23Assessment of participant’s treatment and care needs

23 Assessment of participant’s treatment and care needs (1) The LTCS commissioner must assess the treatment and care needs of a participant in the LTCS scheme for the injury in relation to which the injured person is a participant in the scheme. (2) The assessment must determine the participant’s treatment and care needs that— (a) are reasonable and necessary in the circumstances; and (b) relate to the injury in relation to which the person is a participant in the LTCS scheme. (3) In deciding whether the participant’s treatment and care needs are reasonable and necessary in the circumstances, the LTCS commissioner must consider the following: (a) the benefit that a service will have for meeting the participant’s treatment and care needs; (b) the appropriateness of a service, or request for a service, to meet the participant’s treatment and care needs; (c) the appropriateness of a provider of a service mentioned in paragraph (b); (d) the cost benefit of a service mentioned in paragraph (b). Note The LTCS guidelines may include provisions about which of an injured person’s treatment and care needs are reasonable and necessary in the circumstances (see s 30 (5)).

(4) The assessment must be made in accordance with the LTCS (5) The LTCS commissioner must— (a) certify in writing its assessment of the participant’s treatment and care needs; and (b) include in the certificate its reasons for the findings on which the assessment is based; and (c) give a copy of the certificate to the participant.