Defence Determination 2014/34, Leave – medical absence

I, CHRISTON SCOTT CHAMLEY, Acting Director General People Policy and Employment Conditions, make this Determination under section 58B of the Defence Act 1903.
Dated 17 July 2014
C S CHAMLEY
Acting Director General
People Policy and Employment Conditions
Defence People Group

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Citation
1. / This Determination is Defence Determination 2014/34, Leave –medical absence.
2. / This Determination may also be cited as Defence Determination 2014/34.
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Commencement
This Determination commences on 1August 2014.
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Amendment
Defence Determination 2005/15, Conditions of Service, as amended,1 is amended as set out in this Determination.
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Clause 1.3.26 (Gaining location)
after clause 1.3.26, insert
1.3.26AHealth professional
For the purpose of a medical absence, a health professional means:
a. / Aregistered medical or dental practitionerwho provides services as a Defence member, Australian Public Service employee or otherwise under an agreement in place with Defence.
b. / A registered medical practitioner.
c. / Any of the following persons who are competent, credentialed and authorised by Surgeon General Australian Defence Force to perform an extended role.
i. / A Nursing Officer.
ii. / A Nurse Practitioner.
iii. / An Advanced Medical Assistant (AMA) or Advanced Medical Technician (AMT).
iv. / A Clinical Manager (CM).
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Clause 1.3.38 (Meal period)
after clause 1.3.38, insert
1.3.38AMedical absence
Medical absence is the term used to describe the period for which a member is granted leave to be absent from duty for health reasons.
Related Information:Chapter 5 Part 1B, Medical absence from duty
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Clause 3.2.13 (Reserve member taken to be attending for duty), table item 4
substitute
4. / on a period of medical absencedue to illness or injury arising out of and immediately following a period of Reserve duty / the day that the Commanding Officer approves as the first day of the medical absence / on the earliest of the following days:
a. the day:
i. the period of medical absence authorised has passed; and
ii. the member has been cleared for duty by a service medical officer;
b. the day the Department of Veterans' Affairs commences payment to the member;
c. the day the member starts civilian employment or receives sick leave payment from a civilian employer;
d. a day for which sick leave is payable by the member's employer;
e. the day the member receives unemployment or a similar benefit from Centrelink;
f. the day the member has recovered from their injury and parades with their unit; or
g. the day the Department of Veterans' Affairs notifies the member that it has rejected the claim.
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Clause 5.0.2 (Contents), item for Part 1A
after the item for Part 1A, insert
Part 1B / Medical absence from duty
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Subclause 5.1.2.4 (Leave – overview), example

substitute
Examples:Leave to be absent from duty for medical reasons (this is called a medical absence), examination leave, short absence following long or unusual duty.

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Subclause 5.1.3.2 (Leave types), table item 12

after item 12, insert
12A. / Medical absence
See: Chapter 5 Part 1B / To provide the member with paid leave to be absent from duty when unfit for health reasons. / N / The member can be excused from duty for health reasons that include any of medical, mental health, dentaland rehabilitation reasons.

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Chapter 5 Part 1A (Leave and travel)

after Part 1A, insert the Part in the Schedule

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Paragraph 5.4.19.3.d (Effect of unpaid maternity leave)

omit
convalescence
insert
medical absence

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Clause 9.2.27 (On convalescence)

substitute

9.2.27

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Travel during a medical absence

