Adult Disability Assessment Determination 1999 (Cth)

Adult Disability Assessment Determination 1999

as amended

made under section 38C of the

Social Security Act 1991

This compilation was prepared on 11 December 2008

taking into account amendments up to Adult Disability Assessment Amendment Determination 1999 (No. 1)

Prepared by the Public Law Branch,

Department of Families, Housing, Community Services and Indigenous Affairs, Canberra

Contents

Page

Part 1Preliminary   2

1.1Name of determination   2

1.2   Commencement   2

1.3   Definitions   2

1.4   Delegation   2

1.5Treating health professional   2

1.6Disability assessment components   2

Part 2Adult Disability Assessment Tool   4

2.1Questionnaires   4

2.2Testing method   4

2.3Rating method   4

Part 3Review of decisions   6

3.1Review of decisions   6

Schedule 1Questionnaires   7

Part 1Claimant questionnaire   7

Part 2Professional questionnaire   12

Schedule 2Rating method   16

Notes           24

Part 1            Preliminary

1.1    Name of determination

This determination is the Adult Disability Assessment Determination 1999.

1.2    Commencement

This determination commences on 1 July 1999.

1.3    Definitions

In this determination:

Act means the Social Security Act 1991.

adult means a person aged 16 or more.

claimant means a person mentioned in subsection 2.1 (2).

claimant questionnaire means the questionnaire mentioned in subsection 2.1 (1).

professional questionnaire means the questionnaire mentioned in subsection 2.1 (3).

treating health professional means a person approved under section 1.5.

Note   Some expressions used in this determination are defined in the Social Security Act 1991 (see sections 5 and 23), including:

·officer

·Secretary.

1.4    Delegation

The Secretary may, in writing, delegate to an officer all or any of the powers of the Secretary under this determination.

1.5    Treating health professional

(1)   The Secretary may approve a person as a treating health professional.

(2)   The Secretary may also approve a class of persons as treating health professionals.

Note   A treating health professional is the only person who can complete the questionnaire set out in Part 2 of Schedule 1 (see subsections 2.1 (3) and (4)).

1.6    Disability assessment components

Part 2 of this determination sets out an Adult Disability Assessment Tool.

Note   Under subsection 38C (1) of the Act, the Secretary may, by determination in writing:

(a)     devise a test for assessing the disability, emotional state, behaviour and special care needs of a person aged 16 or over; and

(b)     provide a method for rating the person by giving him or her, on the basis of the results of the test, a score in accordance with a scale.

Under subsection 38C (3) of the Act, the part of the determination setting out the test and the rating method is the Adult Disability Assessment Tool.

Part 2            Adult Disability Assessment Tool

2.1    Questionnaires

(1)   Part 1 of Schedule 1 sets out a questionnaire (the claimant questionnaire) about disability, emotional state, behaviour and special care needs of an adult.

(2)   The claimant questionnaire may be completed only by a person (the claimant) wishing:

(a)    to claim a carer allowance or carer payment, or both, under the Act for the care of an adult; or

(b)    to continue to be qualified for receiving carer allowance or carer payment, or both, under the Act for the care of an adult.

(3)   Part 2 of Schedule 1 sets out another questionnaire (the professional questionnaire) about the disability, emotional state, behaviour and special care needs of an adult.

(4)   The professional questionnaire may be completed only by a treating health professional.

2.2    Testing method

(1)   The test for assessing a person’s disability, emotional state, behaviour and special care needs is the assessment, under this Part, of the answers given in relation to the person in the 2 questionnaires mentioned in section 2.1.

(2)   The following steps are carried out for the test:

(a)    the Secretary must be satisfied that a completed professional questionnaire is an accurate reflection of the disability, emotional state, behaviour and special care needs of the person concerned;

(b)    a score must be calculated:

(i)    using the rating method mentioned in section 2.3; and

(ii)    on the basis of the answers given in the questionnaire.

