Claiming Carer Payment (CP) and/or Carer Allowance (CA) 009-04010000

An online claim will expire after 13 weeks if not submitted. In that case, a new online claim must be submitted. If further assistance is required, for example, there has been a system error, refer to the Level 2 Policy Helpdesk.

Check a carer or their correspondence nominee has the Centrelink online account linked to myGov.

If a carer or their correspondence nominee does not have an online account, there are 4 ways they can link Centrelink to myGov.

Tell customers how to create a myGov account and link their Centrelink online account to it. This will also enable them to receive Centrelink mail online through the myGov Inbox.

Before the customer submits a claim, they may need to meet some more identity requirements. This could include bringing acceptable photo identity documents to a service centre or uploading a document in their Centrelink online account or the Express Plus Centrelink mobile app. The agency will let the customer know if they need to do this.

Service centre staff can help carers or their correspondence nominee with their online claim using Self Service Terminals.

Carers or their correspondence nominee can access the Payment and Service Finder in their Centrelink online account or on the Services Australia website to:

• check if CP and/or CA is an appropriate service offer for them, and
• start their claim

Record a DOC and tell the carer or their correspondence nominee to submit their claim online. From 1 July 2018, eligible carers will receive payments or concession cards from the date they submit a complete claim with all relevant supporting documentation.

Note: different processes apply for carers in vulnerable circumstances, see Intent to claim and vulnerable customers.

Lodgement of a Medical Report on its own is not considered a claim for CP and/or CA.

On the My profile page, information from the carer's record is pre-populated. Carers or their correspondence nominee need to select Update in the sections such as Address or Relationship details that require an update. Note: accommodation details are covered within the claim questions.

For each part of My profile updated, they need to select Save.

Electronic messaging

Carers or their correspondence nominee who provide a mobile phone number or email address are advised they will be subscribed to Electronic Messaging unless they previously declined EM. They will be asked to nominate a preferred contact method (SMS or email) for electronic messages.

They will be subscribed to receive their Centrelink mail online in their myGov Inbox.

They can opt out of these services at any time.

To check if Carer Payment and/or Carer Allowance is the most appropriate service offer, carers can access the Payment and Service Finder:

• in their Centrelink online account, or
• on the Services Australia website

To start an online claim, carers or correspondence nominees must have a Centrelink online account linked to myGov.

Once they have linked their Centrelink online account to myGov, carers or their correspondence nominee need to:

• sign in to myGov and access their linked Centrelink online account
• from the MENU, select Payments and claims > Claims > Make a claim page and select Get started in the Carers category
• answer the streaming questions on the Check eligibility pages to check they are claiming the most suitable income support payment for their circumstances. If they would not be eligible based on their answers, the online claim will advise them why and refer them to the Payment and Service Finder or to contact Services Australia to discuss a more suitable payment
• select Continue. The Care receiver detail page will display. The carer can update links or add new links to claim CP and/or CA for the required care receiver(s). After completing care receiver updates, select Claim now

The Claim navigation page displays the sections of the claim that need to be completed. The sections must be completed in order, and the next section cannot be started until the previous section is complete.

The sections are accessed by selecting the Start button.

Each section contains modules with relevant questions. On each question page, the carer or their correspondence nominee can select Previous, to go back to the previous question.

Carers or their correspondence nominee can read the Digital Assistant text for help with the questions on the current page. Selecting the link below the information text will launch the interactive Digital Assistant.

When the carer or their correspondence nominee has completed each module and reached the end of the section, they will be returned to the Claim navigation page to select the next section.

As a section is completed the carer or their correspondence nominee has the option to return to a previously completed section to change their answers by selecting the Edit option. To return to the Claim navigation page after making changes, the carer can select the last dot on the side navigation and select Continue.

The claim does not need to be completed in one session. Carers or their correspondence nominee can leave the Claim navigation page at any time and the responses will be automatically saved, to continue with the claim later.

All compulsory questions must be answered before the claim can be submitted.

Expired claims

The online claim will expire after 13 weeks if not submitted. See Circumstance Change Monitor (CCM).

To access their online claim, the carer or their correspondence nominee needs to:

• sign in to myGov and access their linked Centrelink online account
• from the MENU, select Payments and claims > Claims > My online claims

A list of all started online claims will display.

If the status of the claim is incomplete, they can choose to:

• Continue claim to display the next question set to be completed, or
• Cancel claim and confirm they want to do this. When cancelled, they will not be able to view or continue the online claim, and no claim information will be recorded. They can start a new online claim at any time

Question sets include:

• Personal details – identity, address, contact details, relationship
• Contact Requirements - Permit to Enquire, Nominee
• Australian Residence
• Accommodation
• Child Details

Question sets will depend on the carer's circumstances and the payment they are claiming. For example:

• Circumstances - details of the carer's paid work, voluntary work, study or training
• Carer Allowance income test (not applicable if the carer is exempt from providing their income details for the CA income test)
• Adjusted Taxable Income (ATI) and tax lodgement details
• Adjusted Taxable Income (ATI) details
• Account-based income streams
• Summary of account-based income streams
• Total income details
• Estimated Adjusted Taxable Income (ATI) details
• Care receiver profile
• Care receiver's personal details
• Care receiver residence status
• Caring arrangements
• Carer Allowance questionnaire relating to the care receiver's care needs
• Carer receivers - they can edit the care receiver/s information
• Care receiver medical details (3 sections with dynamic questions)
• Day to day care needs
• Cognitive functioning
• General behaviour
• Everyday tasks (for child care receivers)
• Special care Needs (for child care receivers)

This section allows the carer to supply or confirm information about their financial income and assets before making their claim. The module includes questions about:

• payment destination
• tax file number
• tax deductions
• cash on hand
• savings
• investments
• business, trust and companies
• other assets
• income
• additional circumstances

Employment details may be pre-filled through Single Touch Payroll (STP) in the online claim for the customer to confirm. This includes the employer name and ABN. Staff can recognise a STP employer has been presented if the question “Do you work for (employer)” is displayed in the claim slider. Further details can be seen on the STP Employer Update (EMCF) screen.

