Training for Independence Report (ACC2126)
**Part A, Report type and service**
Report type:
[x] Plan
[ ] Variation report
[ ] Completion report
Service type:
[x] Training for Independence programme (TI)
[ ] Advisory Services Short-term
[ ] Advisory Services Long-term
TI service stream:
[ ] Te Ata Pō
[x] Te Ata Tū
[ ] Tamariki and Rangatahi
**Part B, Background**
**1. Assessment details**
Supplier name: Kāpiti Community Rehabilitation Services Ltd
ACC supplier number: S14826
Purchase order number: PO2026-04839
Key worker's name: Hannah Bradshaw, Occupational Therapist
Date of first contact: 18/03/2026
**2. Client details**
Client name: Daniel Harrison
Date of birth: 11/09/1997
Claim number: 10082341
**3. ACC details**
ACC contact person: Mere Whitiao
Contact phone number: 04 816 7421
Email address: mere.whitiao@acc.co.nz
**Part C, Plan**
**4. Plan objectives**
Objective 1: Return to work as a graphic designer at part-time hours (3 days per week, 4 hours per day) within a flexible hybrid arrangement, by 24 weeks from programme start (week ending 03/09/2026). Progress measured against agreed hours worked per week, sustained for four consecutive weeks, and confirmed by employer feedback.
Objective 2: Achieve independent community mobility using public transport for at least three return journeys per week (including bus and train routes between home in Paraparaumu and central Wellington), by 12 weeks from programme start (week ending 11/06/2026). Progress measured by independent journey log and key worker observation.
Objective 3: Implement a structured daily routine incorporating energy management strategies, with a self-reported cognitive fatigue rating of 4 or less on a 10-point scale on at least 5 of 7 days per week, by 16 weeks from programme start (week ending 09/07/2026). Progress measured by daily activity diary and Mayo-Portland Adaptability Inventory-4 (MPAI-4) re-administration.
Objective 4: Re-engage in social and recreational activity at a frequency of at least one community-based activity per week (excluding therapy appointments), including resumption of recreational cycling on the Kāpiti coastal path with appropriate safety adaptations, by 20 weeks from programme start (week ending 06/08/2026). Progress measured by activity diary and Community Integration Questionnaire (CIQ) re-administration.
Client summary
Client background:
Daniel is a 28-year-old graphic designer who lives with his parents in Paraparaumu, having returned to their home for support following his discharge from inpatient rehabilitation. Prior to his injury he lived independently in a Wellington flat with two friends, worked full-time at a creative agency in central Wellington, and was an active recreational cyclist and rock climber. He has a partner of three years, Olivia, who lives in Wellington and visits at weekends. Daniel describes his whānau as supportive and is close to his younger sister Rosie, who lives in Christchurch. He identifies as New Zealand European and is not currently affiliated with a religious or cultural group. He has no children and no financial dependents.
Injury related information:
Daniel sustained a severe traumatic brain injury on 14/03/2025 when he was struck by a motor vehicle while cycling home from work in Wellington. He underwent decompressive craniectomy and was managed in the intensive care unit at Wellington Hospital for four weeks. His acute rehabilitation occurred at the ABI Rehabilitation Wellington unit, where he remained as an inpatient until 22/01/2026. On discharge he had residual mild left-sided motor weakness, executive function difficulties (planning, initiation, working memory), cognitive fatigue, low mood with reactive features, and reduced insight into the impact of fatigue on his function. He is no longer fit to drive and has been advised by his neurologist that driving cessation will be reviewed at 18 months post-injury. He is currently on sertraline 50 mg daily, prescribed by his GP, and has weekly contact with the ABI community team during the transition to TI.
Non-injury related information:
Daniel has no significant prior medical history. He has been a recreational user of alcohol, with intake currently abstinent on medical advice. His relationship with Olivia has remained intact throughout the inpatient phase, although both have acknowledged the impact of his cognitive changes on their communication. His parents have taken extended leave from work to support him; this support is time-limited and Daniel's father is planning to return to full-time work in three months, which will reduce the in-home practical support available.
Current function and participation in usual roles and activities:
Daniel is independent in personal self-care including showering, dressing, and toileting. He prepares simple meals (sandwiches, reheated leftovers) but does not yet cook from scratch. He manages medication with a weekly pill organiser set up by his mother. He does not currently drive and uses lifts from family for most community access. He has not returned to work; his employer has held his position open and has offered a graduated return-to-work plan when he is ready. He uses social media to maintain contact with friends but has not attended any in-person social events since discharge. Outcome measures completed at programme start: MPAI-4 total T-score 56 (moderately severe limitations); CIQ total score 14 of 29 (reduced community participation); Goal Attainment Scaling baseline ratings at -2 for all four objectives. Identified strengths include high pre-injury motivation, a supportive whānau and partner, intact long-term memory and language skills, technical computer skills retained, and demonstrated willingness to engage with rehabilitation. Factors impacting current function include cognitive fatigue (the most significant barrier identified by Daniel), low mood, reduced insight into fatigue, and loss of pre-injury identity as a cyclist and creative professional.