1. / The CDF may approve travel at Commonwealth expense for any of the following purposes.
Note: Defence may arrange the travel for the member. If the member makes the arrangements, they would be expected to use the normal Defence business travel procedures.
a. / To assist a member to leave hospital to recover.
b. / To assist the member to reach a location where they are able to wait to go back to hospital
c. / To assist the member to reach a location which the senior medical advisor in the member's region has recommended as most likely to assist the member's recovery.
2. / In making a decision under subclause 1, the CDF must be satisfied that the following conditions are met.
a. / The travel is to the member's home or, if care is not available at their home, an alternative location. The CDF must have regard to any senior medical advisor recommendation about whether the care at the location is adequate for the member's needs.
b. / The senior medical advisor for the location has recommended both the following.
i. / That the member should undertake the travel.
ii. / That the means of travel is safest for the member.
c. / There is not more cost-effective alternative care that would meet the member's health needs.
3. / The CDF may approve the travel at a higher class or by means that are not the most economical, if satisfied it is necessary for the member's safety and consistent with the recommendation under subclause 2.
4. / A member may apply to travel at Commonwealth expense, includingtravel costsfor meals, incidentals and accommodation on the journey. The member can be provided assistance up to the amount that would be payable if they were entitled to travel costs on Defence business for the same period.
See: Chapter 9 Part 5 Division 2, Travel on Defence business using the travel card
5. / The member may be approved to travel at Commonwealth expense but pay for it themself. In this case, the CDF may reimburse up to a maximum of what the Commonwealth would have paid under subclauses3 and4.
NOTE
1. / Defence Determination 2005/15, as amended to date. For previous amendments see Noteto Defence Determination 2014/1 and amendments made by Defence Determinations2014/1, 2, 3, 5, 6, 7, 8, 9, 10, 11, 12, 13, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 27,28, 29, 30, 31, 32 and 33.
SCHEDULE

Part 1B: Medical absence from duty

5.1B.1Purpose

This Part provides a member with paid time away from duty when they are unfit for health reasons. For a member on continuous service, this time away from duty is a type of leave.

5.1B.2Member this Part applies to

This Part applies to the following members.
a. / A member of the Permanent Force.
b. / A member of a Reserve Force undertaking a period of continuous full-time service.
c. / Subject to the conditions in clause 3.2.13, a member of the Reserve Force who is unable to work due to an illness or injury arising out of their Reserve duty may be provided with benefits in accordance with clause 5.1B.5 and 5.1B.8.
Note: A Reservist not on a period of continuous full-time service can access the arrangements in this Part only if they meet the additional conditions for eligibility in clause3.2.13. In some cases, the Reservist may be eligible for payment under clause3.2.13.
See: Chapter 3 Part 2 clause 3.2.13, Reserve member taken to be attending for duty

5.1B.3How to apply for a medical absence

A member must, where it is reasonably practicable, apply for leave to be absent from duty under this Part using Form AD097ADF Leave Application. The application must contain a Form PM101, Medical or Dental Fitness Advice, if one has been provided.

5.1B.4Medical absence without recommendation from a health professional

1. / For the purpose of this clause, a supervisor must be at one of these ranks or higher.
a. / Warrant Officer Class 2.
b. / APS 4.
2. / A member may apply to take a day of leave to be absent from duty as a medical absence without providing a medical certificate for that day, if they provide a statement that they are unfit to work on that day for health reasons.
3. / A supervisor may grant a day of medical absence under this clause to the member on a day-to-day basis for a maximum of three consecutive days, for a period of illness or injury.
Note: Each day must be granted separately by the supervisor. An aggregated period of several days of medical absence can only be granted under clause 5.1B.5.
4. / In relation to the decision under subclause 3, the supervisor may take any of the following actions.
a. / The supervisor may make the decision without the advice of an authorised health professional.
b. / The supervisor may seek advice from an authorised health professional before making the decision.
Note: Personal or health information directly related to the member must not to be provided without the consent of the member.
c. / The supervisor may at any time direct the member to seek assessment by a health professional, in relation to the reason for the leave.
Note 1: If medical absence is granted under this clause, the direction is to be taken as a condition on the grant of the medical absence.
Note 2: If medical absence is refused under this clause, the direction ensures that the member seeks prompt advice from a health professional, who may recommend a medical absence for the purpose of clause 5.1B.5.
Example: The member has been granted on day off by their supervisor without seeing a medical practitioner. The member then contacts the supervisor and tells them that the condition has deteriorated and they need another day off. The supervisor directs the member to see a health professional. The direction makes sure that the member has access to health advice to help them manage any health risks.
d. / The supervisor may decide not to approve the leave.
5. / If the member is being treated under a crisis management plan, the supervisor must only approve leave as recommended by a health professional under clause 5.1B.5.