If a customer confirms the STP employer, STP pre-filled income may also present on the STP Employer Wage Items (EMGI) screen. Staff can accept the STP data on EMGI if the pay event date is after the customer grant date. Staff will need to contact the customer to confirm the amounts prior to accepting the STP data.

If a customer has previously confirmed an employer and advises they do not work for the employer anymore, the employer will still remain as confirmed on EMCF.

A customer will automatically be placed on reporting if STP data is presented to the customer within the claim, regardless of the employer status.

Provide details later

If the carer or their correspondence nominee cannot provide all their income and asset information, they can provide this information on a paper form. This will be advised at Next Steps.

The Review page contains a summary of all of the information provided by the carer so that they can check what they have entered is correct. The information is displayed in sections, for example, About your situation.

If the carer or their correspondence nominee has not completed all required fields, they can select the Update button relevant to the answers that require changing. This will take them back to My profile or the relevant section of the claim to review/update the particular claim questions and responses.

Declaration

When all information is correct, the carer must accept the declaration by ticking the box. Completing the declaration means that a signed claim form is not required.

This page advises the carer or their correspondence nominee of any further information or tasks required for their claim to be submitted and the number of days they have to submit the claim.

To submit their claim, the carer or their correspondence nominee must answer all mandatory questions and provide all their required documents, including identity documents if there is no Identity Status recorded, modules and/or medical reports.

Carers or their correspondence nominee can access their draft claim for 13 weeks.

If the 'Required' tasks on the Next steps page are not all completed, the claim cannot be submitted (some exceptions apply). When the required tasks are completed, select Next at the bottom of the Next steps page, then Submit. The carer can then submit the online claim.

The Next steps page includes:

• a list of supplementary information and supporting documentation required from the carer
• some tasks may have an information pop-up message to explain what type of documentation is required and valid for this task. This is accessed by selecting a word underlined in the task. Selecting this word again will close the pop-up message
• how many days they have to submit their claim
• a link to download or print required forms
• an Upload button
• an Edit button if they have completed a task but need to make a change

Carers or their correspondence nominee can print their claim information now or any time later.

Carers or their correspondence nominee can access their submitted online claim to return to the Next steps page at any time.

When they select Confirm Information before they submit their claim, the carer or their correspondence nominee cannot update the online claim details. They will need to contact Services Australia if they want to provide information in relation to their claim.

Carers or their correspondence nominee can withdraw their online claim when submitted.

Carers or their correspondence nominee can access their started online claim using their Centrelink online account or the Express Plus Centrelink mobile app to upload documents required to be able to submit their claim.

On the Next steps page, there are Upload buttons next to each outstanding task to Upload documents.

Help the carer or their correspondence nominee upload the documents and submit their claim online. If necessary, Service Officers can scan the documents before submitting the claim for the carer. When submitting a claim for a carer, Service Officers must ensure a verbal declaration is read to and accepted by the customer. See Step 9 in Table 2.

Scan the documents and run the Request & Manage Customer Tasks guided procedure to submit the claim.

If the carer or their correspondence nominee uploaded or provided documents before starting the online claim, the document displays as Required on the Next steps page. The carer can either:

• re-upload the document on the Next steps page
• contact by phone or in person to have the Request & Manage Customer Tasks guided procedure run to change the document status from Required to Provided

'Channel hopping' allows:

• the carer or their correspondence nominee to start a claim online and have it continued by a Service Officer, or
• a Service Officer can help a carer by starting a claim, which would then be completed by the carer or their correspondence nominee online (an active Centrelink online account is required)

See Table 2 on the Assisted tab.

An online claim or a claim started using ACC will expire after 13 weeks if not submitted. The carer or their correspondence nominee must then reclaim. In some cases the expired claim can be assessed from the original start date, see Circumstance Change Monitor (CCM). If further assistance is required, for example, there has been a system error, refer to the Level 2 Policy Helpdesk.

For information about payments and services for carers, see Initial contact by a carer.

If the carer or their correspondence nominee is lodging or has lodged:

• documentation for their online claim, see Step 11 on Self service tab
• documentation for their ACC (verbal claim), see Step 9 in Table 2 of the Assisted tab
• a paper claim for CP and/or CA, see Table 4
• a new claim:
• within 13 weeks of rejection of their claim for the same care receiver, see Processing claims for Carer Payment (CP) and/or Carer Allowance (CA)
• within 13 weeks of cancellation of payment for not returning a review for the same care receiver or a CA income review, go to Step 2
• more than 13 weeks after cancellation of payment, go to Step 4
• Otherwise, to lodge a new claim, go to Step 4

A new claim is not required if reclaiming within 13 weeks of cancellation due to not returning a Medical, Manual or CA income review and the review is returned.

