DVA approvals for medical cannabis
While cannabis has been a legal medicine since 2016, the Department of Veteran Affairs (DVA) only started funding cannabis in 2018. Since then, the process has become slightly easier, however, it still takes quite a long time for approval. The process to access medical cannabis is the same for veterans as it is for other patients. The process to get the DVA to fund medicinal cannabis is separate.
There are certain conditions that are much easier to get DVA funding for than others. It’s also important to note that you’ll get approval, start your treatment and pay for your medicine before the DVA will fund and reimburse you for the medication. While we still have a long way to go before the DVA is fully accepting of medicinal cannabis, the fact that veterans are able to receive funding for cannabis is excellent.
In this article, you’ll learn about the DVA framework and the process that your doctor (and specialist) need to go through to get you reimbursed for cannabis. Here’s what the article covers:
- Does the DVA cover medical cannabis?
- What conditions does the DVA cover for medical cannabis patients?
- What is the DVA’s medical cannabis framework?
- What’s the internal DVA process for medical cannabis funding?
- What can I do if my doctor needs help?
If you’d like to look at the following information in a condensed format, please check out the DVA funding infographic below.
Does the DVA cover medical cannabis?
Yes. The DVA has accepted medical cannabis as a legitimate treatment for patients and, as a result, will fund medicinal cannabis for many conditions.
The DVA will consider the request for funding for any conditions. However, the DVA classifies medical conditions into two categories.
- Pre-determined conditions – easier to get funding for
- Other conditions – may still get funding but tends to be a longer, more difficult process.
What conditions does the DVA cover for medical cannabis patients?
As mentioned, the DVA will accept applications for any condition. The predetermined conditions which are easier to get approved are:
- Chronic pain
- Multiple Sclerosis (MS)
- Palliative care
- Nausea and vomiting
- Epilepsy
Other conditions, including a range of mental health conditions (ie PTSD) have been funded in the past. However, since this article was published, the DVA has become more strict and is no longer funding mental health conditions. The difference between the two categories is the speed and difficulty of obtaining approval.
What is the DVA’s medical cannabis framework?
In order to be eligible for DVA funding veterans must meet certain criteria. Here are the steps in the DVA framework:
- Be eligible for and be prescribed medical cannabis by a doctor.
- Have a specialist’s assessment and approval for the treatment.
- Apply to the DVA, with all required documents, for funding.
When you start to look for a doctor to help you with this process, it will be good for you to have an understanding of what it will take. Now, we’ll break down each step.
How do I get DVA funding for medical cannabis?
In order to be eligible for DVA funding veterans must meet certain criteria. Here are the steps in the DVA framework:
- Be eligible for and be prescribed medical cannabis by a doctor.
- Have a specialist’s assessment and approval for the treatment.
- Apply to the DVA, with all required documents, for funding.
When you start to look for a doctor to help you with this process, it will be good for you to have an understanding of what it will take. Now, we’ll break down each step.
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Obtain a prescription
Any GP can prescribe cannabis in Australia, with the exception of Tasmania where you need a specialist. In order to get a script, you must be eligible. Eligibility has three major criteria:
- Do you have a chronic medical condition or conditions that may be treated by cannabis?
- Have you tried other treatments for your medical condition(s)?
- Have those treatments ‘failed’ to provide relief of symptoms from your medical condition (or created unbearable side effects)?
To learn how to assess yourself for these criteria, please see our eligibility article. Your doctor can go through the SAS B pathway, or if they are an Authorised Prescriber, they may be able to give you a script on the spot. You can read our access pathways article to learn more about the SAS and AP models.
Get a specialist assessment
A specialist is defined as a medical specialist in the area of the condition being applied for. That could be a pain specialist, orthopaedic surgeons, vascular surgeons etc.
If the doctor who prescribes is a specialist then they can do the specialist report themselves. If your prescribing doctor is not a specialist they will need to reach out to the relevant specialist. The DVA website states that their assessment confirms that:
- The specialist has advised the patient of potential contraindications;
- The specialist has undertaken a suicide and mental health assessment and determined there is no increased risk from medicinal cannabis on suicide ideation or mental health;
- And, the patient has no current substance use disorder and has a low risk for substance use disorder.
Once you have all of this documentation complete, the doctor may apply to the DVA.
Apply to the DVA
To get cover from the DVA, all of the information mentioned above must be submitted to the DVA. Remember, if your doctor is applying for your cover, they must submit the letter from the specialist along with their application. The application will need to outline:
- The patient’s condition.
- First-line treatments that have actually been used (and failed).
- Details of the particular product being prescribed
- Justification of why the doctor has chosen that product.
- Letter from the specialist.
The application can then be sent to [email protected]. This can be done via email with all supporting documents as an attachment.
What’s the internal DVA process for my application?
There are two internal processes for the DVA to provide funding for medical cannabis. One is for the predetermined conditions, the other is for “other conditions”. The list of predetermined conditions can be found above.
Currently, only the 5 predetermined conditions are generally accepted, however, special consideration can be given on a case-by-case basis for other conditions.
Predetermined conditions
For the predetermined conditions, once submitted, your application goes to a DVA pharmacist. The pharmacist reviews the application. If they are happy that your doctor and specialist have ticked the boxes, your doctor will get an approval letter.
If the pharmacist needs more detailed information, they will request it from your doctor. The team that assess applications are available by phone and are easy to work with.
If approved, the approval will be for a certain period of time (ie. 3 or 6 months). Your doctor will need to provide a clinical report to the DVA to extend your funding
Other conditions
For conditions not considered in the predetermined category, the DVA takes application and assesses them on a special consideration basis. Applications are sent to a DVA appointed specialist.
This specialist does a review of the documentation and may ask for more information from your doctor. In this case, further information could be specific validated questionnaires or even a more detailed monitoring plan.
This category will take longer than the predetermined conditions category to get approval for. Similarly to the predetermined conditions, you’ll get a specific approval time and your doctor will need to supply clinical reports to increase the duration of funding.
What can I do if my doctor needs help?
While any GP can prescribe cannabis in Australia, many doctors won’t be experienced with the DVA process.
We always recommend you start with your GP first because they know you best and know about all of your treatment. That said, you have a few options to get help.
Firstly, any of the medical cannabis product suppliers should be willing to help your doctor with this process.
Entoura, a product supplier, has created a completely free tool that partially automates this process for your doctor or specialist. The tool streamlines the application by providing your healthcare team with all of the documentation they need and allowing them to simply input the important parts of the application. One the checklist is complete and fields are filled in, your doctor can simply submit the application with a click of a button.
Your doctor or specialist can sign up for this free tool at the Entoura Doctor Portal. Patients can also sign up to a patient area of the Entoura portal (same link as above) to learn more about the DVA process.
DVA Funding Process Infographic