5.1B.5Medical absence on recommendation from a health professional

1. / A supervisor may approve a member's application to be absent from duty for a period of 1day or more, having regard to all of the following circumstances.
a. / The period of leave that the member has applied for.
b. / Any recommendation of a health professional. This could include recommendations as to the member's care, remaining in a health facility or undertaking follow-up treatment. The supervisor may make the grant of leave conditional on these recommendations being followed.
Example: A member who is considered at risk by a Defence medical officer has the requirement for a carer documented in their crisis management plan. In the carer's absence the member stays in hospital. The supervisor grants the medical absence conditional on the member following this care plan.
c. / Any other relevant matter.
2. / The supervisor may direct the member to seek further assessment by a Defence health professional, in relation to the reason for the leave. The direction may be given at any time in relation to the grant of medical absence.
3. / Up to three days of absence can be recommended by a health professional who does not provide services for Defence. If the application relates to an absence of more than 3 days, then the recommendation of a Defence health professional is required to support the application.
Related Information: Regulation 35 of the Work Health and Safety Regulations 2011 requires Defence to identify risks and hazards and to eliminate or minimise any risks to health and safety.
Having a Defence health professional assess a member in relation to any significant medical absence means that relevant occupational issues and rehabilitation are identified and help is provided promptly.
4. / Surgeon General Australian Defence Force may direct Defence health professionals as to the maximum periods of medical absence they may recommend, based on their professional qualifications.
Note: A health professional might advise a member to attend a different class of health professional if a longer period of absence might be required for recovery, to assist continuity of care.
Related Information: Health Bulletin No 3/2013, Medical Absences – Responsibilities of Health Professionals.
Notes on disclosure of personal information:
1. A Defence member may provide written consent for health information to be released to specific individuals in their chain of command.
2. If the member's consent is not provided, then information can only be disclosed in accordance with the exemptions to the Privacy Act 1988.

5.1B.6Refusal to grant a medical absence

1. / If a health professional has recommended that a member is unfit for duty, the supervisor may only refuse to grant the member a medical absence for the period of unfitness in either of the following circumstances.
a. / There are alternate duties available that a health professional has confirmed that the member is fit to perform.
Example: The member is recovering from a knee injury and so cannot perform their normal parachute duty and a health professional has recommended they not perform parachute duty. The health professional certifies that they member is able to perform office duties while they recover.
Note: The alternate duty must be consistent with the obligation to keep the member healthy in regulation 58E of the Defence Force Regulations 1952.
b. / There are no alternate duties that the member is fit to perform and the supervisor has performed a written risk assessment setting out how the risks related to the member's attending for duty can be eliminated orminimised, having regard to all of the following.
i. / The risk to the health of the member.
ii. / The risk to any other people.
iii. / The risk to operational requirements of the mission for which the member is performing duty.
iv. / Any relevant requirement to provide medical or dental treatment to the member under regulation 58E of the Defence Force Regulations 1952.
Example: A member taking part in a multinational exercise as the member is recovering from a knee injury and so cannot perform their normal parachute duty. A health professional recommends a period of medical absence, however the supervisor considers that the while member is recovering they can perform administrative duties which are critical to the exercise outcomes. The supervisor consults with a health professional to seek agreement that the member is able to perform office duties. The health professional does not agree that the member is able to perform alternative duties. The supervisor performs a written risk assessment, and decides that any risk of further injury to the member is mitigated. The supervisor refuses to approve the medical absence and tasks the member to carry out administrative duties only.
Note: The risk assessment in paragraph 1.b would require operational imperatives to be weighed against any adverse outcomes to the member or other members resulting from the sick or injured member continuing to work, rather than being placed on medical absence.
2. / A risk assessment made under paragraph 1.b must document all the following matters.
a. / The reasons the recommendation for leave was made.
b. / Any risks to health and safety that may foreseeably arise if the leave is not granted as recommended.
c. / The work-related activities that may involve an increased risk to health and safety in relation to each of subparagraphs 1.b.i to 1.b.iv.
d. / Consultation between the supervisor and the health professional who has recommended the member's leave, or with a Defence medical officer.
3. / A copy of a risk assessment made under paragraph 1.b must be provided to the supervisor's Commanding Officer as soon as practicable after it has been made.
Note1: The Commanding Officer may provide a copy of the risk assessment to the Senior Medical Adviser at the regional Defence Health Facility. Information drawn from the assessment may be used at the officer level across Defence to minimise or eliminate risk, consistent with the notes on disclosure of personal information above.
Note 2: Supervisors and Commanding Officers must be aware of their responsibilities to act in accordance with the Work Health and Safety Act 2011, including the potential for personal liability should a decision not to follow the advice of a health professional lead to further illness, injury, aggravation of injury, medical complication or death.

