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Treatment and therapies
A case manager should understand the treatment and therapies, or lack of treatments and therapies, that an individual may have.
The relationship between treatment and therapies and the likely severity of symptoms may be considered. For example, an individual receiving no treatment or therapies may experience severe symptoms.
The level of treatment and therapies that an individual receives may help case managers to build a clearer understanding of an individual’s lived experience of their disability or health conditions, as well as the attention or supervision they may require with this.
However, an absence of treatment or therapies does not mean there is not a need for attention or supervision in relation to an individual’s disability or health condition. Case managers should consider this when making a determination of entitlement that follows the principles of decision-making.
Example: an individual is not receiving treatment or therapies for their condition
An individual reports that due to severe back pain, they require support from another person with washing and dressing as well as help with using the toilet. They have not noted any details in their application form about seeing a professional for treatment or therapies.
The case manager believes that the individual’s needs may appear inconsistent with the level of input they receive in terms of tests and treatments/therapies. This is because approved medical guidance suggests that an individual with such severe back pain should see a professional if it does not improve, or is stopping them from doing their day-to-day activities. The case manager recognises that there could be a range of reasons for this, and that they would be unable to make a fair and informed determination without clarifying the individual’s circumstances at this stage.
Therefore, the case manager requests a case discussion with a practitioner. They want to better understand how the individual’s condition and symptoms impact on their life before clarifying details of the application with the applicant by phone. This allows the case manager to note the apparent inconsistency and receive advice from a specialist advisor.
The case discussion provides the case manager with more context of why the individual may not be receiving treatments/therapies, which assists in reaching out to the individual for more information and making a fair and informed determination of entitlement.