**5. Plan strategies**
Objective 1 (return to work) will be addressed through a graduated return-to-work programme led by the Occupational Therapist (key worker) in collaboration with Daniel, his employer, and the Vocational Counsellor. Workplace assessment to be completed in week 4. Initial return at 2 hours per day, 2 days per week from week 8, with structured fortnightly increases until the objective target is reached. Cognitive strategies will be integrated, including task chunking, scheduled rest breaks, and use of a digital task management system. Clinical Psychology will provide concurrent support for adjustment to altered work identity and for managing performance anxiety related to return to work. Outcome measure: hours worked per week, sustained over four consecutive weeks.
Objective 2 (community mobility) will be addressed by the Occupational Therapist and Physiotherapist jointly. The Physiotherapist will progress lower limb strength and balance work to ensure safe ambulation in busy environments, including bus stops and train platforms. The Occupational Therapist will deliver a graded public transport programme starting with familiar short routes (Paraparaumu to Waikanae) and progressing to longer commuter journeys (Paraparaumu to Wellington). Mobile phone-based wayfinding and journey planning will be taught. Outcome measure: independent journey log, with at least three return journeys per week sustained over a fortnight.
Objective 3 (energy management) will be addressed by the Occupational Therapist using a structured fatigue management programme adapted for traumatic brain injury, including activity pacing, energy conservation strategies, sleep hygiene, and the introduction of a daily routine matrix. Clinical Psychology will contribute mindfulness-based interventions for managing low mood and rumination. Outcome measures: daily activity and fatigue diary; MPAI-4 re-administration at weeks 8 and 16.
Objective 4 (social and recreational re-engagement) will be addressed through a graded community participation plan led by the Occupational Therapist. Cycling re-engagement will be supported by the Physiotherapist with a graded reintroduction to a stationary cycle, then a recumbent trike on flat terrain, then upright cycling on the Kāpiti coastal path with helmet, hi-vis, and a riding buddy. Social Worker input will support reconnection with friend group and exploration of a local TBI peer support group. Outcome measures: activity diary; CIQ re-administration at week 20.
Proposed programme length: up to 6 months (24 weeks)
Proposed setting: client's home, community settings (public transport routes, workplace, Kāpiti coastal path), and Telehealth where appropriate
Frequency of client contact: weekly to fortnightly, varying by discipline and programme phase
Proposed hours by service item:
| Service item | Delivering discipline | Proposed hours |
|---|---|---|
| Key worker coordination and case management | Occupational Therapist (Hannah Bradshaw) | 18 |
| Occupational therapy intervention | Occupational Therapist | 36 |
| Physiotherapy | Physiotherapist | 20 |
| Clinical psychology | Clinical Psychologist | 16 |
| Vocational counselling and workplace liaison | Vocational Counsellor | 12 |
| Social work | Social Worker | 8 |
| Whānau and partner support sessions | Occupational Therapist and Social Worker | 6 |
**Part F, Provider/Supplier declaration**
I declare the information provided on this form is, to the best of my knowledge, accurate and complete.
Plan, Provider/Supplier signature: _______________________________ Date: 28/05/2026
In the collection, use, disclosure, and storage of information, ACC will at all times comply with the obligations of the Privacy Act 2020, the Health Information Privacy Code 2020 and the Official Information Act 1982. The Privacy Act 2020 and the Health Information Privacy Code 2020 apply to personal and health information. Further details of how and why we collect, use, store and disclose information are set out in our Personal Information and Privacy Policy, which may be viewed on our website www.acc.co.nz/privacy. We use the information collected on this form to fulfil the requirements of the Accident Compensation Act 2001.
**Information gaps, assessor review required**
1. Section 1, Assessment details: purchase order number PO2026-04839 was confirmed verbally; cross-check against the ACC purchase order email before submission.
2. Section 2, Client details: confirm Daniel's preferred contact details (his mobile vs his parents' landline) before the plan is finalised.
3. Section 4, Objective 1: confirm the employer's specific written commitment to the graduated hybrid return-to-work arrangement before locking in the 24-week target; current commitment is verbal only.
4. Section 4, Objective 4: confirm with neurologist that recreational cycling at week 20 is medically appropriate; this objective is contingent on neurologist clearance.
