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Coding a paper claim for Carer Payment (CP) for one care receiver or combined care receivers under 16 009-04050030



A system issue exists resulting in incorrect and/or incomplete claim forms being issued to customers. Staff must follow the workaround available in Network News Update (NNU) - NNU - PD - CLM - CAR - FCSO issuing incomplete system-generated forms (12719)

For Carer Payment/Carer Allowance Smart Centre Processing staff only

This page contains instructions for coding a paper claim for Carer Payment (CP) for one care receiver or combined care receivers aged under 16 including where the carer is claiming CP due to a change of care receiver or during the bereavement period. The following is an interim process subject to change.

Processing Service details for: Carer Allowance/Payment New Claims.

On this page:

Initial processing

Coding medical and care receiver details

Finalising claim

Initial processing

Table 1: this table provides instructions for coding the initial screens of a paper claim for CP for one care receiver or combined care receivers aged under 16 years.

Step

Action

1

A paper CP claim lodged for one care receiver or combined care receivers + Read more ...

Use the Carer New Claim & Review Assessment script for all Carer Payment (CP) and/or Carer Allowance (CA) new claim processing:

  • the script will determine the correct workflow for CP and/or CA child claims
  • if the script is not available follow the existing processing below
  • run the Carer New Claim & Review Assessment script

2

Indexed claim + Read more ...

Has the claim been indexed?

3

Customer Details Task (CDTS) + Read more ...

Select the relevant fields on the CDTS screen and complete the address, payment destination, marital status and Proof of Identify screens.

The Energy Supplement is paid if the carer is eligible. If a frequency change is requested by the carer, check/update the Energy Supplement payment frequency option.

4

Care Receiver Summary (CRS) screen + Read more ...

This is the final screen in the CDTS process.

If E585CU - Incomplete CP link exists error displays within the activity, go to the Link Summary (LS) screen, select the link and then delete the incorrect link via the Action field on the Other Customer Links (OCL) screen.

Does the name of the care receiver for this claim appear on the CRS screen?

  • Yes, and the link is:
    • current (CUR) for CP, the carer is already receiving CP for this care receiver. Reject the claim for CP. Record details on a DOC on the carer's record. Procedure ends here
    • not CUR but is for CP, select the name and press [Enter]. Go to Step 10
    • to another payment, select the name with an 'S' and key 'Y' in the relevant Add a new care receiver or new link type? field. Press [Enter]. On the Link Confirmation (LC) screen, key 'Y' in the Confirm Selection field. Press [Enter] and go to Step 10
  • No, go to Step 5

5

To add the child + Read more ...

On the CRS screen:

  • key 'Y' in the Add a new Care Receiver or new Link Type? Field
  • press [Enter]
  • on the Link Person (LP) screen, in the following fields:
    • Search Type, key ‘CHI
    • Surname of Person, key the child's surname
    • First Name or Initial, key the child's first name or initial
    • Gender, key 'M', 'F' or 'X'
    • Date of Birth, key the child's date of birth
  • press [Enter]

6

Child record + Read more ...

Does a record for the child already exist?

Note: if the care receiver being added is linked to another customer - remember to reassess the losing carer's record. See Carer Payment (CP) for 2 or more carers in respect of the same care receiver.

  • Yes, a record for the child does exist, the Name List (IL) screen is displayed. Select the correct record and the CRS screen will be displayed. 'S'elect the child care receiver and press [Enter]
  • No, a record for the child does not exist. Go to the Add Child (ACHI) screen. The following fields will default:
    Surname:
    First Name:
    Second Name:
    Gender:
    Date of Birth:
    Proof of Birth: Y
    Add Child: Y
    Add another child: N
    • press [Enter] to view the CRS screen
    • 'S'elect the child care receiver and press [Enter]

7

Pensions Task Selector (PTS) screen + Read more ...

Go to the PTS screen.

As this is a Carers claim, the CRS screen will be auto-selected, as will the Assessment field:

Press [Enter].

8

Income and assets + Read more ...

Income and asset coding and verification requirements for CP new claims differ according to:

  • whether the claimant is single or partnered, and
  • if the customer is an existing income support payment (ISP) customer or not

Carer and/or partner is current ISP

The usual notification rules as per Coding income and assets for Centrelink payments and services apply in relation to whether verification is required/requested.

The claim outcome is not delayed while waiting for any verification.

