Processing claims for Carer Payment (CP) and/or Carer Allowance (CA) 009-04040000

Carers can make a claim for CP and/or CA by:

• submitting an online claim
• with help from a Service Officer running ACC, or
• in limited circumstances by lodging a paper claim form

Carers cannot submit claims online or via ACC unless they have provided all required documents (some exceptions apply).

Claims submitted using ACC need a verbal declaration. If the verbal declaration is not complete and documented, send a Customer Declaration Form (CDF), signed, and scanned to the carer's record.

If the customer has accepted the declaration via the online account, Online customer declaration accepted - Yes displays in the Customer Claim Summary.

If ACC is used to submit a verbal claim on behalf of a customer and a verbal declaration is completed, Staff assisted verbal declaration accepted - Yes displays in:

• Process Direct notes
• Customer First Super Case
• Customer Claim Summary

Note: the declaration displays in the system in which it was originally confirmed. A customer may start a claim online or via ACC and then submit it using the other system. See Claiming CP and/or CA.

Paper claim forms lodged at service centres

Check:

• each question has been answered
• the claim form signed
• all required documents provided

Second claim lodged within 13 weeks of the previous rejected claim

If a customer has submitted a second claim within 13 weeks of a claim rejection, do not treat this as a request for review of decision.

However, the second claim can be used to initiate a Secretary Initiated Review of Decision under Section 126 of the Social Security (Administration) Act 1999.

If the carer has not provided all documents

Tell the carer:

• what they need to provide
• any delays in providing these documents will delay the processing of their claim

The paper claim must be accepted and scanned to the customer's record immediately.

If required documents for an online or ACC CP and/or CA new claim are lodged at a service centre, run the Request and Manage Customer Tasks guided procedure to mark the corresponding task as provided.

Verifying partner details before finalising an online claim or ACC

If a customer advises they are partnered within an online claim or ACC, the relationship status must be verified with both parties before the customer's and partner's records are linked.

Verification can be given by the partner either:

• through the 'Partner Confirmation Logon' service on the Services Australia website, using the Temporary Access Code (TAC) provided at the end of the claim
• verbally if partner is present or
• by completing a Partner details (MOD P) form

A Claim ID is created as a work item when:

• the CP and/or CA claim has been submitted (online or via ACC) and
• a Social Online Application (SOA) new claim work item is generated on the carer's record

The claim information can be viewed on the Transaction Summary (TS) screen via the Customer and Claim information table. This includes key information relating to the CP and/or CA claim work item in Process Direct.

A SOA shell claim (with no claim information) is auto-created if a paper claim (SA404, SA409, SA410 or SA411) is scanned onto the customer record.

Process Direct is used to review the CP and/or CA claim information and to process the claim.

Process Direct:

• is used to check and record claim progress
• contains the claim information provided by the carer online, collected through ACC or manually recorded from the paper claim
• lists documents the carer needs to provide
• uploads claim data into a CP and/or CA claim activity (this applies only to online claims and ACC)
• contains functions needed to process claims such as:
• the ability to view scans
• make referrals
• request information from the carer
• includes staff tasks needing to be complete before the claim can be finalised

Claims from carers must be referred to a social worker when the carer is:

• under 18 years of age, (before processing the claim)
• over 80 years of age

Social workers will assess the care situation to ensure the carer:

• has the physical and emotional capacity to provide the level of care needed
• is given information and help to access support services and resources

From 1 July 2018, carers are generally granted CP and/or CA from the date they submit a complete claim with all relevant supporting documentation.

Intent to claim provisions

• only apply to customers in vulnerable circumstances
• CP and/or CA claims may be deemed to be made on the date Services Australia was contacted or the customer started their online claim
• a vulnerable circumstance must exist:
• at any time during the 8 week period up to the contact date
• the customer must be qualified on the contact date and
• they must submit their claim within 14 days of the contact, or
• within 13 weeks under special circumstances

Deemed claims under incorrect claim and inappropriate claim provisions are not limited to customers in vulnerable circumstances.

After determining the date a claim was made, staff should assess if backdating provisions apply. The correct start date for carers who submit a Claim for Carer Allowance following Carer Payment Review (SA341) form, is the date of receipt of the SA341 (the date the carer lodges the SA341).

From 7 December 2020, employment income paid after the start date must be assessed for the same period for which it is paid by the employer.

When Identity Confirmation is not confirmed, a carer's identity must be confirmed when claiming CP and/or CA. Exceptions may be made for vulnerable customers.

Where a care receiver is a child attracting a Family Tax Benefit (FTB), identity requirements are not required for the child care receiver. See Identity Confirmation and Alternative Identity.

See the Resources page for information on different scenarios.

If the carer claims CA for a care receiver, the care receiver cannot also qualify for CA for another disabled adult.

Before granting, rejecting, or cancelling any CA payments:

• more details will be needed from the carer and the care receiver to clarify the circumstances and
• confirm whether the care receiver has ceased providing care

Determining the start date for CA in this situation:

• the decision is independent of:
• whether the care receiver has been paid CA
• the date CA was cancelled, or whether the care receiver is entitled to CA
• the start date determination should follow the normal start date procedures that apply for new claims

Tell the carer that a care receiver aged 16 years of age or over may be eligible for an income support payment.

If the care receiver wants to make a claim, see Claiming income support payments from Centrelink.

If a carer:

• lodges multiple claims for CP for 2 or more care receivers, find out who the carer is claiming for
• is already in receipt of CP for one care receiver and lodges a secondary CP claim, find out if this is a change in care receiver

Multiple care, combined care and exchanged care (child) must be considered.

Note: See Carer Payment (CP) (child) when caring for 2 to 4 children each with a disability or medical condition (combined care) if a carer lodges a claim for CP for 2 to 4 children.

The Process page contains information about contacting customers with multiple claims.

CP/CA and FTB

To receive CP or CA a carer is not required to receive FTB in respect of a child care receiver. For CA, the child must be a dependent child of the carer. For either CP or CA (auto) there is no requirement for the child care receiver to be a dependent child of the carer.

A current Carer Payment (XWP) carer may wish to claim Carer Payment (Standard) for benefits not available under CP (XWP). They can submit an online claim while still current.

To process the claim:

• cancel CP (XWP) from the date the claim is submitted, and
• change the grandfathering status

If not eligible for CP (Standard), the:

• carer's CP (XWP) will be re-granted (if still eligible), and
• customer will be notified of both outcomes

It is not possible to claim CP (XWP) - a full assessment is required. If found not qualified for CP under non-grandfathering provisions, grant the customer CP (XWP) if eligible.

See Transfer from Wife Pension (WP) to Carer Payment (CP).

If a carer or care receiver passes away before the claim is completed, finalise the claim before the death action is completed. If the death action has already been coded, see:

• Complications to grants of Carer Payment (CP) and Carer Allowance (CA), and
• Death of care receiver before claim for Carer Payment (CP) and/or Carer Allowance (CA) is finalised

Additional coding is needed within the claim to end date any Electronic Messaging (EM) subscriptions.

A carer may submit a claim for CP and/or CA on the day the car receiver has passed away. If the customer has contacted on or before the date of death and is considered to be in vulnerable circumstances consider granting from the earlier date. See Intent to claim and vulnerable customers.

If not, the care receiver is assessed as passing away after the claim was submitted. CP and CA can be granted from the date the claim was submitted.

Eligible CP customers can volunteer for Parent Pathways. This service offers flexible and individualised support to parents and carers with children under the age of 6 plan for or pursue their study, training and work goals.