Non-return of a Medical or Manual Review

Check details via Pensions Status History (PNSH), Activity history list (ES, HAL, HAY) screen in Process Direct, or Event Summary (ES) screen in Customer First and issue the appropriate forms.

For child care receivers:

• Review of Carer Allowance/Carer Payment - Medical Report including functional assessment (for a child under 16 years) (SA429 standard form), and
• Review of Carer Allowance/Carer Payment - Care Needs Assessment (for a child under 16 years) (SA423/SA424)

For adult care receivers:

• Review of care provided - Carer Payment and/or Carer Allowance - caring for a person 16 years or over (SA010), and
• Carer Payment and/or Carer Allowance Medical Report for a person 16 years or over (SA332A)

Non-return of a Carer Allowance income review

Check the details via Care Receiver Assessment Results (CJAR), Benefit Status (XBS) or Activity history list (ES, HAL, HAY) screen in Process Direct or Event Summary (ES) screen in Customer First to see if the carer has been cancelled FRC due to non-return of a Carer Allowance income review.

If cancelled, encourage the carer to complete their review through their Centrelink online account. If they create an online account after CA has been cancelled, the Carer Allowance income review will be available for completion. After completing the review online CA will restore if the carer meets the income test.

If the carer is unable to complete the review online, an SA489 should be completed by the carer, income details updated and payment manually restored.

Procedure ends here.

For information about additional assistance, see:

• eligibility for Carer Supplement
• eligibility for Special Disability Trust

Claiming CP for a care receiver aged under 16 years

If the care required is for:

• more than 3 months but less than 6 months, tell the carer or their correspondence nominee about episodic care and short term care
• 2 to 4 children, tell the carer or their correspondence nominee about combined care and/or exchanged care
• 1 or more children and a disabled adult, tell the carer or their correspondence nominee about multiple care
• a child with a terminal illness, see Carer Payment (CP) (child) terminal illness

If the care is being provided by 2 or more carers, tell them about entitlement to payment for 2 or more carers.

An early claim can be made within 13 weeks of becoming qualified for the payment. An early claim can be completed online or via ACC.

CP and/or CA can be claimed online if the carer or their correspondence nominee is registered online with an active Centrelink online account.

Is the carer or their correspondence nominee willing and able to claim online?

• Yes, see Self-managed tab
• No, go to Step 5

ACC is used by Service Officers when a carer or their correspondence nominee is unable or unwilling to claim online. ACC replicates the questions in the online claim. ACC must only be used when the carer or their correspondence nominee is available to answer the questions in ACC.

ACC will identify all documents required from the carer or their correspondence nominee and/or care receiver(s) before the claim can be submitted. Any required documents can be uploaded by the Service Officer or the carer.

If the required documents include a form, e.g. Carer Payment and/or Carer Allowance Medical Report (SA332a), this can be printed by the carer or their correspondence nominee from the Services Australia website or issued by the Service Officer.

If the carer or their correspondence nominee is claiming for more than 1 care receiver, ACC will clearly show which documents are required for each care receiver.

ACC will advise the carer or their correspondence nominee it is important to provide any additional required documents and submit the online claim as soon as possible.

From 1 July 2018, eligible carers will receive payments or concession cards from the date they submit a complete claim with all relevant supporting documentation.

Note: different processes apply for carers in vulnerable circumstances. See Intent to claim and vulnerable customers.

For details about completing ACC with the carer, see Assisted Customer Claim (ACC) table.

A claim started using ACC will expire after 13 weeks if not submitted. The carer or their correspondence nominee must then start a new claim. In some cases, the claim can be assessed from the original start date, see Circumstance Change Monitor. If further assistance is required, for example for a system error, refer to the Level 2 Policy Helpdesk.

Check the Document List (DL) screen for any DOCs relevant to a claim for CP and/or CA.

Update the carer's personal details via the Change in Contact Details workflow and if required, their contact and interpreter details via the Other Contact Details (OCD) screen in Customer First, as these questions are no longer asked in ACC.

If ACC was started before the updates were made, the claim can be exited and the updates made outside the claim before submitting it. The updates will appear on the Review your claim page in ACC.

Note: accommodation details are not to be updated using the Change in Contact Details workflow as they will be updated in ACC.

Staff can access ACC via the ACC desktop icon.

The Customer Claim Summary page will display any current and historical claims, select:

• Make a claim
• Get started link under the Carers category
• information about CP and CA will display. Select Apply for Carer Payment/Carer Allowance
• on the Check your Eligibility for payment page, read the privacy message in full to the carer and select the carer's response. Answer the streaming questions to check their eligibility for the payment. Update Source and Date of Receipt fields if necessary
• select the Continue button

The carer's current links will be displayed, including current:

• partner
• care receivers
• dependent children who do not have a primary record

The carer or their correspondence nominee can update links or add new links to claim CP and/or CA for the required care receiver(s). If the carer is currently receiving Age Pension or Disability Support Pension (DSP) an information message will display on the Add new care receiver pop-up window, advising them they may be better off remaining on their current payment.

After completing the care receiver updates, select Claim now.

The Claim navigation page displays the sections of the claim that need to be completed. The sections must be completed in order, and the next section cannot be started until the previous section is complete.

