Household help services guidelines

The provision of household help services

These guidelines are in line with the Workplace Injury Rehabilitation and Compensation Act 2013 (WIRC Act) and the Accident Compensation Act 1985.

WorkSafe will have regard to these guidelines when making decisions for the provision of household help services to a worker who has an accepted claim under the Victorian Workers Compensation Scheme.

Throughout these guidelines, any reference to WorkSafe also includes WorkSafe’s agents and self-insurers.

Household help services

WorkSafe can fund household help services to assist workers to effectively recover from workplace injuries and safely return to work and life.

Household help services

Household help services are essential household cleaning and gardening tasks:

• provided in the worker's primary residential home
• the worker performed pre-injury
• the worker can no longer perform because of their work-related illness or injury.

Household help services can assist workers with the domestic chores that must be attended to regularly, such as cleaning and lawn mowing. 'Household help' is to be distinguished from 'maintenance', such as painting or the repair of broken items in and around the home.

Helping workers maximise their independence is an important part of the recovery process. WorkSafe can pay for the reasonable costs of household help services that are needed because of a work-related injury or illness.

WorkSafe expects the type and frequency of household help services provided to a worker will reduce as the worker recovers and should be considered an interim or short-term arrangement, unless the worker has long-term needs due to the nature of their injury or illness.

What WorkSafe can pay for

WorkSafe can pay the reasonable costs of household help services a person needs as a result of a work-related injury or illness under Victorian workers compensation legislation.

The treatment or service must meet the following criteria.

• Be clinically justified, safe and effective.
• Be likely to achieve measurable improvement in a person’s functioning.
• Promote progress toward a person’s functional independence, participation and self-management.
• Be for rehabilitation purposes for a work-related injury only.
• Be delivered in line with the Clinical framework.

The service must be referred by a medical practitioner, physiotherapist, osteopath or chiropractor, who is currently providing treatment to the worker.

WorkSafe can pay the reasonable costs for the following household help services.

Equipment to increase a worker's independence

The worker is expected to provide safe and appropriate normal and essential household items for their everyday use. WorkSafe will consider funding adaptive household equipment (AHE) to assist a worker’s independence with household tasks. WorkSafe can consider reasonable AHE recommendations as part of a WorkSafe registered occupational therapist (OT) assessment or by a hospital OT at the time of discharge for a period of 12 weeks .

It is expected that the supply of AHE will reduce or replace the provision of WorkSafe funded household help services. Where a graduated reduction of services is clinically necessary to achieve service replacement, the prescribing therapist must document a plan to reduce services over a defined time period. This should include expected outcomes, complexities and/or barriers, and review points.

AHE can be prescribed to reduce or replace funded household help services when the following applies:

• The worker was performing the task pre-injury.
• The worker seeks independence in the task post injury.
• An OT has assessed and recommended AHE supply to support the worker’s rehabilitation.
• The worker has successfully trialled the equipment. Trials may be completed at the supplier store, or within the worker’s home. If the assessing OT deems a trial is not necessary or appropriate, the clinical rationale for no trial should be documented on the Household help services needs assessment form.

Equipment and related services guidelines

WorkSafe will periodically review a person’s entitlement to household help services to make sure treatment and services remain:

• reasonable
• clinically justified
• outcome focused
• payable under the legislation.

The prescription of AHE must be completed in line with WorkSafe’s equipment and related services guidelines

Services WorkSafe will not pay for

Under the Victorian workers compensation legislation, WorkSafe cannot pay for the following household help services.

• Services for an injury that is not a direct result of the work-related injury or illness.
• Services for a person other than the person with an accepted claim.
• Services that are not a reasonable cost as determined in accordance with the Victorian workers compensation legislation.
• Services provided outside of Australia without prior approval from WorkSafe.
• Services provided by a person who is not approved by WorkSafe to provide household help services.

WorkSafe will not pay for household help services provided without prior approval from the agent.

Under WorkSafe’s determination of reasonable cost, WorkSafe will not pay for costs relating to the following.

