Second opinions and designated health practitioners

Second opinions are used when the information on a Work and Income medical certificate is inadequate, unclear or does not appear to align with other information the case manager may have available.

It may also be used where the supporting information provided by the person when applying for a Supported Living Payment is inadequate to determine entitlement.

When completing the medical certificate, the health practitioner is able to state a second opinion is appropriate. This will initiate a referral to a designated health practitioner.

A case manager may consider referring a person for an assessment by a designated health practitioner when:

• the practitioner has indicated on a Work and Income medical certificate that they are not best placed to provide the information
• the diagnosis is unclear
• the information provided in the medical certificate or other supporting health and/or disability information is ambiguous or conflicting
• a previous medical certificate contains a substantially different diagnosis or recommendation (where the person is applying for Supported Living Payment)
• the person is engaged in activities that appear to be at odds with recorded incapacities or with work capacity information
• capacity for work is unclear
• there is inadequate information in the medical certificate or other supporting health and/or disability information to establish medical eligibility to Supported Living Payment (where the person is applying for this benefit type)
• the person is unable to provide existing reports and/or medical certificate
• the person is applying for Supported Living Payment and they choose to see a designated health practitioner.

The referral will be accompanied by a copy of the original medical certificate and/or available supporting information and, where appropriate, the client's consent to the release of information.

The designated health practitioner is expected to meet with and assess the patient within 10 days of referral, and provide a completed medical certificate to Work and Income within five days of the assessment.

The designated health practitioner is encouraged to discuss any issues with the patient's usual practitioner if necessary or request a Host Doctor Report be completed.

The report completed by the designated health practitioner is used by Work and Income to determine a person's capacity for work and entitlement to financial assistance. It also assists us with helping people to move towards employment.

Work and Income, through the National Accounting Centre, provides a payment for the completion of a designated health practitioner assessment.

The National Accounting Centre checks in the person's Work and Income records to ensure that a report has been requested by the case manager before payments are made.

If a registered health practitioner is interested in becoming a Work and Income designated health practitioner, they should contact the local Health and Disability Team to discuss their application and fill out the form below.

Once completed the form should be returned to the Health and Disability Team.

Designated Doctor application form (PDF 109.22KB)

If you're a designated health practitioner, please contact your local Health and Disability Team if you need further information. If you do not have their contact details, please call our General Enquiries number 0800 559 009 and one of our Customer Services Representatives will arrange for them to contact you.