5. Section 5, Proposed hours: total proposed hours come to 116 across all disciplines; confirm this aligns with the available Te Ata Tū hours envelope for this purchase order before submission.
6. Section 5, Frequency: frequency listed as "weekly to fortnightly" pending discipline-specific scheduling; finalise the discipline-by-discipline cadence with each team member before plan sign-off.
7. Client summary: GP name and contact details for medication management were not captured during the assessment session; obtain and add before submission.
8. Outcome measures: baseline MPAI-4 and CIQ scores recorded above; confirm the date of administration (assumed to be week of first contact) and append the completed measures to the plan submission.
Training for Independence Report (ACC2126)
Part A — Report type and service
(Identify the report type and service type from the transcript or contextual notes. Do not infer from content if not explicitly stated.)
Report type:
"[ ] Plan"
"[ ] Variation report"
"[ ] Completion report"
(Mark with "[x]" the report type explicitly stated in the transcript or contextual notes. Leave all others as "[ ]". Do not omit any option.)
Service type:
"[ ] Training for Independence programme (TI)"
"[ ] Advisory Services Short-term"
"[ ] Advisory Services Long-term"
(Mark with "[x]" the service type explicitly stated in the transcript or contextual notes. Leave all others as "[ ]". Do not omit any option.)
TI service stream:
"[ ] Te Ata Pō"
"[ ] Te Ata Tū"
"[ ] Tamariki and Rangatahi"
(Mark with "[x]" the TI service stream explicitly stated in the transcript or contextual notes. Leave all others as "[ ]". Do not omit any option. Only include this section if the service type is Training for Independence programme. Omit if the service type is Advisory Services Short-term or Advisory Services Long-term.)
Part B — Background
1. Assessment details
(Source restriction: populate from the contextual notes only. Do not include information from the transcript, or you will fail.)
"Supplier name:" [supplier organisation name](Only include details if explicitly mentioned in the contextual notes or clinical note provided; otherwise leave blank.)
"ACC supplier number:" [ACC supplier number](Only include details if explicitly mentioned in the contextual notes or clinical note provided; otherwise leave blank.)
"Purchase order number:" [purchase order number](Only include details if explicitly mentioned in the contextual notes or clinical note provided; otherwise leave blank.)
"Key worker's name:" [key worker full name and professional title](Only include details if explicitly mentioned in the contextual notes or clinical note provided; otherwise leave blank.)
"Date of first contact:" [DD/MM/YYYY](Only include details if explicitly mentioned in the contextual notes or clinical note provided; otherwise leave blank.)
2. Client details
(Source restriction: populate from the contextual notes and patient details only. Do not include information from the transcript, or you will fail.)
"Client name:" [client full name](Only include details if explicitly mentioned in the contextual notes or clinical note provided; otherwise leave blank.)
"Date of birth:" [DD/MM/YYYY](Only include details if explicitly mentioned in the contextual notes or clinical note provided; otherwise leave blank.)
"Claim number:" [ACC claim number](Only include details if explicitly mentioned in the contextual notes or clinical note provided; otherwise leave blank.)
3. ACC details
(Source restriction: populate from the contextual notes only. Do not include information from the transcript, or you will fail.)
"ACC contact person:" [ACC contact person name](Only include details if explicitly mentioned in the contextual notes or clinical note provided; otherwise leave blank.)
"Contact phone number:" [ACC contact phone number](Only include details if explicitly mentioned in the contextual notes or clinical note provided; otherwise leave blank.)
"Email address:" [ACC contact email address](Only include details if explicitly mentioned in the contextual notes or clinical note provided; otherwise leave blank.)
Part C — Plan
(Only include Part C if the transcript or contextual notes explicitly state this is a Plan report or an Advisory Services Long-term plan. If the report type is Variation report, Completion report, or Advisory Services Short-term, omit Part C entirely.)
4. Plan objectives
(Source restriction for section 4: populate the client summary primarily from the transcript. Factual details such as dates, demographics, and claim information should be sourced from the contextual notes where available. You may make reasonable professional inferences based on the information provided.)
"Objective 1:" [Detailed SMART rehabilitation goal agreed with the client and team, including the specific functional target, how progress will be measured, and the target timeframe](Only include details if explicitly mentioned in the transcript or contextual notes; otherwise leave blank.)
"Objective 2:" [Detailed SMART rehabilitation goal agreed with the client and team, including the specific functional target, how progress will be measured, and the target timeframe](Only include details if explicitly mentioned in the transcript or contextual notes; otherwise leave blank.)