(3)   If the Secretary is not satisfied that the professional questionnaire is an accurate reflection of the person’s disability, emotional state, behaviour and special care needs, the Secretary must ask for a replacement professional questionnaire to be completed by another treating health professional.

2.3    Rating method

(1)   Steps 1 to 5 in Schedule 2 set out the method for rating a person, on the basis of the answers given in each questionnaire completed in relation to the person.

(2)   The method gives the person a score:

(a)    in accordance with the scale mentioned in subsection 38C (2) of the Act; and

(b)    that determines whether the person is a care receiver to which paragraph 198 (2) (a), subparagraph 198 (2) (d) (i) or paragraph 954 (1) (c) of the Act applies.

Part 3            Review of decisions

3.1    Review of decisions

For Chapter 6 of the Act, a decision under section 1.5 or subsection 2.2 (3) is taken to be a decision of an officer under the Act.

Schedule 1        Questionnaires

(section 2.1)

Part 1          Claimant questionnaire

Division A

For each question, the claimant must tick only the response code that best describes how well the person in care usually manages. Help means any physical assistance, guidance or supervision. Without help means that the person initiates and completes activities without assistance or supervision.

Does the person in care:

1	Move around the house (may use walking stick, frame, wheelchair etc)?	Response code
Without help	a
With help of one person	b
With help of two people	c
Is confined to bed	d
2	Fall over indoors or outdoors (or from wheelchair)?	Response code
Often	a
Sometimes	b
Never	c
3	Move to and from bed, chair, wheelchair and walking aids?	Response code
Without help	a
With some help	b
With a lot of help	c
Cannot do this	d
4	Have difficulty hearing others (even with hearing aids)?	Response code
Always	a
Often	b
Sometimes	c
Never	d

5	Have difficulty seeing clearly (even with glasses)?	Response code
Always	a
Often	b
Sometimes	c
Never	d
6	Need help or attention during the night?	Response code
Always	a
Often	b
Sometimes	c
Never	d
7	Have loss of bladder control or bowel control or both (incontinence)?	Response code
Always	a
Often	b
Sometimes	c
Never	d
8	Use continence aids or equipment (eg colostomy, catheter, pads)?	Response code
Without help	a
With some help	b
With a lot of help	c
Does not use aids	d
9	Use the toilet?	Response code
Without help	a
With some help	b
With a lot of help	c
Cannot use a toilet	d
10	Eat his or her food (does not include meal preparation)?	Response code
Without help	a
With some help	b
With a lot of help	c
Cannot feed themselves	d
11	Shower or bathe himself or herself?	Response code
Without help	a
With some help	b
With a lot of help	c
Cannot do this	d
12	Dress himself or herself? (eg buttons, zips, etc)	Response code
Without help	a
With some help	b
With a lot of help	c
Cannot do this	d
13	Look after his or her grooming (eg shaving, caring for hair, and teeth)?	Response code
Without help	a
With some help	b
With a lot of help	c
Cannot do this	d
14	Take care of his or her own medication (eg takes the right tablet at the right time)?	Response code
Without help	a
With some help	b
With a lot of help	c
Cannot do this	d
Does not take medication	e
15	Take care of his or her own treatment (eg oxygen, wound care, gastric feeding)?	Response code
Without help	a
With some help	b
With a lot of help	c
Cannot do this	d
Does not have treatment	e

Division B

For each question, the claimant must tick only the response code that best describes how well the person in care usually manages.

Does the person in care:

1	Understand what you, the carer, say?	Response code
Always	a
Usually	b
Sometimes	c
Never	d
2	Understand what other people say?	Response code
Always	a
Usually	b
Sometimes	c
Never	d
3	Let others know how he or she feels and what he or she wants (eg by speaking, using sign, or a communication aid)?	Response code
Always	a
Usually	b
Sometimes	c
Never	d
4	Know where he or she is?	Response code
Always	a
Usually	b
Sometimes	c
Never	d
5	Know whether it is morning, afternoon, or night?	Response code
Always	a
Usually	b
Sometimes	c
Never	d
6	Remember things that happened today?	Response code
Always	a
Usually	b
Sometimes	c
Never	d

Division C

For each question, the claimant must tick only the box that best describes how the person in care usually behaves.