This page displays:

• Claim status
• Claim sections
• Advice to submit the claim as soon as possible to be paid from the earliest date

From 1 July 2018, eligible carers will receive payments or concession cards from the date they submit a complete claim with all relevant supporting documentation. Note: different processes apply for carers in vulnerable circumstances, see Intent to claim and vulnerable customers.

The sections are accessed by selecting Get started.

Each section contains modules with relevant questions. On each question page, the carer or their correspondence nominee can select Previous, to go back to the previous question. Carers or their correspondence nominee can read the Digital Assistant information text for help with the questions on the current page. Selecting the link below the text will launch the interactive Digital Assistant.

When the carer or their correspondence nominee has completed each module and reached the end of the section, they will be returned to the Claim navigation page to select the next section.

As a section is completed, the carer or their correspondence nominee has the option to return to a previously completed section to change their answers by selecting the Edit option. They can then navigate directly to the module they wish to update by selecting the relevant tab.

To return to the Claim navigation page after making changes, the carer or their correspondence nominee can select the last dot on the side navigation and select Continue.

The claim does not have to be completed in one session. Carers or their correspondence nominee can leave the Claim navigation page at any time and the responses will be automatically saved, to continue with their claim later.

Carers or their correspondence nominee must answer all compulsory questions and upload required documents before they can submit their claim.

Question sets include:

• Personal details – identity, address, contact details, relationship
• Contact Requirements – permission to enquire, nominee
• Australian Residence
• Accommodation
• Child Details

For CP and/or CA claims, these modules include:

• Circumstances
• Details of the carer's paid work, voluntary work, study or training
• Carer Allowance income test (not applicable if the carer is exempt from providing their income details for the CA income test)
• Tax lodgement details
• Adjusted Taxable Income (ATI) details
• Account-based income streams
• Total income details
• Estimated Adjusted Taxable Income (ATI) details
• Care receiver profile
• Care receiver's personal details
• Care receiver residence status
• Caring arrangements
• Carer Allowance questionnaire relating to the care receiver's care needs
• Care receivers - edit the care receiver/s information
• Care receiver medical details (3 sections with dynamic questions)
• Day to day care needs
• Cognitive functioning
• General behaviour
• Everyday tasks (for child care receiver)
• Special Care Needs (for child care receiver)

Income and asset modules based on the carer's responses to trigger questions in the claim, including:

• Payment destination
• Tax File Number
• Tax deductions
• Cash on hand
• Savings
• Investments
• Business, trust and companies
• Compensation and damages
• Other assets
• Income
• Additional circumstances

Employment details may be pre-filled through Single Touch Payroll (STP) in the online claim for the customer to confirm. This includes the employer name and ABN.

The carer or their correspondence nominee is advised if there is existing income and asset information.

Current payment destination details will display if the carer is currently in receipt of a payment. The carer or their correspondence nominee can either select this account or add a new account.

Where the carer or their correspondence nominee elects to claim both Carer Payment and Carer Allowance, they can elect to get the payments into the same account or separate bank accounts for each payment type.

The carer or their correspondence nominee must provide the following details for the relevant payment destination:

• name of account
• branch (BSB) number
• account number

Carer does not have their payment destination details available

If the carer or their correspondence nominee is unable to provide a payment destination within 14 days due to having barriers in opening a bank account, a temporary exemption can be granted for 28 days. Note: the carer will not receive any payments until a payment destination is provided.

The Payment Destination page in ACC can be bypassed by selecting the 'I do not have bank account details' checkbox. No account information will be saved, and the Service Officer can continue claim to submission.

Before selecting the checkbox, staff must consider all of the following:

• this option must not be selected where the carer has a bank account but is unable to provide the details when ACC is being completed
• this checkbox must only be selected if the carer does not own a bank account and is unable to provide a payment destination within 14 days due to having barriers in opening a bank account, or where no payment destination is provided within a paper claim
• where this option is selected, the carer must be advised they will not receive any payments until a payment destination is provided

The carer or their correspondence nominee must be advised to provide their bank details as early as possible.

Check all information is correct on the Review your claim page. If mandatory information is missing, a red Update required message will display.

Exit ACC and update using the Change in Contact Details workflow. If contact or interpreter details need to be updated, navigate to the Other Contact Details (OCD) screen in Customer First to update.

If other answers need to be corrected, select the relevant Update button.

This information will populate into the claim.

The Next button will not be enabled until the required updates are made.

Customer declaration

If ACC is used to complete the claim, encourage the carer or their correspondence nominee to submit their claim using their Centrelink online account so that the carer can monitor the progress of their claim through the Claim Tracker.

If the carer or their correspondence nominee declines the offer to submit their claim online:

Read the relevant verbal declaration script to the carer, ensuring they accept the statement. By ticking the Declaration box on the Review your claim page, Service Officers are confirming that they have read the declaration script and the carer accepts it.

Where the carer has accepted the declaration via their online account, 'Online customer declaration accepted - Yes' will display in the Customer Claim Summary.

If ACC is used to submit a verbal claim on behalf of a carer and a verbal declaration is completed, 'Staff assisted verbal declaration accepted - Yes' will display in:

• Process Direct notes, and/or
• Customer First Super Case, and/or
• Customer Claim Summary

Note: where the declaration has been accepted via an online claim or ACC and:

• the claim is not submitted (for example, outstanding tasks), and
• the claim is subsequently 'Submitted' using the alternative system (online claim or ACC)

The declaration will display as accepted in the system it was originally 'Confirmed' in.