"Objective 3:" [Detailed SMART rehabilitation goal agreed with the client and team, including the specific functional target, how progress will be measured, and the target timeframe](Only include details if explicitly mentioned in the transcript or contextual notes; otherwise leave blank.)
"Objective 4:" [Detailed SMART rehabilitation goal agreed with the client and team, including the specific functional target, how progress will be measured, and the target timeframe](Only include details if explicitly mentioned in the transcript or contextual notes; otherwise omit completely.)
Client summary
Client background:
[Detailed summary of the client's key demographic information, living situation, family and whānau context, life roles and activities, and relevant health information](Only include details if explicitly mentioned in the transcript or contextual notes; otherwise leave blank.)
Injury related information:
[Detailed summary of the injury details, management to date, and current injury related needs relevant to the TI programme](Only include details if explicitly mentioned in the transcript or contextual notes; otherwise leave blank.)
Non-injury related information:
[Detailed description of any relevant non-injury related factors that may influence the rehabilitation programme](Only include details if explicitly mentioned in the transcript or contextual notes; otherwise omit completely.)
Current function and participation in usual roles and activities:
[Detailed description of the client's current functional level and participation in their usual roles and activities, including outcome measures used, factors impacting on current function, identified client strengths, and any other relevant considerations](Only include details if explicitly mentioned in the transcript or contextual notes; otherwise leave blank.)
5. Plan strategies
(Source restriction for section 5: populate primarily from the transcript. You may make reasonable professional inferences based on the information provided.)
[Detailed description of the strategies and outcome measures to achieve each of the objectives listed in section 4, including the specific intervention approach for each objective, the disciplines involved, the proposed outcome measures, and how progress will be tracked](Only include details if explicitly mentioned in the transcript or contextual notes; otherwise leave blank.)
"Proposed programme length:" [programme length e.g. 3 months, up to 6 months](Only include details if explicitly mentioned in the transcript or contextual notes; otherwise leave blank.)
"Proposed setting:" [setting e.g. client's home, place of education, clinic, Telehealth, community](Only include details if explicitly mentioned in the transcript or contextual notes; otherwise leave blank.)
"Frequency of client contact:" [frequency e.g. weekly, fortnightly](Only include details if explicitly mentioned in the transcript or contextual notes; otherwise leave blank.)
Proposed hours by service item:
[Breakdown of proposed hours across the programme](Only include if explicitly mentioned in the transcript or contextual notes; otherwise omit completely. Format as a three-column markdown table with the following columns: Service item, Delivering discipline, Proposed hours. Write each service item as a new row.)
Part D — Variation report
(Only include Part D if the transcript or contextual notes explicitly state this is a Variation report. If the report type is Plan or Completion report, omit Part D entirely.)
6. Potential changes to services
(Source restriction: populate primarily from the transcript. You may make reasonable professional inferences based on the information provided.)
[Description of proposed changes to the programme](Only include if explicitly mentioned in the transcript or contextual notes; otherwise omit completely. Format as a two-column markdown table with the following columns: Reason for variation, Proposed changes to service. Write each variation item as a new row.)
7. Progress summary, recommendations, and other comments
(Source restriction: populate primarily from the transcript. You may make reasonable professional inferences based on the information provided.)
[Detailed summary of the client's progress to date, any recommendations for ACC to action and the rationale, and any other relevant comments or observations](Only include details if explicitly mentioned in the transcript or contextual notes; otherwise leave blank.)
Part E — Completion report
(Only include Part E if the transcript or contextual notes explicitly state this is a Completion report. This applies to completion of a Training for Independence programme, Advisory Services Short-term, or Advisory Services Long-term. If the report type is Plan or Variation report, omit Part E entirely.)
8. Outcomes
(Source restriction for section 8: populate outcome descriptions primarily from the transcript. You may make reasonable professional inferences based on the information provided. For each objective, mark the rating that most accurately reflects the outcome discussed. Mark only one rating per objective.)
Objective 1 outcome:
[Detailed description of the outcome achieved for objective 1, including the extent to which the functional goal was reached, any barriers encountered, and reasons why the client could not fully achieve the outcome if relevant](Only include details if explicitly mentioned in the transcript or contextual notes; otherwise leave blank.)
"Date outcome achieved (if relevant):" [DD/MM/YYYY](Only include details if explicitly mentioned in the transcript or contextual notes; otherwise leave blank.)
"Rating against objective:"
"[ ] Not achieved"
"[ ] Minimally achieved"
"[ ] Partially achieved"
"[ ] Fully achieved"
(Mark with "[x]" the rating that most accurately reflects the outcome for objective 1 based on the transcript. Leave all others as "[ ]". Do not omit any option.)