Does the person in care:

1	Wander away or ‘run away’ from home?	Response code
Never	a
Sometimes	b
Often	c
2	Shout, scream at or threaten other people?	Response code
Never	a
Sometimes	b
Often	c
3	Physically harm other people?	Response code
Never	a
Sometimes	b
Often	c
4	Damage furniture, possessions or objects?	Response code
Never	a
Sometimes	b
Often	c
5	Laugh or cry without apparent reason?	Response code
Never	a
Sometimes	b
Often	c
6	Withdraw from contact with other people, or appear depressed, worried or fearful?	Response code
Never	a
Sometimes	b
Often	c
7	Deliberately harm himself or herself (eg by biting, scratching skin, hitting or banging his or her head)?	Response code
Never	a
Sometimes	b
Often	c
8	Have unusual, inappropriate, or repetitive behaviours (eg uncontrolled eating, spinning objects, hand flapping, rocking, calling out or saying the same thing over and over again)?	Response code
Never	a
Sometimes	b
Often	c

Part 2          Professional questionnaire

Division A

This is an assessment of personal activities of daily living.  For each function, the treating health professional must tick only the box that best describes the person receiving care.

The information under each function should be used as a record of what a person does, not as a record of what a person could do.

The main aim is to establish degree of independence from any help, physical or verbal, however minor and for whatever reason.

The need for supervision renders the person not independent.

A person’s performance should be established using the best available evidence.  Asking the person, friends or relatives or both, and nurses will be the usual source, but direct observation and common sense are also important.  However, direct testing is not needed.

Usually the performance over the preceding 24-48 hours is important, but occasionally longer periods will be relevant.

Middle categories imply that the person supplies more than 50% of the effort.

Use of aids to be independent is allowed.

1	Bowels - Assess preceding week.  If needs enema, then ‘incontinent’.	Response code
Incontinent (or needs to be given enema)	a
Occasional accident  (once a week)	b
Continent	c
2	Bladder - Assess preceding week.  Occasional = less than once a day. A catheterised person who can completely manage the catheter alone is registered as ‘continent’.	Response code
Incontinent or catheterised and unable to manage	a
Occasional accident  (once a week)	b
Continent	c
3	Grooming - Assess preceding 24-48 hours.  Refers to personal hygiene including cleaning teeth, fitting false teeth, doing hair, shaving, washing face. Implements can be provided by helper.	Response code
Needs help with personal care: face, hair, teeth	a
Independent (implements provided)	b

4	Toilet use - Should be able to reach toilet or commode, undress sufficiently, clean self, dress and leave. With help = can wipe self, and could do some of the above.	Response code
Dependent	a
Need some help but can do some things alone	b
Independent (on and off, wiping, dressing)	c
5	Feeding - Able to eat any normal food (not only soft food). Food cooked and served by others, but not cut up. Help = food cut up, person feeds self.	Response code
Unable	a
Needs help in cutting, spreading butter etc	b
Independent (food provided within reach)	c
6	Transfer - From bed to chair and back. Unable = no sitting balance (unable to sit), 2 people to lift. Major help = 1 strong or skilled or 2 normal people. Can sit up. Minor help = 1 person easily, or needs any supervision for safety.	Response code
Unable - no sitting balance	a
Major help (physical, 1 or 2 people), can sit	b
Minor help (verbal or physical)	c
Independent	d
7	Mobility - Refers to mobility about house or indoors. May use aid. If in wheelchair, must negotiate corners or doors or both unaided. Help = by 1 untrained person, including supervision, moral support.	Response code
Immobile	a
Wheelchair independent, including corners etc (ie. uses wheelchair without assistance)	b
Walks with help of 1 person (verbal or physical)	c
Independent	d
8	Dressing - Should be able to select and put on all clothes which may be adapted. Half = requires help with buttons, zips etc but can put on some garments alone.	Response code
Dependent	a
Needs help but can do about half unaided	b
Independent (including buttons, zips, laces etc)	c