Non-current claimant is single or has a non-current partner

  • Rejections:
    • medical and/or ADAT rejection at Streaming - no Income and Asset coding is required
    • if it appears Income and Asset levels advised will preclude payment - all coding is to be done at Streaming and allow the system to reject. No verification is required (unless necessary to accurately determine the value, for example, managed investment)
    • basic eligibility not met (that is, residence qualification), any Income and Asset details that have not been coded or verified are required to be coded at finalisation
  • Grant:
    • code all income and assets at Streaming with requests for verification sent at that time, see Requesting information (CLK)
    • run the Streaming and Progress DOC script to make sure the ^^CUST keyword is added and the claim is held for 14 days
    • the claim cannot be finalised until all verification has been received
    • if the carer does not return the required information within 14 days reject the claim FRC
    • if the carer requires a social work referral, the referral must not be delayed while waiting for the customer to return information. Run the Streaming and Progress DOC script as per current process to request a social work referral be booked

See Assessing the Income and Assets (SA369) or Recording and correcting employment income details.

9

Pensions Assessment (PNA) screen + Read more ...

The PNA screen will display the Start Day as calculated by the system. Check that the correct start day has been calculated, and overwrite the date, if required. For more information, see Start Day.

Carers who claimed or contacted in relation to a claim for CP (child) before 1 October 2009, may have their claim backdated to 1 July 2009, or to the date on which they became qualified for CP (child), whichever is later. The backdating provisions are subject to the carer having satisfied CP (child) eligibility.

For example:

  • the carer was residentially qualified
  • the care receiver would have received the relevant qualifying rating from the relevant date
  • the carer was providing constant care throughout the period, and
  • the carer would have passed the relevant income and assets tests and the payment was payable to them from the relevant date

To backdate a payment all relevant dates of effect must equal the date of grant on the (PNA) screen.

For example:

  • the link start date on the Link Summary (LS) screen
  • the Date of Event on the Care Receiver Care and Institution Details (CRCI) screen
  • the Effect Date on the Child Medical Details (CDMD) screen
  • the Care Load - Behaviour (CLBHA) screen
  • the Accommodation (AC) screen

Note: the date of receipt of the new claim activity does not require adjustment to allow for backdating.

After completing the screens selected from PTS the screen flow will navigate to the CRS screen. The care receiver's name should now appear on CRS with 'YES' in the CP Link field.

10

Care Receiver Task Selector (CETS) screen + Read more ...

If required, select the Exchanged Care screens (in addition to those selected by default).

Press [Enter] to accept the selected screen flow.

Note: if this is a change in care, due to a system limitation, the date of effect of the claim for CP cannot be coded as the cancellation date of the CP for the previous care receiver. This means that the carer may miss out on one day's payment.

For example, CP is cancelled from 4 February 2015 and paid up to and including 3 February 2015. The system only allows CP for the new care receiver to be granted from 5 February 2015 so the carer is not paid for 4 February 2015.

In these cases:

  • CP should be cancelled from Date Paid To (DPT) - 1 using cancellation code CLR - withdrawn/voluntary surrender. See Cancellation and suspension of Carer Payment and/or Carer Allowance
  • waive the resultant debt
  • CP should then be granted from DPT + 1 for the new care receiver. Cancelling CP (child) will also result in the automatic cancellation of CA (auto)

To make sure the carer is advised the correct cancellation date, a manual cancellation letter is also required. See Creating a Q134 letter.

This will make sure the correct date of grant appears on the carer's Pensioner Concession Card (PCC) and the grant letter.

Coding medical and care receiver details

Table 2: this table provides instructions for coding the child medical details, details of further care receivers and the care receiver's income and asset details screens of a paper claim for Carer Payment (CP) for one care receiver or combined care receivers aged under 16 years.

Step

Action

1

Child Medical Details (CDMD) screen + Read more ...

Complete the coding on the Child Medical Details (CDMD) screen.

Note: there is a known issue where the First Contact Service Offer (FCSO) workflow may issue a Carer Payment Medical Report (for a child under 16 years) (SA398) when a medical report with a functional assessment is required.

The incorrect medical report may cause a CP (child) new claim to automatically reject reason 'THP' (Treating Health Professional Score too low). If this occurs:

  • manually issue the correct medical report to the carer - Carer Payment Medical Report including functional assessment (for a child under 16 years) (SA427)
  • the SA427 includes the functional assessment
  • once the correct medical report (SA427) is received, the claim can be correctly assessed

Report any incidents of incorrect forms being issued by the FCSO workflow to the Centrelink Payments Support Team (CPST).

