220.127.116.11 Role of Medical Practitioners (EMEP)
The role of medical practitioners in relation to EMEP is to assist people to complete their claim form by certifying that they, or the person they are caring for is:
- required to use certain essential medical equipment at home that attracts an EMEP, OR
- required to use additional heating and/or cooling at home because they have a certain medical condition that results in an inability to regulate their body temperature.
Medical practitioners will provide this certification by completing and signing a section of the EMEP claim form.
Definition of a 'medical practitioner' for the purposes of the EMEP
A medical practitioner is defined in SSAct section 23 to mean a person registered and licensed as a medical practitioner under a state or territory law that provides for the registration or licensing of medical practitioners. A medical practitioner may be:
- a general practitioner, OR
- other medical specialist.
In remote areas where there is limited access to doctors, a community nurse or aboriginal health worker can provide the relevant certification. In this case, the nurse or aboriginal health worker provides the certification based on clinical notes from a medical practitioner, and the diagnosis must have been made by a medical practitioner.
Act reference: SSAct section 23(1)-'medical practitioner'
Claims for equipment where claimant already receives rebate from a state or territory government for same piece of equipment
Where the person with medical needs, or their carer, currently qualifies for assistance for the same equipment under one of the state or territory government schemes. Medical practitioners are not required to verify that the medical equipment is required.
Receipt of assistance through one of these schemes is accepted as proof that the medical equipment is required.
Claims for medically required heating/cooling
Medical practitioners are required to assist in the completion of claim forms for all people who are claiming an EMEP because of their need for medical heating/cooling. Evidence of qualification for a state or territory government heating/cooling rebate cannot be used as evidence of qualification for the EMEP, because the qualification criteria for the state and territory schemes vary considerably, and are not consistent with the EMEP qualification criteria.
What the medical practitioner certifies
Where a person claims an EMEP in respect of a piece of essential medical equipment that appears on the EMEP equipment list, the medical practitioner certifies that:
- the piece of equipment is essential to manage the person's condition, AND
- the person has been advised by the medical practitioner to use the equipment at home.
Where the person claims an EMEP as they have a medical requirement for heating/cooling, the medical practitioner certifies that:
- the person has a specified medical condition, AND
- the person is unable to regulate his or her body temperature because of that medical condition, and requires medical heating and/or cooling in their home.
Note: In determining whether a person has an inability to regulate body temperature, for the purposes of the EMEP, consideration should be given whether a person would risk serious harm to his or her health without medically required heating and/or cooling.