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Prosthetics > Funding
How your prosthesis is funded will depend on the cause of your amputation. Generally speaking the following categories apply.
If you lost your limb in a work or transport accident in Victoria, then your rehabilitation costs, which includes all the costs of your prostheses will be met by WorkCover or TAC.
If you lost your limb due to disease, you will be covered by the Victorian Artificial Limb Program (VALP). VALP will also cover you if you lost your limb in an accident for which there is no compensating body, for example at home or during recreation. Each state in Australia has an Artificial Limb Program but funding may vary from State to State.
Veterans who either lost their limb as a result of injuries received while serving, or who have a Gold Card, will have their prostheses paid for by the Department of Veterans Affairs.
Because there are these different funding sources; the type of prosthesis, and other rehabilitation services you can get will depend on the cause of your amputation.
TAC-Victoria
TAC is required by their charter to pay all reasonable costs associated with your rehab. This means that if your Prosthetist can make a case for any particular piece of componentry being appropriate for you then TAC will fund it. Silicon liners, energy storing feet and hydraulic knees, for example, will commonly be supplied. This does not mean open slather, however. If TAC think the costs are not reasonable they can refuse to pay. As most case managers have an allied health background, and some are ex-Prosthetist, they have a pretty good idea of what is suitable and what is not. They also have a panel of experts which can make the call on difficult decisions.
In return TAC expects a certain amount of care of your prosthesis from you. While replacement limbs due to wear and tear, stump changes or medical issues are rarely a problem, any damage due to negligence may result in a bill for you.
TAC can also help with physiotherapy, home modifications, Orthotics or shoe modifications if required. Basically they have a policy for everything. Most of these are available on their website or via your coordinator.
Transport Accident Commission State Contacts
Victoria
www.tac.vic.gov.au
Ph: 1300 654 329
Ph: 132 213
South Australia
Ph: 1300 360 067
Queensland
www.transport.qld.gov.au
Ph: 13 23 80
Western Australia
Ph: 138 138
NT
Ph: 1300 654 628
Tasmania
WorkCover
These days most work accident claims are met by a number of insurance companies, with WorkCover providing the overall legislative framework. Like TAC these companies are required to meet 'reasonable costs', so fairly good componentry can usually be fitted if required. A major difference is that many of the people handling the claims may have little in the way of a health or medical background. This, combined with their being a number of companies, can result in inconsistencies in treatment. Also in contrast to TAC, there is much less transparency in their policies, which can also be frustrating. That said, if the case is properly made then most prostheses will be funded.
WorkCover Victoria
PH: 1300 136 089
WorkCover ACT
PH: 02 6205 0200
WorkCover SA
PH: 13 18 55
WorkCover QLD
PH: 1300 362 128
WorkCover NSW
PH: 13 10 50
WorkCover WA
PH: 1300 794 744
WorkCover NT
PH: 1800 019 115
WorkCover TAS
PH: 1800 019 115
Government Funding
The government largely leaves the running of the scheme to these hospitals. Generally you will have to attend an Amputee Clinic and see a doctor (an Amputee Rehabilitation Consultant) before you can be prescribed a prosthesis. The doctor, usually in consultation with the Prosthetist, will decide what type of prosthesis, and also attend to any other medical issues associated with your amputation.
Like many public health services, funding is limited. This means your prosthesis will come from a limited range of componentry, with many of the more sophisticated items not available. There is no standard list for these, and what is available may vary a little from one clinic to another. Broadly speaking, energy storing feet won't be available but multiaxial will. Hydraulic knees won't be included. Silicon liners may be available in a limited way, at the doctor's discretion.
Other Equipment > Aids and Equipment Program
The A&EP is a Federal Government program which provides assistance to the disabled. The aim of the program is to help people live at home by providing the equipment needed to maintain their independence.
What does it fund?
Funding is available for equipment such as wheelchairs, walking frames, orthopaedic shoes, orthoses, communication devices and home modifications. The funding may not cover the whole most of the equipment, so you may have to make a contribution. The scheme is not means tested, but you must meet certain criteria to be eligible. For your initial application, a doctor must certify that your condition is permanent.
You cannot access A&EP funding if you are eligible for DVA/TAC/WorkCover Assistance, or if you are in a Commonwealth funded nursing home or Supported Residential Service
How do I get access to A&EP?
For many amputees their first contact with the program may come while still an inpatient at the rehabilitation hospital, when their occupational therapist may apply for funding changes to the home, for example to install a ramp for wheelchair access or to make necessary adjustments to bathroom facilities. The program is co-ordinated through various public hospitals and the application process can take several months to be processed.
Click here for A&EP State contacts
Click here for Artificial Limb Service State contacts
