Coding a paper claim for Carer Allowance (CA) where the care receiver is 16 years or over 009-03040060

If a carer or care receiver has passed away and the claim has not been finalised, finalise the claim before completing the death action.

Does the care receiver receive CA for another adult care receiver?

• Yes, go to Step 2
• No, go to Step 3

Contact should be made with both the carer claiming CA and the care receiver to clarify the caring situation. Before contacting, check if either carer is a nominee for the other carer. If so, only contact the carer who is the nominee.

If neither carer is the nominee for the other person, contact the existing carer first, unless the available information indicates this is not appropriate:

• ask if they are still providing care to their care receiver and if not, when they ceased providing care
• explain that another person has lodged a claim for CA for them and if granted their CA payment will cease
• obtain their permission to discuss their situation with the other carer

If the existing carer gave their permission to discuss their situation with the other carer, contact the other carer:

• If the existing carer is still providing care, explain the existing carer's CA entitlement will cease if they are granted CA
• Unless they are receiving CA for another adult care receiver, invite them to claim CA in respect of the care receiver which the existing carer receives CA for, if appropriate

If the caring situation is very complex or there are sensitive issues, a referral to a social worker may be appropriate.

Does the new applicant wish to proceed with their claim for CA?

• Yes, cancel the existing carer's CA payment
• If the existing carer continued to provide daily care to another adult care receiver, the existing carer remains entitled to CA until the date a determination is made to grant their carer CA, cancel existing carers CA from that date
• Otherwise, cancel CA from the date care ceased. This must occur before processing the claim for CA for the new carer
• If CA is being granted to the new carer, the normal start date provisions for a new claim apply, go to Step 3
• No:
• The new carer will be required to withdraw their claim
• If the new carer is otherwise qualified for CA, CA must be either granted or the claim withdrawn
• Whilst the claim could be rejected - customer request, the decision would not be reviewable because claims rejected at the customer's request cannot be appealed against
• In some cases, social worker involvement may be required to determine if the current carer can provide daily care. In these instances, no decision should be made until after the social worker's referral
• Where both the care and care receiver claim for each other and neither want to withdraw their claim, refer these cases to the Level 2 Policy Help Desk for assistance

Processing the claim on the carer's record.

When indexed Social Application is created, go to Step 4.

Note: see Social Applications if more details are required.

From 1 July 2018

Intent to claim provisions were amended on 1 July 2018 and apply only to customers in vulnerable circumstances. See Intent to claim and vulnerable customers.

Note: from 1 July 2018, the Customer Contact Details (CCD) screen is read only. See Contact in relation to an intended claim.

Before 1 July 2018

If the claim were lodged more than 14 days after the date of initial contact, as recorded on the Contact Claim Date (CCD) screen, an extension of the deemed date of lodgement from 14 days up to 13 weeks could be considered due to:

• medical condition, or
• exceptional circumstances

The date from which the payment will be granted may depend on this date if the claim cannot be backdated via other means.

The date the agency issued the Claim for Carer Allowance following Carer Payment Review (SA341) review is not an intent to claim, and therefore cannot be the deemed start date of the claim. Additionally, the date the review was started or completed is not the date of claim and no CCD should be recorded based on review dates.

The correct start date of the claim is the date of receipt of the SA341 (the date the carer lodged the SA341) unless there was prior personal contact. If a carer contacted within 14 days prior normal start date rules will continue to apply and the initial contact date can be used as the contact claim date.

• The RSLEG screen will display
• Record the legal residence status
• The Customer Details Task (CDTS) screen will display (it is the first screen back in the CA workflow)
• Select the relevant fields on the CDTS screen and complete the address, payment destination, relationship status, proof of identify and other relevant screens

The final screen in the CDTS process is the CATS screen:

• The Care Receiver Summary (CRS) screen will be pre-selected
• Press [Enter]
• the Care Receiver Summary (CRS) screen will appear

Does the name of the care receiver who this claim relates to appear on the CRS screen?