• Services that the worker did not themselves perform prior to their injury or illness.
• Services provided at a home other than the worker’s primary place of residence.
• Services sub-contracted to or provided by a non-registered provider.
• Services provided by friends, partners or family members.
• Services that were provided without a referral from a medical practitioner, physiotherapist, osteopath or chiropractor, who is currently providing treatment to the worker.
• Services that were provided by purchased labour prior to the injury or illness.
• Services that address the injury(ies) or physical restrictions of occupants other than the worker.
• Services that are of no clear measurable benefit to the worker.
• AHE that does not promote independence or provide any benefit compared to the worker’s existing equipment.
• AHE or household help services for the replacement of equipment previously funded by Worksafe.
• New AHE where the worker’s existing household equipment will meet the need.
• A single service billed to more than one claim held by the worker.
• Fees associated with cancellation or non-attendance or services not provided to the worker, including the worker not being at home when the provider attends.
• Services provided above the level and amount approved by WorkSafe.
• Telephone calls and telephone consultations with the worker or other providers.
• Travel time for the service provider.
• The costs of any housework consumables, for example, cleaning cloths, cleaning liquids.
• Food preparation.
• Watering or applying fertilisers or pesticides.
• The costs of any lawn mowing or gardening consumables, for example, fuel and fertilisers.
• The costs of repairs and maintenance associated with running costs of adaptive household equipment.
• The cost of home maintenance products, for example, gutter guards and synthetic turf.
• Raw garden materials, for example, plants or mulch.
• Car care.
• Home or furniture maintenance including cleaning of drapes, blinds or carpets.
• Property maintenance or repair including painting, watering, fertilising, applying pesticides to gardens, or maintaining paving.
• Pool and spa cleaning.
• Rubbish or grass removal or disposal.
• The costs associated with heating and cooling of the home, or heating materials such as wood. However, in exceptional circumstances WorkSafe may consider the provision of household services to collect and chop wood as household tasks where those costs (or an alternative) are reasonable and necessary. The following eligibility criteria must be met.
  • ­An assessment completed by an occupational therapist.
  • ­The worker has no other means of heating the living areas of the home (kitchen, lounge and utilised bedroom).
  • ­The residential home of the worker is not connected to mains gas.
  • ­The residential home of the worker is not connected to electricity supply.
  • ­There are insufficient solar panels and/or batteries to heat the home kitchen, lounge and utilised bedroom).
• Other services that would require a professional to complete, for example, decluttering, solar panel cleaning, vacate cleans, chimney cleaning and arborists.
• Increased service costs as a result of a worker relocating to new place of residence or larger property.
• Pet care.
• Support of hobbies or personal lifestyle interests, for example, hobby farm, animal breeding or showing.

How much WorkSafe can pay

WorkSafe will pay for household help services in line with our fee schedules.

Sometimes there is a difference between what a provider charges and what WorkSafe will pay as the reasonable cost. If the provider charges more than what WorkSafe will pay, workers will need to pay the difference. In this instance, WorkSafe recommends the provider advise the worker prior to providing any services.

Household help service providers must refer to WorkSafe’s instructions for invoicing.

Who can provide these services

Household help services are delivered by providers who are approved and registered with WorkSafe to provide these services.

WorkSafe will only fund household help services delivered by providers that meet the following conditions.

• Registered by WorkSafe to provide household help services.
• Hold a current Australian Business Number (ABN) or a Victorian business registration.
• Hold the requisite insurance coverage to deliver household help services.

Find out how to register for approval as a provider.

Accessing services

WorkSafe can fund household help services if a medical practitioner, physiotherapist, osteopath or chiropractor provides a referral prior to the commencement of the service or if requested by an OT employed or contracted by a hospital registered with WorkSafe as part of the discharge from hospital.

Further, WorkSafe requires the following for the request, review and approval of household help services.

Service delivery expectations

WorkSafe expects that all providers delivering household help services as part of the Victorian workers compensation scheme follow the below principles.

• Provide culturally safe and respectful services.
• Protect the person’s human rights and report any concerns of abuse, neglect or discrimination to an appropriate regulatory or complaints body.
• Support the person to maximise their independence, promote recovery and self-advocacy.

WorkSafe also expects that any treatment or service provided is reasonable, clinically justified, outcome focused, and in line with the Clinical Framework.

WorkSafe has reporting and engagement expectations for all providers delivering services to workers. WorkSafe expects providers to communicate, collaborate and provide information to WorkSafe and other relevant parties as required.

For example:

• Providers should work with treating health practitioners or other providers, such as medical practitioners to enable the most appropriate treatment
• Providers should work with occupational rehabilitation providers, treating health practitioners and employers in relation to return to work.

Providers are required to comply with the requirements set out in these guidelines and in the Application for registration to provide services to workers.