If the carer or their correspondence nominee is unable or declines to provide a verbal declaration:

• print the CDF via the printer icon on the right of the Review your claim page
• do not submit claim without the CDF being completed and signed. Ask the carer or their correspondence nominee to sign the CDF. Scan the CDF to their record

Open Customer First, select:

• CRN/BP hyperlink
• Cases tab
• Super case for business partner
• Transaction tab
• the appropriate claim ID for the CDF required for printing
• next page (forward arrow) in the top right hand corner
• review claim
• print and close window
• send a Q004 to the carer with:
• printed review of claim
• CDF signature block relevant to the claim type. See the Resources page for links to copies of the declarations in the CDF
• ask the carer or their correspondence nominee to sign and return the CDF signature block within 14 days
• add a detailed note on the carer's record stating the Q004, review of claim and signature block was issued with the expected due date
• if the carer has not returned the signed CDF in 14 days, determine if special circumstances warrant an extension. For more details, see Table 1, Step 9 in Requesting information (CLK)

Declaration

When the carer has accepted the verbal declaration or returned the signed CDF, tick the declaration box on the Review your claim screen.

If the carer or their correspondence nominee requests a copy of their claim summary, this can be printed via ACC and provided to them:

• open ACC desktop icon
• go to Claim Details page
• when claim details open, right click on claim details, select Print
• when printed, close this link immediately

Next steps

This page advises any further information or tasks required for the claim to be submitted. It also displays:

• a countdown clock with days remaining to submit the claim before it expires
• links to download or print required forms

Encourage carers or their correspondence nominee to access their Centrelink online account via myGov or the Express Plus Centrelink mobile app to upload documents and submit their claim.

On the Next steps page in the documents and forms section there is an Upload button to upload documents.

Alternatively, carers or their correspondence nominee can upload their supporting documents for income and assets by using the Upload documents service online.

Some tasks may have an information pop-up message with help text to explain what type of documentation is required and considered valid for this task. This is accessed by clicking on a specific word, which is underlined in the task. Clicking on the specific word again will exit the pop-up message.

If the carer or their correspondence nominee uploaded or provided documents before starting the online claim or ACC, the document displays as Required on the Next steps page. The carer can either:

• re-upload the document from the Next steps page
• contact by phone or in person to have the Request & Manage Customer Tasks guided procedure run to change the document status from Required to Provided

Help the carer or their correspondence nominee upload the documents and submit their claim online.

If necessary, scan the documents and run the Request & Manage Customer Tasks guided procedure to submit ACC for the carer. Note: if this is done the carer will not have access to the Claim Tracker or notification.

To submit the claim, all mandatory questions must be answered, and all required documents must be provided, including CDF (signed by carer or their correspondence nominee where applicable) or verbal declaration and identity documents where there is no Identity Status recorded. Some exceptions apply.

When all Required tasks are completed, the Save button will change to Submit so the claim can be submitted.

The Submitted page will display:

• Claim ID
• Estimated Completion Date Range (ECDR), a date range that can be given to the carer
• a 'withdraw claim' option
• tabs that link to Notifications, Tasks & Review claim details information

Claim processing is completed using Process Direct. See Processing claims for CP and/or CA.

Check the Notes or the Customer Claim Summary section of Process Direct to see confirmation DOC of verbal declaration acceptance.

If a verbal declaration has been accepted, it should be clearly recorded in an automatic DOC or the claim summary displays as 'staff assisted verbal declaration accepted - Yes' or 'online customer declaration accepted - Yes'.

Has a verbal declaration been accepted and recorded?

• Yes, the claim can be assessed and processed:
• See Processing claims for CP and/or CA
• No, go to Step 2

Make 1 attempt to contact the carer or their correspondence nominee via phone to obtain acceptance and record the verbal declaration. The Resources page contains the verbal declaration scripts.

The outcome of this discussion must be clearly documented on the carer's record including the date, time and reason for contact.

Has the verbal declaration been made and accepted?

• Yes, the claim can be assessed and processed
• See Processing claims for CP and/or CA
• No, go to Step 3

Send the paper CDF and signature block to the carer or their correspondence nominee. This must be signed and returned before the claim is assessed. See Step 9 in Table 2.

Has the carer or their correspondence nominee returned and signed the CDF within 14 days?

• Yes, the claim can be assessed and processed
• No, the claim is to be rejected 'FRC'. Clearly document the action taken on the carer's record

If a carer or their correspondence nominee was previously issued a paper claim form via the First Contact Service Offer (FCSO) workflow, all forms must be completed and lodged by the carer to assess a claim for CP and/or CA.

Claims lodged via a Service Centre

Service Officers are required to scan the paper claim to the carer's record where in most cases, a Social Application (SOA) new claim will be created automatically within Process Direct. For more information, see Claim lodgement of Centrelink claims. Procedure ends here.

Claims lodged via the agency's scanning provider

These claims must be scanned to the carer's record where, in most cases, a SOA new claim will be created automatically within Process Direct. Procedure ends here.

Processing Service Officer is allocated a paper claim

In most cases, a SOA should exist in Process Direct on the carer's record automatically when the paper claim was scanned. If a SOA does not exist, Processing must create a SOA Shell to process the claim.