• Yes, and the link is current (CUR) for CA, the carer is already receiving CA for this care receiver. Reject the claim for CA. Record all details on a DOC in the carer's record. Procedure ends here
• Yes, and the CA link is not CUR, or the link is to another payment:
• 'S'elect the name and key 'Y' in the relevant Add a new care receiver or new link type? field. Press [Enter]
• The Link Confirmation (LC) screen will be displayed, with a 'Y' in the Confirm Selection: field. Press [Enter]. On CRS screen, 'S'elect (SELF) and press [Enter]. Go to Step 10
• No, go to Step 7

If after making extensive efforts to identify the care receiver (such as phone calls, a Request for Information (RFI) letter to the carer and searches on the system), the care receiver cannot be identified, see Rejecting a Carer Allowance (CA) claim.

On the CRS screen, code 'Y' in the Adult: field and press [Enter]. The Link Person (LP) screen will display.

Is the care receiver the partner of the carer?

• Yes, code the LP screen, then go to the National Index Name List (IL) screen
• Select the partner record and press [Enter]
• The Link Confirmation (LC) screen will appear. Confirm the selection
• The system will navigate to the partner's record, within the new claim activity
• Go to Step 9
• No,
• No record exists (such as no National Index records found matching the search criteria), go to the Add Person (AP) screen and create a customer record. Go to Step 8
• A record exists, go to the IL screen. Select the appropriate record and press [Enter]. The LC screen will appear. Confirm the selection. Go to Step 8

The care receiver's record is displayed:

• A CRA/ADD activity will be on AL screen
• 'S'elect the activity and press [Enter]

Note: if the care receiver record was only recently created in Step 6, the Residency screens (RSLEG, etc.) will display before the CDTS screen appears. These will need to be updated.

• Complete the automatically selected screens:
• the last screen in the screen flow is the Carer Allowance Task Selector (CATS) screen
• press [Enter] to accept the pre-selected screens
• if the carer has the Date of departure field coded but no date in the Return Date field, on the Australian Departure and Return (ADR) screen, Depart/Return Aus field will also be selected
• At the Care Receiver Summary (CRS) screen:
• 'S'elect (SELF)
• Press [Enter]

Press [Enter] to accept the default screen flow.

• Select the THP Assessment, and the Adult Disability Management (ADMG) screen will display
• This is the first of the Adult Disability Assessment Tool (ADAT) screens which calculate the ADAT score for a care receiver. For help coding these screens this, see Coding the Adult Disability Assessment Tool (ADAT)
• If the THP assessment was signed more than 6 months ago and it is determined to be an accurate reflection of the adult care receiver's condition, record the date signed by the THP as the date the claim was lodged. Ensure this is clearly documented on the carer's record
• Note: eligibility for CA requires the medical condition to be present for at least 12 months (except where terminal). Processing Service Officers are expected to manually assess this as part of the claim process. An automatic rejection is not generated when a Period of Condition (POC) of less than 12 months (L12) is coded
• The final screen to calculate the ADAT score is the ADAS screen which displays the total ADAT score for the care receiver
• Press [Enter]

Note: specific information relating to eligibility under Section 954A is coded on the CDCR screen, in addition to care details which apply no matter what section of the Social Security Act the carer is being assessed under.

In cases where the CDCR screen was not updated to show the date care ceased for a previous carer receiving CA then, if the start date for the current carer is:

• after the date paid to for the previous carer, add a new line on the CDCR screen for the previous carer. Code zero days in care from the date of cancellation
• before the date paid to for the previous carer, investigate the date the previous carer ceased providing care. Where there is a dispute regarding dates in care. See Change of care for Carer Payment (CP) and Carer Allowance (CA) customers. When the date has been determined add a new line on the CDCR screen for the previous carer with the date care had ceased

This is for carers of adult care receivers who do not live with the person they provide care for.

• Yes, go to Step 4
• No, code the following fields:
• Effect Date - date from which the claim is to be granted
• Relationship to Care Rcvr: one of:
  'PAR' Parent
  'ORL' Other Relation
  'URL' Unrelated (including foster parent)
  'PTR' Partner/Spouse
  'CHD' Child
• Lives Separately: 'N' (default). Note: if this indicator is N, any information coded in the Living Separately section of the screen will result in an error message
• Code either:
  Care Days/Fortnight - number of days the adult is in the care of the care receiver, values 1 to 14, or
  Care %: percentage of care provided to the care receiver, values 1 to 100
  Note: if daily care is not required/provided, code '0' (zero) in one of the above fields
• Press [Enter]
• Go to Step 5

The carer is being assessed under Section 954A, as they do not live with the care receiver.

