAC for reimbursement.

• services that are not required for the treatment of transport accident-related injuries.
• services provided by individuals who do not meet the occupational therapy provider registration requirements or comply with the Allied Health Policy
• services that are not evidence based, reasonable, clinically justified and outcome focused, and in line with the TAC’s occupational therapy service expectations.

This includes:

• Occupational therapy provided by students or by practitioners who are not registered with AHPRA.

Within the first 90 days of a client’s accident, the TAC can help pay for the reasonable costs of an initial occupational therapy assessment and report without the need for the occupational therapist or the client to contact the TAC for approval first. A client may access services independently or following a referral from a medical practitioner or on discharge from hospital.

Following the initial assessment and report, the TAC may help pay for the reasonable costs of the further occupational therapy services. If an occupational therapist intends to continue treating a TAC client beyond 90 days after their transport accident, they will need to send a request in writing using the relevant TAC template. The TAC will review a client’s treatment to ensure it’s reasonable, clinically justified, outcome focused and in line with the Clinical Framework. The TAC will assess the request and let the occupational therapist and the client know the decision about what the TAC can help pay for and for how long.

If a client has not received treatment in 6 months they will need to seek approval from the TAC before the TAC will pay for further treatment. Occupational therapists should ask their client for a copy of their approval if they haven’t seen the client in 6 months.

To provide TAC-funded occupational therapy, an occupational therapist must:

• be registered under the Health Practitioner Regulation National Law (AHPRA) to practice in the occupational therapy profession (other than as a student),
• comply with the TAC Allied Health policy, and
• adhere to the principles of the Clinical Framework for the Delivery of Health Services.

TAC provider registration

Occupational therapists have the option to apply for registration on the TAC's Occupational Therapy Access Registry. Providers registered on the Occupational Therapy Access Registry are eligible for service arrangements that include access to enhanced fee rates and preferential referrals coordinated by TAC.   For information on the Occupational Therapy Access Registry and registration requirements, visit the Registration information page.

Occupational therapists who are not registered on the Access Registry can continue to provide services to TAC clients under standard arrangements.

Specific requirements apply to each occupational therapy service type. All occupational therapists must ensure they are familiar with and meet the service-specific requirements. These requirements must be read in conjunction with the occupational therapy policy, registration requirements and other relevant TAC policies and guidelines.

The TAC expects that occupational therapy services promote independence and support TAC clients to achieve the best possible outcomes. This includes:

• Making recommendations that support clients to experience improved quality of life through a focus on independence and social and community participation.
• Delivering services that are individualised and outcomes focused.
• Recommending the least restrictive practices and only when necessary and as a last resort to protect the client and/or others from harm.
• Collaborating with the TAC, treating teams and relevant community services.
• If requested, actively participating in the TAC client planning process.
• Proactively identifying any changes to a client’s circumstances, needs or behaviour and notify the TAC if these may impact on the nature or frequency of the services recommended.

Promoting independence and avoiding treatment dependence

In line with Principle 3 of the Clinical Framework, the TAC expects that occupational therapists promote independence from treatment and services through early education, setting clear treatment expectations and encouraging active participation in daily activities. Strategies that empower the injured client to manage their injury and discourage overreliance on treatment and services should be incorporated into all phases of recovery. Further guidance on promoting injury self-management is available in the TAC Clinical Framework.

Allied health assistance

The treating occupational therapist may recommend allied health assistance to help a client with achieving rehabilitation or recovery goals. This is to be charged as per the allied health assistant fee schedule and cannot be charged at the same rate as an occupational therapist.

Certificates of capacity

As part of the client’s treatment, occupational therapists can complete Certificates of Capacity to assess and certify a client’s capacity for work.

The TAC uses the following principles to make socially and economically responsible decisions in line with the Transport Accident Act 1986:

1. Entitled

A TAC client is entitled to a treatment or service if the TAC has accepted liability for the accident-related injury that relates to the treatment or service.

2. Reasonable

When deciding if a treatment or service is reasonable, the TAC considers whether the cost of the treatment or service is reasonable in relation to the relevant fee schedule.

3. Clinical justification

When deciding if a treatment or service is clinically justified, the TAC considers whether the following conditions are met:

• The treatment or service is clinically appropriate for the client’s transport accident injuries and presentation.
• The treatment or service complies with the principles of the Clinical Framework in that it:

• results in a measurable benefit to the injured person
• reflects the adoption of a biopsychosocial approach
• empowers the client to self-manage their injury
• has goals focused on optimising function, participation and return to work and health
• is based on the best available research evidence.

• The treatment or service has a duration and frequency appropriate to the client’s condition and recovery progress. These factors are assessed on a case-by-case basis.  Treatment or service sessions may be more frequent during the acute recovery phase but are expected to become less frequent over time.
• Clients with severe injury or permanent disability may require longer term allied health supports as part of their MyPlan. Please refer to Treating clients with severe injury or permanent disability section above.
• The treatment or service should be discontinued and the client discharged when either:

• the client can independently manage their recovery,
• the client reaches a phase of maintenance and further progress is unlikely with ongoing treatments or services, or
• there is no measurable benefit on outcome measure scores from continued treatments or services.

4. Outcome focused

When deciding if a treatment or service is outcome focused, the TAC considers whether it is progressing or achieving individualised recovery or participation goals that are meaningful to the client.