Lifetime Care and Support (Catastrophic Injuries) Act 2014

The LTCS commissioner must assess the treatment and care needs of a participant in the LTCS scheme for the injury in relation to which the injured person is a participant in the scheme.

Note Treatment and care needs, of a participant in the LTCS scheme—see s 9.

The assessment must determine the participant’s treatment and care needs that—

are reasonable and necessary in the circumstances; and

relate to the injury in relation to which the person is a participant in the LTCS scheme.

In deciding whether the participant’s treatment and care needs are reasonable and necessary in the circumstances, the LTCS commissioner must consider the following:

the benefit that a service will have for meeting the participant’s treatment and care needs;

the appropriateness of a service, or request for a service, to meet the participant’s treatment and care needs;

the appropriateness of a provider of a service mentioned in paragraph (b);

the cost benefit of a service mentioned in paragraph (b).

Note The LTCS guidelines may include provisions about which of an injured person’s treatment and care needs are reasonable and necessary in the circumstances (see s 30 (5)).

The assessment must be made in accordance with the LTCS guidelines.

Note The LTCS guidelines are made under s 93.

The LTCS commissioner must—

certify in writing its assessment of the participant’s treatment and care needs; and

include in the certificate its reasons for the findings on which the assessment is based; and

give a copy of the certificate to the participant.