If any of the forms below are lodged separately to other required forms, the date the first form/s is lodged is deemed to be the date of lodgement of the claim, and constitutes lodgement of the claim:

• Claim for Carer Payment and/or Carer Allowance (SA404)
• Claim for Carer Allowance (SA409)
• Claim for Carer Allowance following Carer Payment review (SA341)
• Claim for Carer Payment (SA410)
• Claim for Carer Payment and Carer Allowance (SA411)
• Carer Payment and/or Carer Allowance - caring for a person 16 years or over (SA406)
• Carer Payment and/or Carer Allowance - caring for a child under 16 years (SA407)
• Any legacy Carer Payment and/or Carer Allowance claim forms, for example, SA336 or SA337
• Assessment for Carer Payment under an international Social Security agreement form (AUS156)

Has the carer or their correspondence nominee lodged part of a claim (SA404, SA406, SA407, SA409, SA410 or SA411)

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

For Carer Payment/Carer Allowance Smart Centre Processing staff only.

CP and/or CA medical reports and CNA forms are not accepted as a claim for CP and/or CA.

Has the carer or their correspondence nominee lodged a medical report or CNA but there is no record of a CP and/or CA claim being submitted?

• Yes, see Table 5
• No, procedure ends here

For Carer Payment/Carer Allowance Smart Centre Processing staff only.

If the carer or their correspondence nominee has not lodged all forms, make genuine attempts to contact.

• If contact was unsuccessful, go to Step 4
• If contact was successful and a claim form exists without all required forms, go to Step 4
• If contact was successful and no claim form exists, request carer or correspondence nominee to complete an online claim or offer an Assisted Customer Claim (ACC)
• If the customer declines, advise the customer forms will be posted, go to Step 4

• Request carer or correspondence nominee to complete and return all forms
• In Customer First generate a Q999 letter using the template to request the required forms
• Print the Q999 locally
• Manually print the required forms to the customer from Online Forms
• Send Q999 and forms via local mail guidelines
• In Process Direct manually place claim On Hold with the reason: ‘Customer to provide information' for the appropriate time allowed
• Annotate the Claim Progress DOC

Investigate the carer's record to establish why a medical report or CNA is being lodged.

Upon investigation, if:

• the First Contact Service Offer (FCSO) workflow has been run in the past 13 weeks, go to Step 2
• an online claim has been submitted in the past 13 weeks, go to Step 3
• neither of the above apply, go to Step 4

Eligible carers will receive payments or concession cards from the date they submit a complete claim with all relevant supporting documentation.

Note: different processes apply for carers in vulnerable circumstances, see Intent to claim and vulnerable customers.

Go to Step 5.

Is the online claim for the same care receiver(s) as stated on the medical report?

• Yes:
• ensure the Request & Manage Customer Tasks guided procedure has been run to change the document status from Required to Provided
• process the claim as per normal procedures. Procedure ends here
• No, go to Step 4

CP and/or CA medical reports and CNA forms are not accepted as a claim for CP and/or CA. If a carer lodges a medical report or CNA without an online claim or paper claim, they (or their correspondence nominee) must be contacted to:

• find out if they want to make a claim and to explain the process
• offer to run ACC with them

If the carer or their correspondence nominee:

• cannot be contacted after genuine attempts, a Q999 letter must be issued to the carer to acknowledge receipt of the medical report or CNA and advise the carer (or their correspondence nominee) to claim online. See the Resources page for the Q999 approved letter text
• wants to proceed with claiming CP and/or CA:
• but does not want to claim while on the phone to the Service Officer (ACC)
• would prefer to complete an online claim
• the Service Officer must complete a comprehensive DOC on the carer's record

Text for DOC

Ext Details: CP/CA Online Claim Required

Text: 'A medical report was lodged by the carer. Contact was made with the carer or their correspondence nominee and ACC was offered and declined. The carer has decided to claim online.

It has been explained to the carer or their correspondence nominee that a formal claim is required, the preferred option is an online claim.

Eligible carers will receive payments or concession cards from the date they submit a complete claim with all relevant supporting documentation.

Note: different processes apply for carers in vulnerable circumstances, see Intent to claim and vulnerable customers.

Under 'Instructions for the customer (carer)' at question 3 on the Medical Report, the carer must indicate whether they are claiming for CP and CA or CA only.

For example, if the carer selects CA only on the Medical Report and the THP indicates in the Medical Report at question 6 the claim is for CP and CA, the claim is assessed for the payment the carer has indicated on the initial claim.

Action

Assess the claim for the payment the carer has indicated on the initial claim, not both payments if indicated on the Medical Report by the THP.

Additionally, the carer must be given the opportunity to lodge a claim for:

• either CP or CA (depending on the claim lodged). When the claim for the other payment has been received, determine if 'special circumstances' are applicable to the start date.
• CA only by issuing a SA341. When the claim for CA has been received the date of lodgement of the SA341 will be treated as the date of claim.

Carer indicates they are applying for both CP and/or CA. However, THP does not indicate at question 6 either CP or CA on the Medical Report.

Action

Assess the claim the carer has lodged or completed.

Circumstance Change Monitor (CCM) rules allow a claim to be submitted without the carer providing all the documents necessary for their claim to be assessed. Do not reject these claims until the carer has been given an opportunity to lodge the outstanding documents.

Claims with a claim exemption under ‘special circumstances', may present within a few days of claim submission. See Table 8 in Circumstance Change Monitor (CCM).

