Veterans can check many of the medical and allied health services claimed from the Department of Veterans’ Affairs through services linked to myGov.
Reviewing this information can help you identify consultations, prescriptions or services you do not recognise. It can also help you maintain a more complete record of the treatment and evidence connected with your DVA claim.
Recent reporting about provider conduct within the veteran-support system has brought renewed attention to billing, medical reports, commercial advocacy and the handling of veterans’ information.
An investigation or allegation does not establish wrongdoing. However, every veteran has good reason to understand who is acting for them, what is being claimed in their name and how their personal information is being used.
Where can you see DVA-funded services?
DVA advises that many services can be viewed through My Health Record and Medicare’s Claim History, both of which can be accessed through myGov. This information is not currently available through MyService.
My Health Record may display:
- GP and specialist consultations;
- referrals and correspondence between healthcare providers;
- diagnostic results, including some imaging and pathology;
- medications recorded through the PBS or Repatriation Pharmaceutical Benefits Scheme;
- care plans and other documents uploaded by providers; and
- immunisation history.
Medicare’s Claim History may show GP, specialist and allied health consultations. The records will not necessarily contain every DVA-funded service.
What might not appear?
DVA says that some services are not currently visible through these records, including:
- medical-report claims not billed through Medicare;
- some pathology and hospital services;
- services using DVA-specific item numbers;
- household and community support, such as cleaning, transport or lawn mowing; and
- documents a provider has not uploaded.
An empty or incomplete record does not necessarily mean that no service was delivered or claimed. My Health Record may also contain limited information when it is first activated.
What should you look for?
When reviewing your history, consider whether you recognise:
- the provider’s name;
- the date of the consultation or service;
- the type of service recorded;
- prescriptions you do not remember receiving;
- referrals or reports you did not authorise;
- repeated appointments that appear inconsistent with your treatment; or
- services recorded while you were elsewhere or did not have an appointment.
There may be an innocent explanation for an unfamiliar entry. A provider may trade under a different business name, a claim may appear later than the appointment date, or the description may use unfamiliar billing language.
Start by recording the details and asking the provider or DVA for clarification.
How can you report an unexplained service?
If you find a DVA-funded service you do not recognise or believe you did not receive, DVA asks that you provide as much information as possible, including the provider’s name, service date, description, amount claimed if visible, and why the entry appears incorrect.
DVA currently accepts integrity concerns through its online reporting form, by email at [email protected] or by telephone on 1800 VETERAN. Keep a copy of what you report and any response you receive.
Keep your own DVA claim records
Your claim file can contain highly sensitive medical, service and financial information. It is sensible to maintain your own copy of important records, including:
- DVA claim and reference numbers;
- documents lodged in support of each condition;
- medical reports and invoices;
- signed authorities and representative nominations;
- DVA determinations;
- correspondence with an advocate, lawyer or provider;
- fee agreements; and
- records showing who has received your personal information.
Ask for copies of medical reports prepared for your claim. You should understand the conditions being addressed, the purpose of the report and who will receive it. Do not sign a blank authority or a document you have not had an opportunity to read.
Questions to ask before engaging a paid provider
Paid assistance does not guarantee that DVA will process a claim faster or reach a particular outcome. DVA decisions must be made under the applicable legislation and evidence.
- What are your qualifications and experience?
- Are you a lawyer, an advocate, a medical provider or a claims business?
- Who will actually perform the work?
- How are the fees calculated?
- Are any fees linked to my compensation, impairment points or a particular outcome?
- Are there cancellation or termination fees?
- Do you hold professional indemnity insurance?
- Where will my medical and service information be stored?
- Will any information be held or accessed overseas?
- Do you receive referral fees, commissions or another financial benefit from medical providers?
- Will I receive copies of everything lodged in my name?
- What happens if I disagree with your advice or want to end the arrangement?
Promises of guaranteed compensation, special access to DVA or unusually fast outcomes should be treated cautiously.
Understand the difference between a lawyer and an advocate
Veterans can lodge claims themselves, receive free assistance through eligible ex-service organisation advocates, engage a paid commercial service or obtain help from a lawyer. These options do not provide identical protections or services.
A lawyer is subject to professional duties, legal-practice regulation and requirements concerning costs disclosure. An advocate or commercial claims provider may operate under a different framework.
Whichever option you choose, the provider should be transparent about their role, qualifications, fees, conflicts and responsibility for your information.
What if you are concerned about an existing arrangement?
Do not immediately cancel an agreement without reviewing its terms. Some agreements may contain notice requirements or termination charges.
- Obtain a complete copy of your file.
- Request an itemised explanation of fees.
- Identify every authority you have signed.
- Check whether the provider remains nominated with DVA.
- Obtain independent advice about the agreement.
- Protect any upcoming DVA review or appeal deadline.
Changing providers does not automatically extend a statutory time limit.
KSC Law assists veterans with DVA compensation claims, reviews and appeals. If you are uncertain about a claim, medical report or existing service arrangement, our team can review the documents and explain your position. Contact KSC Law.
This article provides general information and does not constitute legal advice. Do not delay action on a DVA deadline while investigating a provider or billing concern.
Sources: DVA guide to checking funded services and DVA guidance on choosing help.