Household help services policy

What WorkSafe will pay for

The WorkSafe Agent (the agent) can pay the reasonable costs of household help services when required as a result of a work-related injury or illness under Victorian workers compensation legislation.

A written request for household services must be provided from the treating medical practitioner, physiotherapist, chiropractor or osteopath before the agent will consider whether or not to approve household services. Prior approval must be given by the agent before household services can be provided.

The agent will periodically review a worker's entitlement to household help services to ensure that the costs of the services are reasonable and the services are necessary and appropriate for the worker's work-related injury or illness.

Background

Household help services may be provided to assist with a worker's recovery, rehabilitation and return to work taking into account the worker's:

• injury or illness
• stage of recovery, including their physical rehabilitation program
• domestic circumstances

Household help is provided to replace only the labour component of routine household tasks performed pre injury or illness. Services are to support a worker regain independence during rehabilitation and are short term. If the service is required longer term, self-management strategies or adaptive equipment may be explored to assist maximise a workers independence with household activities.

The agent will not pay for, or reimburse the costs of, any housework, gardening or lawn mowing consumables.

Household help services do not extend to the needs of other independent adults living in the worker's household.

There is an expectation that family/household members will contribute to household tasks. The agent will consider the reasonable contribution of family/household members to household tasks when assessing household help services requests. Household help services are not provided to complete all the tasks the worker undertook pre-injury.

Definitions

In this policy, household help services means the provision of basic and routine housework and gardening tasks that the worker performed pre-injury or illness and can no longer perform as a direct result of their work-related injury or illness. Household help services consist of:

• housework tasks
• lawn mowing tasks
• gardening tasks

Guidelines

What can the agent pay for in relation to household help services?

The agent can pay the reasonable costs of household help services, up to the maximum amount, that are:

• required as a result of the work-related injury or illness
• for the worker only
• requested by treating medical practitioner, physiotherapist, chiropractor or osteopath
• reasonable, necessary and appropriate in the circumstances
• approved by WorkSafe under the Act
• supplied by WorkSafe registered and approved service providers under the Act
• to replace a worker's labour in the home for routine, common, basic housework, standard lawn mowing and simple gardening tasks associated with maintaining themselves in the home i.e. where, prior to the work-related injury or illness, the household tasks were performed by the worker and not by other people such as family members or purchased labour

The agent can also pay the reasonable costs of household help services where a worker provided housework assistance for a child who:

• lives in the home
• was dependent on the worker to perform the tasks preinjury or illness
• is unable to perform the tasks themselves
• has no other adults living in the home to undertake the tasks for the child

The household help services required - including the tasks, frequency and for how many hours the services will be provided - will depend on the needs of the individual worker.

Household help services

Please note that the agent will not pay for, or reimburse the costs of, any housework consumables or equipment e.g. cleaning cloths, house rubbish removal, cleaning liquids, brooms, mops and vacuum cleaners etc.

Who can provide household help services?

The agent will only pay for household help services by providers who are:

• registered and approved by WorkSafe to provide household help services
• able to provide evidence of Australian company or Victorian business registration
• able to provide evidence of current public liability insurance (minimum $5million)

The registration period is valid for the term of the current public liability insurance.

Registration status can be renewed by submitting a copy of the renewed public liability insurance (or certificate of currency) to WorkSafe prior to the expiry date of the current registration.

Further information on WorkSafe's required level of public liability insurance can be found on WorkSafe's Application for Registration to Provide Services to Workers.

What information does the agent require to consider paying household help services?

WorkSafe considers household help to be a referred service. A referral must be provided for household help services prior to commencement of services.

To receive prior approval for household help services, the worker's treating medical practitioner, physiotherapist, chiropractor or osteopath must provide a written request to the agent for household help services prior to commencement of any services. The household help services request must specify the:

• relationship between the household help requested and the worker's work-related injury or illness
• household help tasks required
• the period of time that household help is required and any commencement date, e.g. to undergo and recover from surgery
• a quote for the services requested from a registered provider
• the agent will review a workers family circumstances alongside the household help service request to determine reasonableness and necessity

The agent will review a worker's entitlement to household help services over the duration of the claim to ensure that the costs of the services are reasonable and the services are necessary and appropriate for the worker's work-related injury or illness. This may involve the agent referring to an Occupational Therapist to conduct an assessment to determine the necessary level of support required and to maximise the worker's independence and participation.

What happens if I change my residence?

Agents may be required to reassess approved services for workers who move homes as there may be change in service requirements. The relevant exclusions to services would apply in these circumstances.

When will the agent respond to a request?

Within 10 working days of receiving the household help services request, the agent will advise whether:

• the request has been approved
• the request has been denied, or
• further information is required to make a decision

Where further information is required, the agent will advise whether the request has been approved or denied within 10 working days of receiving the additional information.

What WorkSafe / the agent will not pay for

WorkSafe will not pay for household help services when the worker did not perform them prior to their injury or illness. WorkSafe will not pay for services provided at a home other than the worker’s primary place of residence.

WorkSafe will not pay for:

• services delivered by a provider that is not registered and approved by WorkSafe to provide that service
• services subcontracted to, or provided by a non-registered provider
• fees associated with cancellation or not being at home when the provider attends
• telephone calls and telephone consultations with the worker or other providers
• travel time for the service provider
• services provided above the level and amount approved by WorkSafe
• services provided by friends or by family members
• services that were provided by purchased labour prior to the injury or illness
• services that extend to other adults in the home
• services provided outside of Australia unless prior approval from the Agent is received
• more than one service per day for the same worker
• the costs of any housework consumables or equipment, for example, cleaning cloths, cleaning liquids, brooms, mops and vacuum cleaners
• watering
• the costs of any lawn mowing or gardening consumables or equipment, for example, mowers, weeders and fertilisers
• the cost of home maintenance products, for example, gutter guards and synthetic turf
• raw garden materials, for example, plants or mulch
• food preparation
• self-care tasks including bathing, dressing or personal grooming
• pet care
• support of hobbies or personal lifestyle interests, for example, hobby farm, animal breeding or showing
• car care
• home or furniture maintenance including cleaning of drapes, blinds or carpets
• home modifications including painting, renovation or modification
• 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
• heating materials such as wood
• provision or chopping of firewood
• cost of utilities associated with the heating or cooling of a residence
• other services which would require a professional to complete, for example, decluttering, solar panel cleaning, vacate cleans, chimney cleaning, arborists, etc
• relocation costs to move to a new primary residential home
• the cost of housework equipment/appliances or gardening implements unless recommended by an Occupational Therapist as assistive equipment for the worker