Place the claim on hold until the date the documents due to be returned. If the required documents have not been returned at this time, reject the claim.

A new claim may not be required if a carer contacts about the rejection of their CP and/or CA claim and additional information can be used to reassess the decision if provided.

Has the carer contacted Services Australia within 13 weeks of being notified about the rejection decision?

• Yes, go to Step 2
• No, a new claim is required

Has the carer provided additional information to support their claim?

• Yes, proceed with the reassessment. Go to Step 3
• No, the claim is not to be rejected a second time and any additional information received must be recorded. Advise the customer of their review and appeal rights

CP and/or CA claims rejected due to not meeting the Adult Disability Assessment Tool (ADAT) or the Disability Care Load (Child) Assessment Determination (DCLAD) qualifying scores following the initial new claim assessment:

• investigate the carers/care receivers record and the most recent medical report to determine the rejection reason
• consider any new information or medical evidence (medical report or Care Needs Assessment (CNA)) provided by the carer and record this information accordingly. The existing medical report and/or CNA responses, which resulted in the initial rejection of the claim, must not be deleted

Note: any additional information/medical evidence (medical report) that has been submitted must be recorded on the carer and/or care receiver record, even if this evidence is not likely to change the outcome.

Reassess in Customer First or Customer Record.

Create a Reassessment (REA) activity in the correct record:

• Carer's record when the care receiver is aged under 16 years
• Care receiver's record when care receiver is aged over 16 years

Go to:

• Child Medical Details (CDMD) child aged under 16 years
• Adult Medical Details (ADMD) aged over 16 years

Is coding required for the new medical information?

• Yes, reassessment is for a care receiver aged:
• over 16 years, go to Step 4
• below 16 years, go to Step 5
• No, if the carer:
• now qualifies for payment, grant CP and/or CA based on the original claim. A SOA shell must be created to reassess and process the original claim. See Table 2, Step 7 in Processing claims for Carer Payment (CP) and/or Carer Allowance (CA)
• does not qualify for payment, go to Step 6

Use Customer First or Customer Record to complete a reassessment activity for Carer Payment/Carer Allowance for a person aged over 16 years.

See the Resources page for taskcards with screenshots.

In the care receiver's record:

• Key CRS in the Nxt: field
• 'S'elect self to open the Care Receiver Task Selector (CETS) screen
• 'S'elect Disability Assessment Tool (Adult)

In the Adult Disability Assessment Tool Summary (ADAS) screen:

If coding both a new Medical and Care Needs:

• Key 'Y' in the Add a new ADAT assessment: field
• Source: key as applicable
• DOR: key the Date of Receipt when all forms required for reassessment were provided

Press [Enter] to progress through the following screens:

• Adult Disability Management (ADMG) - key 'I' in the Action: field
• Adult Disability Behaviour (ADBH)
• Adult Medical Details (ADMD):
• key the information provided in the new SA332(a) medical report
• Effect Date: key the same date as the original assessment
• key 'I' in the Action: field
• press [Enter]
• Adult Disability Personal Activities (ADPA):
• after keying all responses from the Treating Health Professional (THP), press [Enter] to populate the screen fields with response descriptions and corresponding scores
• press [Enter]
• Adult Disability Cognitive Functions (ADCF):
• after keying all responses from the THP, press [Enter] to populate the screen fields with response descriptions and corresponding scores
• press [Enter] to return to the ADAS screen and view the outcome of the care receiver's ADAT score
• complete all coding and key 'AR' in the Nxt: field
• check the AR screen carefully before finalising

If coding a new Care Needs only:

Select the existing ADAS line.

Press [Enter] to progress through the following screens:

• Update Adult Disability Management (ADMG)
• Update the date signed
• Key 'C' in the Action: field
• Source: key as applicable
• DOR: key the Date of Receipt when the form required for reassessment was provided, press [Enter]
• Update Adult Disability Behaviour (ADBH), press [Enter]
• Press [Enter] through the ADMD, if area code presents record area code and ‘C’ in source, continue to enter through ADPA and ADCF screens to ADAS
• Complete all coding and key ‘AR' in the Nxt: field
• Check the AR screen carefully before finalising

If coding a medical only:

• Select the existing ADAS line
• Go to the ADMD screen and key 'Y' in Add another THP response: field
• Source: key as applicable
• DOR: key the Date of Receipt when the form required for reassessment was provided
• Key 'I' in the Action: field

Press [Enter] to progress through the following screens:

• Adult Medical Details (ADMD):
• key the details of the information provided in the new SA332(a) medical report
• Effect Date: key the same date as the original assessment
• key 'I' in the Action: field
• press [Enter]
• Adult Disability Personal Activities (ADPA):
• after keying all responses from the THP, press [Enter] to populate the screen fields with response descriptions and corresponding scores
• press [Enter]
• Adult Disability Cognitive Functions (ADCF):
• after keying all responses from the THP, press [Enter] to populate the screen fields with response descriptions and corresponding scores
• press [Enter] to return to the ADAS screen and view the outcome of the care receiver's ADAT score
• Complete all coding and key ‘AR' in the Nxt: field
• Check the AR screen carefully before finalising

Check the CDCR/CRCI screens. If these screens require updating, go to these screens before finalising.