Code the following fields:

• Effect Date - date from which the claim is to be granted
• Relationship to Care Rcvr: one of:
• 'PAR' Parent
• 'ORL' Other Relation
• 'URL' Unrelated (including foster parent)
• 'PTR' Partner/Spouse
• 'CHD' Child
• Lives Separately: 'Y' (defaults to N). If this indicator is Y, any information coded in the Living Together section will result in an error message
• In Living Separately section of the screen:
• Code 'Y' or 'N' in the Paid Award Wages: field
• Code 'Y' or 'N' in the Provides Daily Care: field
• Hours/Week: field has been split into two columns
  In Cust column, code the number of hours per week stated by the carer
  In CSO: column, code the number of hours per week that have been verified by the Service Officer. Because the Service Officer will, in most cases, only verify up to the 20-hour mark and stop once eligibility is determined, the CSO: column takes numbers up to 20 and has a code for '>20'

Is care shared?

• Yes, go to Step 5
• No, press [Enter]. Go to Step 6

The percentage of the total care provided by the carer is coded in the Shared Care %: field. For example, if carer A provides 15 hours care and carer B, provides 10 hours, carer A's care percentage is 15/25 x 100 = 60%. Carer B's care percentage is 10/25 x 100 = 40%.

For grants under Section 954A, the percentages are only relevant if both carers claim payment. If only one carer claims, that carer receives 100%.

Note: when a declaration of shared care is determined, the percentage of care provided must be coded (before the review period starts) to reflect the carer with the greater amount of care is the primary carer.

If care is shared, the Shared Care: field should be coded with one of the following, depending on the result of the assessment:

• MET = Care requirements met. Care is provided daily and at least 20 hours care is provided per week
• LOH = Hours too low. Care is provided daily, but less than 20 hours care is provided per week
• NDC = No daily care. Care is not provided daily and at least 20 hours care is provided per week
• CNM = Care requirements not met. Care is not provided daily and less than 20 hours care is provided per week

Note: for shared care cases, the Shared Care: field is used by the system to determine eligibility, not the hours coded in the Hours/Week: field, but all fields should still be completed.

• Enter through all the screens checking that information shown is correct. If the information is not correct, edit the data as appropriate
• If the care receiver is not the partner, go to the Assessment Results (AR) screen and finalise the activity. Go to Step 6
• If the care receiver is the partner, the carers record will be opened, and the CDTS screen will be displayed
• The final screen is the Carer Allowance Task Selector (CATS) screen. Go to Step 8

Key 'FL' (flip) in the Nxt: field to return to the carer's new claim activity.

• 'S'elect the CDA/NCL activity from the AL screen and press [Enter] to go to the CDTS screen
• This screen will have other screens pre-selected which must be viewed/updated in turn
• The final screen is the Carer Allowance Task Selector (CATS) screen

• Press [Enter] to accept the pre-selected screens - the Care Receiver Summary (CRS) and Assessment Results (AR) screens
• (CRS screen will display. The care receiver's name should appear with LNK in the Adt Sts field. Select the care receiver on the CRS screen and press [Enter]

The Assessment Results: field will be automatically selected. Press [Enter].

This will show the assessment action defaulted because of the ADAT processing.

Select the Process Direct desktop icon to display to the Process Direct Landing page. For information about the Process Direct Landing page, see Process Direct navigation and common screens table. Locate the carer's record by selecting the Customer Summary tile and entering the following details on the Search Customers screen:

• Last Name, First Name, and Date of Birth, or
• Customer Reference Number (CRN)

Select Go

• Go to the CA Adjustable Taxable Income (CAATI) screen

The CAATI screen will display the following tables:

• Actual ATI – CA eligibility is determined using the actual Adjusted Taxable Income (ATI) for the reference tax year. The reference tax year is usually the previous tax year immediately before the current tax year
• Current Financial Year Estimate ATI – in limited circumstances where the carers ATI for the past year they selected was too high (or their and their partner's combined ATI was too high), the carers CA qualification may be assessed using a current year estimate of income subject to certain conditions. For more information see Carer Allowance (CA) income test - determining reference tax year and assessable income components
• ATI Summary – the ATI summary will display the final assessment of the income details provided for the carer and their partner if they have one. This will include deemed income from account-based income streams if the carer (and their partner if they have one) is 60 years of age or older

These tables may or may not be pre-populated depending on whether the carer (and their partner if they have one) have previously provided CA income test details, or if the carer has completed an online claim.