9	Stairs - To be independent must be able to carry any walking aid used.	Response code
Unable	a
Needs help (verbal, physical, carrying aid)	b
Independent up and down	c
10	Bathing - Usually the most difficult activity.  Bath: Independent = must get in and out unsupervised, and wash self.  Shower: Independent = unsupervised or unaided or both.	Response code
Dependent	a
Independent	b

Division B

1	In your opinion is the person cognitively impaired?			Response code
No, please go to Division C			a
Yes, please answer question 2			b
2	Cognitive Function			Response code
This is an assessment of cognitive function.  Ask the person receiving care for the following information.  Tick box (4) to indicate if the person’s answers were right or wrong.
Right	Wrong
Time (to nearest hour)	a
Memory Phrase: Repeat this phrase after me and remember it for later - 42 West Street
Name of institution or suburb where the person lives	b
Recognition of 2 persons in the room (doctor, nurse, carer etc)	c
Date of birth (day, month and year)	d
Name of present Prime Minister of Australia	e
Count backwards from 20 to 1	f
Repeat the memory phrase	g
3	Unable to administer Abbreviated Mental Test because:	Response code
Person unable to communicate	a
Person refuses to participate	b

Division C

For each question tick (4) the response code that best describes the person’s usual state.

Does the person:

1	Show signs of depression?	Response code
Never	a
Sometimes	b
Most of the time	c
2	Shows signs of memory loss?	Response code
Never	a
Sometimes	b
Most of the time	c
3	Withdraw from social contact?	Response code
Never	a
Sometimes	b
Most of the time	c
4	Display aggression towards self or others?	Response code
Never	a
Sometimes	b
Often	c
5	Display disinhibited behaviour?	Response code
Never	a
Sometimes	b
Often	c

Schedule 2        Rating method

(section 2.3)

STEP 1

If a medical practitioner has certified that the care receiver is in the terminal phase of a terminal illness and is not expected to live for more than 3 months, the total final score is 30 (no further steps relevant).

STEP 2

(1)   Calculate a score for each question in the claimant questionnaire of the Adult Disability Assessment Tool set out in Part 2 of this determination. If a claimant has marked more than 1 answer to any question in division A, B or C, accept only the answer which gives the highest score.

(2)   Calculate the total score for each division by adding the score for each answer in that division.

(3)   Calculate the total claimant questionnaire score by adding the total score from each division of the Adult Disability Assessment Tool.

Division A

Question	Answer	Value	Score
1	a	0
b	3
c	6
d	9
2	a	2
b	1
c	0
3	a	0
b	3
c	6
d	9
4	a	3
b	2
c	1
d	0
5	a	3
b	2
c	1
d	0
6	a	9
b	6
c	3
d	0
7	a	3
b	2
c	1
d	0
8	a	0
b	1.5
c	3
d	0
9	a	0
b	1.5
c	3
d	4.5
10	a	0
b	2.5
c	5
d	7.5
11	a	0
b	1.25
c	2.5
d	3.75
12	a	0
b	1.25
c	2.5
d	3.75
13	a	0
b	2
c	4
d	6
14	a	0
b	1
c	2
d	3
e	0
15	a	0
b	1
c	2
d	3
e	0

Total A =

Division B

Question	Answer	Value	Score
1	a	0
b	0.5
c	1
d	1.5
2	a	0
b	0.5
c	1
d	1.5
3	a	0
b	1
c	2
d	3
4	a	0
b	1.5
c	3
d	4.5
5	a	0
b	1.5
c	3
d	4.5
6	a	0
b	1.5
c	3
d	4.5