In the Care Receiver's record:

• Key CRS in the Nxt: field
• 'S'elect self for the respective care receiver
• Key CDCR/CRCI in the Nxt: field to go to either of these screens
• Effect Date: key the correct dated from the original assessment
• complete all coding and key 'AR' in the Nxt: field
• check the AR screen carefully before finalising

Does the carer now qualify for payment?

• Yes:
• grant CP and/or CA based on the original claim
• a SOA shell must be created to reassess and process the original claim. See Table 2, Step 7 in Processing claims for Carer Payment (CP) and/or Carer Allowance (CA)
• No, go to Step 6

Use Customer First or Customer Record to complete a reassessment activity for Carer Payment/Carer Allowance for a child aged under 16 years.

See the Resources page for taskcards with screenshots.

If coding both a new Medical and Care Needs:

Go to the carer's record:

• Key CRS in the Nxt: field
• If the child has a:
• child record, ‘S'elect relevant child's name
• adult record, go to their record and ‘S'elect Self from CRS to open the Care Receiver Task Selector (CETS) screen
• ‘S'elect:
• Disability Assessment Tool (Child), and
• Care Load Summary

In the Child Disability Assessment Tool Summary (CDAS) screen. In the following fields:

• Key 'Y' in Add a new THP assessment
• Effect date: key the correct date of effect from the original assessment
• Source: key as applicable
• DOR: key the Date of Receipt when all forms required for reassessment were provided

Press [Enter] to start the process and progress through the following screens:

• CDMD:
• Key the details of the information provided in the new medical report
• Key 'I' in the Action: field
• Press [Enter]
• Treating Health Professional Assessment (CDTT):
• Key the details as per normal new claim processing
• Key 'I' in the Action: field
• Press [Enter]
• Care Load Summary (CLS):
• Key 'Y' in Add a new Care Needs assessment
• Source: key as applicable
• DOR: key the Date of Receipt when all forms required for reassessment were provided
• Press [Enter]
• Care Load - Behaviour (CLBHA):
• Key the details as per normal new claim processing
• Key 'I' in the Action: field
• Press [Enter]
• Care Load - Behaviour (CLBHB):
• Key the details as per normal new claim processing
• Key 'I' in the Action: field
• Press [Enter]
• Care Load - Everyday Tasks (CLET):
• Key the details as per normal new claim processing
• Key 'I' in the Action: field
• Press [Enter]
• Care Load - Special Care Needs (CLSCB):
• Key the details as per normal new claim processing
• Key 'I' in the Action: field
• Press [Enter] to return to the CDAS screen and view the outcome of the care receiver's DCLAD score

If coding a new Care Needs only:

Select the existing CLS line.

• Key 'Y' in Add a new Care Needs assessment

Press [Enter] to progress through the following screens:

• Update Care Load Behaviour screen (CLBHA)
• Effect Date: key the correct date from the original assessment
• Update the date signed
• Key the details as per normal new claim processing
• Source: key as applicable
• DOR: key the Date of Receipt when the form required for reassessment was provided
• Key 'I' in the Action: field, press Enter
• Update the Care Load – Behaviour screen (CLBHB)
• Key the details as per normal new claim processing
• Press [Enter] through the CLET,CLSCA and CLSCB screens to CLS
• Complete all coding and key ‘AR' in the Nxt: field
• Check the AR screen carefully before finalising

If coding a medical only:

• Select the existing CDAS line
• Key 'Y' in Add another THP response: field
• Effect date: key the correct date from the original assessment
• Source: key as applicable
• DOR: key the Date of Receipt when the form required for reassessment was provided
• Key 'I' in the Action: field

Press [Enter] to progress through the following screens:

• Child Medical Details (CDTT):
• key the details of the information provided in the new medical report
• key 'I' in the Action: field
• press [Enter]
• after keying all responses from the THP, press [Enter] to populate the screen fields with response descriptions and corresponding scores
• press [Enter] to return to the CDAS screen and view the outcome of the care receiver's CDAT score
• Complete all coding and key ‘AR' in the Nxt: field
• Check the AR screen carefully before finalising

If updates are required to days of care:

• in the carer's record, key CRS in the Nxt: field
• ‘S'elect:
• the child care receiver to navigate back to CETS
• Care Details for CA, and/or
• Care and Institution Details for CP
• amend any changes to daily/constant care if required
• key the correct date of effect in the Effect Date: field
• complete all coding and key 'AR' in the Nxt: field
• check the AR screen carefully before finalising

Does the carer now qualify for payment?

• Yes:
• grant CP and/or CA based on the original claim
• a SOA shell must be created to reassess and process the original claim. See Table 2, Step 7 in Processing claims for Carer Payment (CP) and/or Carer Allowance (CA).
• No, go to Step 6

Take the following action:

• annotate the initial rejection DOC or create a new DOC to record the new information provided. If there has been an update to either the Adult Disability Assessment Tool (ADAT) or the Calculating the total Disability Care Load Assessment Determination (DCLAD) score, the new Treating Health Professional (THP) and carer scores must be recorded in the DOC. Any additional information/medical evidence (medical report) that has been submitted must be recorded on the carer and/or care receiver record, even if this evidence is not likely to change the outcome
• phone the carer or their correspondence nominee to tell them the claim will not be granted
• tell the carer about their review and appeal rights. See Initial contact about a decision and the review of decision process
• the claim is not to be rejected a second time

Note: if the carer or their correspondence nominee provides additional information, verbally or in writing, it must be recorded in Process Direct to ensure the carer's record reflects their most recent circumstances.