Have the carers responses pre-populated into the relevant fields, and the ATI Summary is correct

• Yes, go to Step 6
• No, go to Step 3

• To add a new actual ATI, select Add
• To edit an existing actual ATI, select Edit next to the actual ATI to be updated

The Create/Change Actual ATI screen will display, enter updates as provided by the carer for the following:

• Date of Effect: date the assessment is to apply from
• Financial Year: the reference tax year [YYYY/YYYY]
• Has Lodged Tax Return: Yes or No
• Taxable Income: gross taxable income as displayed on the Tax Notice of Assessment
• Target Foreign Income: any income received from a source outside Australia
• Net Investment Loss: the sum of net financial investment losses and net rental property losses
• Employer Provided Benefits: employer provided fringe benefits more than $1,000
• Reportable Super Contributions: employer superannuation contributions under salary sacrifice and personal deductible superannuation contributions
• Tax Free Pensions/Benefits: tax free government pensions and benefits
• Child Support Paid: deductible child maintenance expenditure
• Receipt Financial Year: date recorded on the Tax Notice of Assessment as being assessed

Fields that are marked with * are mandatory and the carer must provide a value/response

Select Save.

Note: All financial values are to be recorded as whole dollar amounts. Do not include cents and do not apply rounding.

Has the carer asked to provide Current Financial Year Estimate ATI?

• Yes, go to Step 4
• No, go to Step 5

If the carer is requesting to submit a Current Financial Year Estimate of Adjusted Taxable Income (ATI), the carer must provide evidence of the reason for estimate. Service Officers must check the evidence provided, and determine the reason meets the allowable reasons for a Current Financial Year Estimate ATI to be accepted.

• To add a new current financial year estimate ATI, select Add
• To edit an existing current financial year estimate ATI recorded, select Edit next to the current financial year estimate ATI to be updated

The Create/Change Current Financial Year Estimate ATI screen will display, enter updates as provided by the carer for the following:

• Date of Effect: date the assessment is to apply from
• Financial Year: the reference tax year [YYYY/YYYY]
• Reason for Estimate: retirement or partial retirement, closure of business, receipt of an inheritance, reduced working hours due to caring, catastrophic event or natural disaster, one off cost due to care receiver needs
• Other Reason: free text option where available reasons are not suitable
• Estimate Accepted: Yes or No
• Rejection Reason:
• 'PRV' same reason used for previous financial year
• 'UNS' unsatisfactory evidence of change of circumstances
• 'FUT' the change has not yet occurred
• 'UNA' the reason given is not an acceptable change of circumstances
• Taxable Income: gross taxable income as displayed on the Tax Notice of Assessment
  If a person has accessed superannuation under the First Home Super Saver (FHSS) Scheme these withdrawals will contain some portion that the ATO will determine as taxable, and this will be reflected on an individual NOA. However, for Services Australia purposes, FHSS Scheme withdrawals are not counted towards taxable income. If referring to a person's NOA who has accessed superannuation under this scheme, exclude any taxable income attributed to the FHSS Scheme. Advice from the individual on the value to be excluded should be obtained as this detail will not be included on the NOA but is expected to be information the individual has access to from their FHSS Scheme submission and approval paperwork
• Target Foreign Income: any income received from a source outside Australia
• Net Investment Loss: the sum of net financial investment losses and net rental property losses
• Employer Provided Benefits: employer provided fringe benefits more than $1,000
• Reportable Super Contributions: employer superannuation contributions under salary sacrifice and personal deductible superannuation contributions
• Tax Free Pensions/Benefits: tax free government pensions and benefits
• Child Support Paid: deductible child maintenance expenditure
• Receipt Financial Year: date recorded on the Tax Notice of Assessment as being assessed

Fields that are marked with * are mandatory and the carer must provide a value/response.