If the SA398/SA428 has been correctly issued and the reuse provisions:

  • apply when the form is returned, a medical report with a functional assessment (SA427) is not required, but if the SA398/SA428 is recorded the system will read a THP score of zero
  • do not apply when the form is returned, a new medical report with a functional assessment (SA427) will be required and must be requested from the carer

To record the return of the SA398/SA428 on the CDMD screen, 'correct' the most recent THP assessment. Although the new THP medical report may be completed by a different THP and would have been completed on a different date, this is the preferred method as it still recognises the pre-existing, re-usable DCLA information, does not reject CP and cancel CA and does not re-set the re-use provision dates.

Is there more than one care receiver?

2

Code additional care receivers if claim is for combined care of 2 to 4 children + Read more ...

The medical coding for the remaining child/ren care receiver/s must be added to the assessment. Code the CDMD screen:

  • key 'Y' in the Add another child? field on the CDMD screen after the details for child one have been coded
  • on the Link Person (LP) screen, in the following fields:
    • Search Type, key ‘CHI
    • Surname of Person, key the child's surname
    • First Name or Initial, key the child's first name or initial
    • Gender, key 'M', 'F' or 'X'
    • Date of Birth, key the child's date of birth
  • press [Enter]

Note: if the child being added is linked to another customer, reassess the losing customer's record, see Carer Payment (CP) for 2 or more carers in respect of the same care receiver.

Does a record for the child already exist?

  • Yes, a record for the child does exist, the Name List (IL) screen is displayed, select the correct record and then on the CRS screen 'S'elect the child care receiver and press [Enter]
  • No, a record for the child does not exist, go to the Add Child (ACHI) screen. The following fields will default:
    Surname:
    First Name:
    Second Name:
    Gender:
    Date of Birth:
    Proof of Birth: Y
    Add Child: Y
    Add another child: N
    • press [Enter] to view the CRS screen
    • 'S'elect the child care receiver and press [Enter] to code the claim for the second child care receiver (and third and fourth children if applicable)

3

Code the Care Needs Assessment form + Read more ...

4

Care Load Validation (CLVL) screen + Read more ...

If the CLVL error SR004 displays on SWE, a process called validation will be required.

Is validation required?

5

Care Receiver Care & Institution Details (CRCI) screen + Read more ...

Complete the following fields:

  • Date of Event if the claim is to be backdated, key the date into this field
  • Carer CRN, key the carer's Customer Reference Number (CRN)
  • Carer is, use field help (?) for relevant code
  • Constant Care, use field help (?) for more information. Note: if the THP is not sure whether constant care for the child is required for a significant period each day and has not provided the details that clarify the situation, contact the THP for more clarification. Once all the information from the form and the discussion with the THP has been considered, the Service Officer makes the final decision. If the care receiver is part of a combined care package see Carer Payment (CP) (child) when caring for 2 to 4 children each with a disability or medical condition (combined care):
    • key 'Y' if the THP and the carer state the care receiver requires constant care
    • key 'C' if the THP states that constant care is not required for an individual but is required for the care receivers in total
    • key 'N' if the THP and carer state that the care receiver does not require constant care and the Service Officer agrees. If the Service Officer disagrees with the THP and/or carer and has made the determination that constant care is required, key 'Y' if one care receiver or 'C' if combined care receivers and DOC the decision
  • Permanently in Institution: 'Y' or 'N' accordingly

Press [Enter]. The system will redisplay CRCI to confirm the details coded. Press [Enter].

6

Care Receiver Income and Assets Details (CRIA) screen + Read more ...

Code the income and assets details of the child care receiver and - if the care receiver lives with their parent or legal guardian - the combined income and assets of the child care receiver, their parent or legal guardian and their partner and any FTB children.

Do not include the family home, funds received from the National Disability Insurance Agency (NDIA) that are deposited into an account used to manage the care receiver's National Disability Insurance Scheme (NDIS) plan, and assets obtained to specifically assist the care receiver in respect of their disability. See Coding the CRIA screen.

Note: if there is more than 1 care receiver, a CRIA screen should be coded for each care receiver. The system will not combine totals but will separately assess each care receiver. The income and assets details of all assessable persons for that care receiver should be included.

