Assistance dog services policy

Background

WorkSafe Victoria (WorkSafe) and/or its authorised agents can pay for the reasonable costs of vision or hearing assistance dogs where required as a result of a work-related injury or illness under Victorian Workers' Compensation Scheme.

WorkSafe has an obligation to ensure the financial viability of the Workers' Compensation Scheme, as well as ensuring the efficient, effective and fair occupational rehabilitation of injured workers.

WorkSafe will periodically review a worker's entitlement to a vision or hearing assistance dog ensuring that the service remains reasonable for the work related injury or illness and is payable under the scheme.

This policy should be read together with the following:

Definitions

An assistance dog is a generic term for a vision, hearing, or service dog trained to perform identifiable physical tasks and behaviours that assist a person to reduce the effect of a disability. Assistance dogs are covered under legislative access laws for public access rights when working with their handler.

There are three main types of assistance dogs:

• Vision assistance dogs, commonly known as guide dogs or seeing eye dogs are trained to help people who are blind or visually impaired navigate in the community more safely and independently.
• Hearing assistance dogs are trained to assist people who are deaf and hearing impaired by alerting them to sounds.
• Service dogs are trained to assist people who have various physical and neurological disabilities to manage personal and other tasks.

Under this policy, vision or hearing assistance dogs may be considered for funding. Service dogs are not able to be funded under this policy as they are considered a non-established, new or emerging treatment or service (NeNETS).

Assistance dogs are not therapy, emotional support or companion dogs. Under Australian Law these dogs are considered pets. While all dogs can naturally provide emotional support to a human being, an assistance dog requires extensive training to perform tasks as well as meet a high standard of behaviour and hygiene.

Evidence based research

An established evidence base exists to support the effectiveness of vision and hearing assistance dogs. They are considered an established service and can be funded under this policy.

Currently there is no strong clinical evidence base to suggest that other types of assistance dogs are effective in the treatment or support of conditions such as post-traumatic stress disorder (PTSD) or other psychological conditions in injured workers, diabetes, immobility due to physical impairment, seizure and autism. These types of assistance dogs are unable to be funded under this policy.

All other types of assistance dogs are considered NeNETS. Although a separate and distinct policy exists for NeNETS, other types of assistance dogs are currently not funded under that policy as there is no existing strong clinical evidence about their effectiveness. Unless and until strong clinical evidence emerges as required under NeNETS policy, other types of assistance dogs are unable to be funded by WorkSafe.

Guidelines

What WorkSafe can pay for under this policy

Vision and hearing assistance dogs may be classified as a personal and household service under the Workplace Injury Rehabilitation and Compensation Act 2013 (the Act).

Vision assistance dogs guide their handlers to navigate safely around their community and remain independent. Hearing assistance dogs are trained to alert their handlers to certain sounds in the home, workplace and public to help ensure safety and security and to enable independence.

WorkSafe can pay for the reasonable costs of a vision or hearing assistance dog where there is clinical justification that it is necessary to measurably improve function, independence, mobility, community involvement and safety. In addition, the following six criteria must be met:

1. Required as a result of a work-related injury or illness that has caused:
   • vision impairment leading to a worker being assessed as legally blind and/or
   • hearing impairment assessed as severe to profound
2. is reasonable, necessary and appropriate in the worker's circumstances
3. there has been an assessment indicating the suitability of a dog for the worker including consideration given to the dogs care, welfare and living environment, by a provider organisation that meets the criteria outlined in this policy
4. the dog is a vision or hearing assistance dog which has been provided, trained and accredited by a provider organisation that meets the criteria outlined in this policy
5. a referral by a medical practitioner has been provided to the Agent containing the information under the heading below 'What information does WorkSafe require?'
6. prior approval has been provided by the Agent

WorkSafe may pay the reasonable costs associated with:

• An assessment to determine the workers suitability for a vision or hearing assistance dog
• the provision, training and accreditation costs of an appropriately selected and matched vision or hearing assistance dog
• a replacement vision or hearing assistance dog in the event of death or retirement of an existing vision and/or hearing assistance dog
• ongoing training required by the provider, re-accreditation costs, Public Access Test (PAT) costs, specialised harnesses and jackets required while working
• reasonable maintenance expenses up to a limit of $2,500 per year to maintain the welfare of the assistance dog (see expenses section)

Funding for a vision or hearing assistance dog will continue while the injury is ongoing and requires an assistance dog, until such time as a worker's entitlements to medical and like expenses stop.