5.1B.7Granting a medical absence without an application form

1. / A supervisor may grant a period of leave under 5.1B.4 or 5.1B.5 for a member who has not made a formal application, if both the following conditions are met.
a. / The supervisor has regard to any statement from the member, a person who is responsible to care for the member while they are unfit for duty, or a health professional.
Note: An absence of more than 3 days should only be approved with the recommendation of a Defence health professional.
See:Subclause 5.1B.5.3, Medical absence on recommendation from a health professional
b. / The supervisor is satisfied that the member is unable to formally apply for leave to be absent under this Part within a reasonable period due to their unfitness for duty.
2. / If a supervisor grants leave without a formal application from the member, they must create a record of the grant of leave, in accordance with the process set out in clause 5.1B.8.

5.1B.8Administrative requirements for granting a medical absence

1. / When a supervisor under this Part has made a decision to approve or refuse a member a medical absence, they must notify the member or their nominated representative of the decision as soon as possible and take the relevant action in the table.
Item / If a member has applied... / then the decision-maker must...
1. / in writing on an application form
Related Information:
Form AD097, ADF leave application
Form PM101, Medical or dental fitness advice / a. sight any relevant certificate from a health professional; and
b. give the decision to the member’s unit, which must record the member’s medical absence in PMKeyS and file the relevant Form AD097 and Form PM101 (if provided) in the member’s leave folder.
2. / and the supervisor refuses to approve the grant of leave under subclause 5.1B.6 / give the application, any risk assessment relating to the refusal and a copy of the decision to their Commanding Officer.
If the member cannot apply for leave... / then the decision-maker must...
3. / using a form described in item 1 above within a reasonable period / record any decision to grant leave and give the decision to the member’s unit, which must record the member’s medical absence in PMKeyS and file any subsequent Form AD097 in the member’s leave folder.
Note 1: The member's unit must ensure records are made and kept. It may use an administrator to perform this task, such as the Unit Orderly Room, Military Personnel Administration Centre or Ship's Office responsible for administering the member's leave.
Note 2: Nothing in this Division limits the situations in which a member may be directed to seek assessment by a health professional. If a member is granted a medical absence of 28 days or longer under this Part, the member's medical employment category may be reviewed.
Related information:In some cases the member may need to change to a different employment category or their service may be ended on medical grounds, depending on the extent of their incapacity and their capacity for rehabilitation. This action occurs under the Defence (Personnel) Regulations 2002.
2. / If the supervisor considers the member to be at risk of self-harm and a crisis management plan is not in place, the supervisor must direct the member to seek advice from a health professional.
Note: The purpose to ensure that any necessary assessment and treatment is started and a medical management plan is put in place, as required by Defence Instruction (General) Personnel 16-26, Management of a suicidal episode in the Australian Defence Force.

5.1B.9Payment of salary and allowances on a medical absence