Objective 2 outcome:
[Detailed description of the outcome achieved for objective 2, including the extent to which the functional goal was reached, any barriers encountered, and reasons why the client could not fully achieve the outcome if relevant](Only include details if explicitly mentioned in the transcript or contextual notes; otherwise omit completely.)
"Date outcome achieved (if relevant):" [DD/MM/YYYY](Only include details if explicitly mentioned in the transcript or contextual notes; otherwise leave blank.)
"Rating against objective:"
"[ ] Not achieved"
"[ ] Minimally achieved"
"[ ] Partially achieved"
"[ ] Fully achieved"
(Mark with "[x]" the rating that most accurately reflects the outcome for objective 2 based on the transcript. Leave all others as "[ ]". Do not omit any option.)
Objective 3 outcome:
[Detailed description of the outcome achieved for objective 3, including the extent to which the functional goal was reached, any barriers encountered, and reasons why the client could not fully achieve the outcome if relevant](Only include details if explicitly mentioned in the transcript or contextual notes; otherwise omit completely.)
"Date outcome achieved (if relevant):" [DD/MM/YYYY](Only include details if explicitly mentioned in the transcript or contextual notes; otherwise leave blank.)
"Rating against objective:"
"[ ] Not achieved"
"[ ] Minimally achieved"
"[ ] Partially achieved"
"[ ] Fully achieved"
(Mark with "[x]" the rating that most accurately reflects the outcome for objective 3 based on the transcript. Leave all others as "[ ]". Do not omit any option.)
Objective 4 outcome:
[Detailed description of the outcome achieved for objective 4, including the extent to which the functional goal was reached, any barriers encountered, and reasons why the client could not fully achieve the outcome if relevant](Only include details if explicitly mentioned in the transcript or contextual notes; otherwise omit completely.)
"Date outcome achieved (if relevant):" [DD/MM/YYYY](Only include details if explicitly mentioned in the transcript or contextual notes; otherwise leave blank.)
"Rating against objective:"
"[ ] Not achieved"
"[ ] Minimally achieved"
"[ ] Partially achieved"
"[ ] Fully achieved"
(Mark with "[x]" the rating that most accurately reflects the outcome for objective 4 based on the transcript. Leave all others as "[ ]". Do not omit any option.)
Other events affecting outcomes:
[Detailed description of any other events that may have affected the client's outcomes during the programme](Only include details if explicitly mentioned in the transcript or contextual notes; otherwise omit completely.)
"Global Rating of Change score:" [GROC score as reported by the client](Only include details if explicitly mentioned in the transcript or contextual notes; otherwise leave blank.)
9. Programme summary, recommendations, and other comments
(Source restriction: populate primarily from the transcript. You may make reasonable professional inferences based on the information provided.)
[Detailed summary of the overall programme including additional information, relevant reports or service information, transition planning to other services or community supports, involvement of other agencies or community organisations, and any recommendations for ACC](Only include details if explicitly mentioned in the transcript or contextual notes; otherwise leave blank.)
Part F — Provider/Supplier declaration
"I declare the information provided on this form is, to the best of my knowledge, accurate and complete."
"Plan — Provider/Supplier signature: ___________________________ Date: _______________"
"Variation report — Provider/Supplier signature: ___________________________ Date: _______________"
"Outcome report — Provider/Supplier signature: ___________________________ Date: _______________"
"In the collection, use, disclosure, and storage of information, ACC will at all times comply with the obligations of the Privacy Act 2020, the Health Information Privacy Code 2020 and the Official Information Act 1982. The Privacy Act 2020 and the Health Information Privacy Code 2020 apply to personal and health information. Further details of how and why we collect, use, store and disclose information are set out in our Personal Information and Privacy Policy, which may be viewed on our website www.acc.co.nz/privacy. We use the information collected on this form to fulfil the requirements of the Accident Compensation Act 2001."
Information gaps — assessor review required
(After generating the full report above, review every section and identify areas where information was insufficient or missing. Generate a numbered checklist with the specific section reference and what is missing. Be specific.)
[Numbered checklist of information gaps requiring assessor review before submission]
(Rules — apply to entire template:
1. Never fabricate client details, claim numbers, dates, supplier information, or purchase order numbers.
2. You may make reasonable professional inferences and clinical assessments in clinical sections.
3. If factual information has not been provided, leave it blank.
4. Use NZ English spelling throughout. Use DD/MM/YYYY for all dates.
5. For all tables: only create rows for items discussed. Do not fabricate entries.
6. Objectives must be SMART — specific, measurable, achievable, relevant, and time-bound.
7. Do not abbreviate or truncate any section. Generate complete content for every section that has source data available.)