* WorkSafe will undertake regular review of new and emerging evidence and update this policy as required

If approval is given for funding an assistance dog under this policy, the following expenses may or may not be funded.

** WorkSafe's Equipment and Related Services Policy and Guidelines allow for payment of the reasonable costs of maintenance for high cost equipment items. WorkSafe has extended that allowance to maintenance expenses of vision and hearing dogs up to a maximum amount of $2,500 per year. This amount can be reimbursed to the worker (note this is a total amount across all categories). Itemised tax invoices must be supplied.

What WorkSafe will not pay for under this policy

• PTSD or psychiatric, mobility, diabetes, autism and seizure or alternative assistance dogs other than vision or hearing assistance dogs.
• An assistance dog for a person other than the worker.
• Therapy, emotional support or companion dogs.
• Animals or species other than dogs.
• Any services that are not aligned with this policy.
• Costs associated with maintaining the welfare of the dog exceeding the amount funded under the capped yearly maintenance expense fee.
• Costs incurred after the retirement of an assistance dog.
• Assistance dogs that are obtained or purchased prior to receiving agent approval.
• Appointments where the worker cancels or does not attend.
• Treatment or services provided outside Australia without prior written approval from WorkSafe or its agent.
• If the worker no longer wants, or is no longer able to have an assistance dog or if the dog ceases to hold accreditation as an assistance dog, funding will stop.

Assistance dogs for PTSD, other psychological conditions, seizures, diabetes and autism are claimed to be used to treat or stabilise a condition. Currently there is no high quality scientific or clinical evidence base to suggest that the use of assistance dogs to treat or support these conditions are effective. Longer term benefits and adverse effects of these types of assistance dogs on a worker's symptoms, and the welfare of the dog are currently unknown.

Who can provide an assistance dog?

Only accredited member organisations of Assistance Dogs International (ADI) or the International Guide Dog Federation (IGDF) can provide, train and accredit an assistance dog.

WorkSafe expectations for service delivery

The assistance dog must be provided, trained and accredited by an ADI or IGDF accredited provider organisation under an ADI or IGDF accredited program ensuring adherence to their standards. This includes screening and matching processes, ethical treatment and training of dogs, treatment of workers with respect and dignity, lifetime support and follow up.

Providers must show effectiveness, empower the worker to manage their injury, and use evidence-based methods to optimise the worker's function and recovery. This support aligns to the principles of the Clinical Framework for the Delivery of Health Services.

Clinical Framework for the Delivery of Health Services

The Clinical framework outlines a set of guiding principles for the delivery of health services. These principles are intended to support health professionals in their treatment of an injury.

What information does WorkSafe require?

Approval must be sought from the WorkSafe agent before obtaining an assistance dog.

A request from a medical practitioner is required for a vision or hearing assistance dog to be approved.

The medical practitioner request must include:

• the type of assistance dog being requested
• the accepted condition relevant to obtaining an assistance dog under this policy
• other treatments, services or aids in place to support the worker's condition
• how the worker would benefit from an assistance dog e.g. which physical tasks and behaviours the dog can perform to assist the worker and reduce the effect of their disability

Any request for an assistance dog that is not a vision or hearing assistance dog, will be reviewed under the NeNETS policy. See Requests for dogs other than vision or hearing assistance dogs.

Vision or hearing assistance dogs – Two step approval process

Requests for vision and hearing assistance dogs are approved under a two-step process:

Requests for assistance dogs other than vision or hearing assistance dogs

Any request for an assistance dog that is not a vision or hearing assistance dog, will be reviewed under the NeNETS policy.

When will WorkSafe respond to a request?

Once all required information is received, notification of an outcome for each step in the approval process will be made within 28 days.

Suspended from providing services

If a provider is no longer accredited by ADI or IGDF, WorkSafe will suspend the provider from providing services.

Note: This policy is a guideline issued by WorkSafe Victoria under Victorian workers’ compensation legislation in respect of the reasonable costs of services, and services for which approval should be sought from the WorkSafe Agent or self-insurer (as the case may be) before the services are provided.