The medical certificate: Domestic Purposes Benefit: Care of Sick or Infirm
Who can complete the certificate?
The medical certificate must be completed by a registered medical practitioner. In most cases this should be the supported person’s usual medical practitioner.
Completing the medical certificate
As a medical practitioner, you need to decide:
- whether full-time care and attention is required for the person to live at home
- how long the full-time care and attention is required
- if the supported person would otherwise require rest home care, residential disability care, extended care services for severely disabled children and young people, hospital care or care of a similar kind.
It is important to note that while this assistance is income tested, medical practitioners do not assess if the carer meets the income threshold.
The following pages provide a guide to completing each question in the medical certificate.
Once completed, the certificate should be given to either the carer or the supported person, who will return it to Work and Income.
Medical details
Q4 to Q7
Work and Income recognises that there are circumstances where you may feel you are not in the best position to provide the information. This may be because you are placed in a conflict of interest, or because of the person’s complex social, financial or environmental factors.
Please indicate who you consider best placed to provide the required medical information – yourself, a second opinion (eg designated doctor) or another health practitioner. If you signal that you are not the best person to complete the medical certificate, you can still continue to provide the information to the best of your knowledge.
Tell us if you are the supported person’s usual medical practitioner and when you last saw them. Also tell us what information you are basing the recommendation on. For example, this may be a face-toface interview when completing the form, a previous assessment undertaken, a NASC assessment, a specialist assessment, and/or a review of medical notes.
It is not always necessary for the practitioner completing the medical certificate to be the supported person’s usual medical practitioner and/or to have seen them recently. However, in such cases, this medical certification should be based on relevant previous assessments or medical information that you have sighted.
Q8
Please provide the details of the supported person’s diagnoses. This information will help the case manager understand the nature of the supported person’s overall condition, and to accurately record this information. List the diagnoses in order of their impact starting with the most significant.
Where a condition is the result of an accident covered by ACC, please indicate this in the appropriate box. Some payments made by ACC may affect eligibility to this assistance.
Q9 and Q10
A Needs Assessment and Service Co-ordination (NASC) assessment is not required for this benefit. However, a NASC assessment may provide you with useful information to guide your recommendation of whether the person requires full-time care and attention.
Q11 and Q12
This question provides a structured guide to your recommendation and is a source of useful information for Work and Income. The need for care and attention can be influenced by a number of factors. Please tick the most relevant factors.
Factors should only be indicated if the person requires support over and above what is ordinarily needed by someone of the same age or what is developmentally appropriate.
Q13
Full-time care and attention means that the person will require 24-hour access to care and attention. The level of care and attention must be over and above the ordinary care and attention required by someone of the same age. This does not mean the carer is expected to give 24-hour care, but they must be available if required.
This is a key question. If the carer is not required to give full-time care and attention to the supported person, the carer will not be eligible for this benefit. In this case, Work and Income will consider the information provided to see if the carer may qualify for other types of assistance.
Q14
This assistance can only be granted when the supported person, if they were not being cared for at home, would otherwise need:
- rest home care
- residential disability care
- extended care services for severely disabled children and young people or
- hospital care (in-patient or residential hospital care)
- care equivalent to any of these kinds of care.
When this level of care would not otherwise be required, the carer is not eligible for this benefit. In these cases, Work and Income will consider the information provided to see if the carer may qualify for other types of assistance.
Q15
The needs for this level of care and attention can change over time. For example, people with episodic/ relapsing conditions such as Multiple Sclerosis may have periods where they are unable to live independently and require full-time care and attention from hospital or residential services, or from a full-time carer. Once the relapse or episode abates, however, they may no longer require this level of support.
Those with static or deteriorating conditions, like adults with Down’s Syndrome or dementia respectively, are unlikely to see significant improvements. Their needs are more likely to increase and the need for care is generally permanent.
Registered medical practitioner verification
This section records your details and lets us know if the supported person, or their guardian or legal representative, has agreed that the information contained in the certificate can be disclosed to Work and Income.
Where you have not met with the supported person (or their representative) or they have not agreed to the release of the information, you should select the ‘No’ option and state the reason why in the space provided. For example where the supported person lacks capacity due to advanced dementia and has no legal representative, you would state this in the textbox.
We use your HPI number to check your current registration status. If you are not registered as a medical practitioner we will be unable to accept the certificate from you.
When completing the medical certificate, you are encouraged to use a stamp which imprints the necessary name and address details.
