Social Work

Service Description

Social workers are trained professionals who provide counselling and support to help navigate and manage emotional and practical challenges. They can also provide information and guidance on accessing community resources and support systems. Social workers can help TAC clients with the treatment of a transport accident injury, including conditions such as:

  • anxiety
  • depression

Accredited Mental Health Social Workers (AMHSWs) are social workers who have completed additional training in mental health. AMHSWs conduct mental health assessments and provide therapeutic interventions.

Counselling for family members by a qualified social worker

Immediate family members (spouse, partner, sibling, parent, grandparent, child or grandchild) can receive counselling if their loved one has died or is severely injured as a result of a transport accident. A parent of a dependent child includes:

  • a person who has day-to-day care and responsibility of the child, with whom the child normally resides
  • a guardian of the child.

The TAC will pay for counselling from a doctor, registered psychologist or qualified social worker if a loved one has a severe injury.

Clients and family members can access a range of TAC supports when a family member dies, as well as support for grief and loss.

Eligibility

The TAC can pay for the reasonable cost of approved social work services, including mental health social work, for clients requiring counselling as a result of a transport accident injury. These services must be referred by a medical practitioner.

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.

The TAC will pay for the client’s treatment and services according to the social work fee schedule. If a provider’s fee is higher than the TAC rate, the client may need to pay the difference.

The TAC will review the client’s treatment to ensure it is reasonable, clinically justified, outcome focused and in line with the Clinical Framework and notify the provider and client of the decision.

What the TAC will pay for

Approved services delivered to TAC clients will be paid in accordance with the TAC Social work fee schedule, including:

  • client consultations
  • individual treatment
  • group treatment
  • case management
  • completion of mental health treatment plans and progress reports, when requested
  • visiting a client who is an inpatient in a private hospital where the hospital has consented, and the hospital is not a TAC arrangement hospital

The TAC can help pay for:

  • travel to conduct treatment in the community, where this is clinically justified

Travel time can be paid for travel to and from provider's practice address and their client's residence. Where more than one client is visited in a single travel period, total travel costs should be apportioned equally between clients.

For details see What the TAC can pay for and How to seek TAC approval.

What the TAC won’t pay for

  • services unrelated to transport accident injuries
  • services that are not evidence based, reasonable, clinically justified and outcome focused
  • costs exceeding the TAC rate unless pre-approved
  • private travel costs incurred by a provider counselling family members, when services are performed out of rooms
  • travel costs incurred by a client's family member to travel to the destination where the family counselling services will be undertaken
  • neurotherapy treatment

Also see general items the TAC cannot pay for.

Information required by the TAC

Within the first 90 days of a client’s accident, the TAC can help pay for social work without the need for prior approval. The TAC may contact clients or their service providers to discuss client progress and ensure that treatment is clinically justified, and outcome focused.

If a client needs social work beyond 90 days after their transport accident, the provider must seek TAC approval before funded treatment can be delivered. Prior approval is also needed if it has been more than 6 months since the client last received TAC-funded treatment.

Clients who have not received funding for social work services within the first 90 days must have a mental health treatment plan completed after attending 3 sessions. Subsequent mental health treatment plans must document clear evidence of client need and progress for subsequent services.

The TAC will review clients’ treatment to ensure it aligns with the Clinical Framework and continues to be reasonable, clinically justified and outcome focused. Based on this assessment, the TAC will inform the provider and client about what the TAC will help pay for and for how long.

When the TAC client has not received treatment in 6 months, they need to seek approval from the TAC before further treatment. Providers should ask the TAC client for a copy of their approval if they haven’t seen them in 6 months.

Provider Guidelines

To provide TAC-funded social work, a social worker must:

  • be a qualified social worker who is eligible for full membership of the Australian Association of Social Workers (AASW) to practice in the Social Work profession (other than as a student). To be recognised as an AMHSW, social workers must meet specific criteria outlined by the AASW
  • comply with the TAC Mental Health & Wellbeing policy
  • adhere to the principles of the Clinical Framework for the Delivery of Health Services

Service Standards

The TAC expects mental health and wellbeing providers to integrate the principles of the Clinical Framework for the Delivery of Health Services (Clinical Framework) in their daily practice.

Providers are expected to:

  • use person-centred, strength-based approaches
  • promote client independence
  • be goal-oriented and time-limited
  • engage the client’s support network
  • develop and implement transition plans
  • deliver services appropriately and be equipped with necessary specialised knowledge

Conflict of interest

Providers are expected to deliver services in line with the TAC’s policy on Funding Treatment by a Member of the Client's Immediate Family.

How the TAC makes a decision

The TAC uses the following principles to aid socially and economically responsible decision-making in line with the Transport Accident Act 1986:

1. Entitled

The TAC client is entitled to social work services if the TAC has accepted liability for the transport accident-related injury or condition requiring social work support.

2. Reasonable

When determining if social work services are reasonable, the TAC considers whether the cost of the service is reasonable in relation to the social work fee schedule.

3. Clinically Justified

The TAC will decide if social work services is clinically justified, the TAC considers:

  • if this service is appropriate to support the client to achieve their transport accident-related recovery goals
  • how the client is presenting, and how will the treatment address barriers to these goals
  • how will efficacy of treatment be measured, considering best practice and outcome measures
  • whether the provider has taken steps to build client independence and self-management
  • whether all elements of the clinical framework have been considered.

4. Outcome Focused

The TAC will decide if the social work service is outcome focused. This includes the TAC considering whether the service is progressing and/or achieving the referral goals.