Select Save.

Note: All financial values are to be recorded as whole dollar amounts. Do not include cents and do not apply rounding.

Go to Step 5

Assess must be selected to generate the Adjusted Taxable Income (ATI) summary values and display any deemed income assessed.

• Select Assess

Check the ATI summary is correct for the following fields:

• Date of Effect: date the assessment is to apply from
• Financial Year Used: the reference tax year [YYYY/YYYY]
• Current or Prior Year ATI: current budget year or actual ATI
• Customer Lodged Tax Return: Yes or No
• Partner Lodged Tax Return: Yes or No
• Combined Total Deemed Income: non editable
• Combined Total ATI: non editable
• Income Test Met: Yes or No
• Reason:
• 'EXM' Exempted
• 'LMT' Below Income Threshold Limit
• 'FIT' Failed Income Test
• 'ENA' Estimated Income Not Accepted
• Source:
• 'ATO' ATO Review
• 'CLM' Claim
• 'COC' Change of Circumstance
• 'IMO' Initial Mail Out Review
• 'NRC' Non-Review Customer Reported Change of Circumstance

Is the ATI Summary correct?

Yes, go to Step 6

No, update the actual ATI. See step 3 in this table for instructions

After addressing any data validations, select Save to load the data.

Assess will then display.

Select Assess. Wait as it can take a little time.

Errors, warnings, or messages may display and need to be addressed.

If there are no errors, the Assessment Results (AR) screen will display. Check that the outcome is correct.

Select Finish.

The Update Header Data screen will display. Record:

• Receipt date, and
• Channel

Complete all other related tasks for the customer such as clean screen coding and return to the carers claim in Customer Record (CR).

If there is a warning message, press PF2 for instructions to find out what to do.

Refer all CP and/or CA new claims before the claim is finalised to a social worker where the carer is aged under 18 years. This is a mandatory requirement with no exceptions.

A referral to a social worker is required before finalising the claim if otherwise qualified and the carer is:

• under 18 years of age

A referral to a social worker is required if otherwise qualified and the carer is:

• over 80 years of age

It is necessary to ensure the carer can and does provide the care receiver with the level of care and attention daily that is required. A young or elderly carer may have difficulty accessing support services and resources. A social worker can help with this.

Is the carer claiming or receiving Carer Allowance (CA) for another care receiver at the same time as the one just coded?

Note: a carer is allowed to receive a maximum of 2 CA payments (and no more than 2) if they provide care for two disabled adults. Each adult care receiver must qualify for Carer Allowance in their own right. Where a CA (adult) claim is received for a third care receiver, reject the claim with the rejection code TCR (Max of two adult care receivers allowed). See Rejecting a Carer Allowance (CA) claim.

• Yes, go to Step 2
• No, go to Step 3

• Key 'CRS' in the Nxt: field
• Press [Enter]
• Add the new care receiver. For help with adding a new care receiver, see the relevant link below:
• Creating a Carer Payment link for paper claims (carer is not partner of care receiver), or
• Creating a Carer Payment (CP) link for paper claims where the care receiver is the carer's partner
• Code the new claim details for the second care receiver. (For help, see Steps 7 to 9 in the Initial processing - paper claim table through the Coding care and medical details - paper claim table
• The screen flow will go back to the AR screen to show assessment of claim
• Press [Enter]

Go to Step 4

Press [Enter] the screen flow will default to the Assessment Results (AR) screen.

Record all details on a DOC in the carer's record and complete the activity via the Assessment Results (AR) screen.

If the carer has qualified for CA (Adult) based on the health professional's component of at least twelve, and an overall score of at least thirty, they may qualify for CP as well, whether the care receiver is a lower ADAT score adult or higher ADAT score adult:

• CA (Adult): health professional score twelve, total score thirty
• CP: higher ADAT score adult: health professional score ten, total score twenty-five
• CP: lower ADAT score adult: health professional score eight, total score twenty