Total B =

Division C

Question	Answer	Value	Score
1	a	0
b	3
c	6
2	a	0
b	3
c	6
3	a	0
b	3
c	6
4	a	0
b	2
c	4
5	a	0
b	2
c	4
6	a	0
b	2
c	4
7	a	0
b	3
c	6
8	a	0
b	2
c	4

Total C =

Total A   +

Total B   +

Total C   __________

Total claimant questionnaire score        

STEP 3

(1)   Calculate a score for each question in the professional questionnaire of the Adult Disability Assessment Tool. If a treating health professional has marked more than 1 answer to any question in division A or C, accept only the answer which gives the highest score. In division B, question 2, no score is given for a right answer; each wrong answer by the care receiver is allocated the score indicated. Where all answers to question 2 are left blank because the care receiver is unable to communicate, no points should be awarded for the question but points should be allocated in accordance with question 3.

(2)   Calculate the total score for each division by adding the score for each answer in that division.

(3)   Calculate the total professional questionnaire score by adding the total score from each division of the Adult Disability Assessment Tool.

Division A

Question	Answer	Value	Score
1	a	3
b	1.5
c	0
2	a	3
b	1.5
c	0
3	a	2
b	0
4	a	3
b	1.5
c	0
5	a	5
b	2.5
c	0
6	a	9
b	6
c	3
d	0
7	a	9
b	4.5
c	4.5
d	0
8	a	5
b	2.5
c	0
9	a	4
b	2
c	0
10	a	2.5
b	0

Total A =

Division B

Question	Answer	Value	Score
1	a	Nil
b	Nil
2	a	1.5
Maximum	b	1.5
score for	c	1.5
question	d	1.5
2 is 10.5	e	1.5
f	1.5
g	1.5
3*	a	8.5
b	8.5

Total B =

* If question 3 is answered, ignore any points awarded in question 2 of this division.

Division C

Question	Answer	Value	Score
1	a	0
b	2
c	4
2	a	0
b	1.5
c	3
3	a	0
b	2
c	4
4	a	0
b	3
c	6
5	a	0
b	2
c	4

Total C =

Total A   +

Total B   +

Total C   _________

Total professional questionnaire score            

STEP 4

Add the claimant questionnaire total score (from step 2) and the professional questionnaire total score (from step 3) to achieve a final total score.

Total claimant questionnaire score   +

Total professional questionnaire score            _________

Total final score  

STEP 5

The minimum professional questionnaire score that must be achieved if an individual is to qualify for payments is as follows:

(a)    a professional questionnaire score of 10 for carer payment under subparagraph 198 (2) (a) (i) of the Act;

(b)    a professional questionnaire score of 32 where an individual care recipient is qualified to have 2 carers for carer payment under subparagraph 198 (2) (a) (ii) of the Act;

(c)    a professional questionnaire score of 8 for carer payment where the care is provided to an adult and that adult’s dependent child under subparagraph 198 (2) (d) (i) of the Act;

(d)    a professional questionnaire score of 12 for carer allowance (adult) under paragraph 954 (1) (c) of the Act.

Notes

Note 1

The Adult Disability Assessment Determination 1999 (in force under section 38C of the Social Security Act 1991) as shown in this compilation is amended as indicated in the Tables below.

Under the Legislative Instruments Act 2003, which came into force on 1 January 2005, it is a requirement for all non-exempt legislative instruments to be registered on the Federal Register of Legislative Instruments.

Table of Instruments

Title	Date of notification in Gazette or FRLI registration	Date of commencement	Application, saving or transitional provisions
Adult Disability Assessment Determination 1999	29 April 1999 (see Gazette 1999, No. S 180)	1 July 1999
Adult Disability Assessment Amendment Determination 1999 (No. 1)	25 June 1999 (see Gazette 1999, No. S 275)	1 July 1999	—

Table of Amendments

ad. = added or inserted      am. = amended      rep. = repealed      rs. = repealed and substituted
Provision affected	How affected
Part 3 (S. 3.1) .........................	ad. No. S 275, 1999;