A rejection code will be produced if any of the following apply, and there is not a different rejection reason selected based on the 'hierarchy of non-qualification reasons':

  • if the income is too high, CP will reject CIH (care receiver income too high)
  • if the assets are too high, CP will reject CAS (care receiver income too high)
  • if no income or assets are provided, CP will reject IAU (care receiver income and assets unknown)

Complete the new claim coding to assess all remaining qualification and payability issues.

Finalising claim

Table 3: this table describes the coding of Exchanged Care issues and Care Assessment results as part of processing a paper claim for CA for care receivers aged under 16 years.

Step

Action

1

Exchanged Care screen + Read more ...

Were the 'Exchanged Care' screens selected from the CETS screen?

2

Exchanged Care Summary (CECS) screen + Read more ...

This screen shows the start and end dates of the parenting plans, as well as the parenting plan type. This could be:

  • 'RGP' - Registered Parenting Plan
  • 'PRP' - Parenting Plan
  • 'PRO' - Parenting Order

This screen also shows a 'free text' field for recording any other parent or guardian who is party to the same parenting plan, and with whom the carer is exchanging care.

'S'elect the relevant Parenting Plan to go to the Exchanged Care Details (CECD) screen.

3

Exchanged Care Details (CECD) screen + Read more ...

The CECD screen records parenting plan details (start and end date of the plan, the type of plan, and whether constant care is provided).

It enables grouping together of the care receiver/s being exchanged in the parenting plan. Care receivers can be given a number (1 or 2) to allocate them to the relevant Exchanged Care group (1 or 2). Use field help ('?') for more information.

This screen also allows entry of the percentage of care for each Exchange Group.

Where there is a change in the level of care as set out in any parenting plan relevant to a carer claiming (or already receiving) CP (child) under multiple care provisions, a Manual Follow-up (MFU) is created.

The MFU is required if:

  • the end date of a parenting plan is reached, or
  • there is a change in the percentage of care recorded on the CECD screen (in Exchange Group 1 or 2) that results in a combined total care percentage of less than 100% for a carer. Where there are multiple parenting plans, the MFU will generate regardless of the parenting plan to which the change in percentage applies. See information under 'Identifying multiple parenting plans' in the procedure on Carer Payment (CP) (child) exchanged care

The MFU will:

  • alert the Service Officer that a change in percentage of care has occurred, and prompt follow up regarding a carer's continuing eligibility for CP (child) under exchanged care provisions
  • navigate to the CECS screen when selected, and
  • where applicable, list Customer Reference Numbers (CRN) of any other carers who are party to the same parenting plan (where known) to help the Service Officer to determine if other carers may also require follow up

The next screen to display is the Exchanged Care Assessment Selection (CECA) screen.

4

Exchanged Care Assessment Selection (CECA) screen + Read more ...

This CECA screen is a display screen, showing the care receivers for both Exchanged Care groups for assessment, which is determined by the combination of care receiver/s on in both groups. Multiple care receivers can be 'S'elected for assessment.

Care receivers are listed in the following priority order, with the highest scores (as displayed) first:

  • Terminally ill is 'Y'es
  • Highest Care Needs Assessment (CNA) score
  • Highest Adult Disability Assessment Tool (ADAT) score

Warnings will display in the following circumstances:

  • when only one child is selected, exchanged care cannot apply. Consider mainstream care CP (child). The assessment displayed will be 'MST'
  • If one lower ADAT score adult and one or more children are selected, confirm that this is not multiple care. The assessment displayed will be 'MUL'
  • 2 or more children selected, confirm that this is not combined care. The assessment displayed will be 'COM'
  • if one or more adults are selected, or more than 4 children, or one adult with more than 2 children, there is no valid assessment type for these combinations. Claimants should test their eligibility under other criteria
  • an incomplete Carer Specialist Assessment Team (CSAT) referral exists as a PEN/CRF activity and is not completed

Key 'CECR' in Next to access the Exchanged Care Assessment Results Summary (CECR) screen.

5

Exchanged Care Assessment Results Summary (CECR) screen + Read more ...

The CECR screen is a display only screen, and shows the provisional data from the current activity or historical data (which has been confirmed). The following fields:

  • Assessed Type shows the type of assessment stream the Exchange Group was assessed under
  • Qual indicates whether the carer is qualified either provisionally ('Y'es or 'N'o) (lower case) or confirmed ('Y'es or 'N'o) (upper case)
  • RSN displays the qualifying and non-qualifying reason codes

6

Record all details on a DOC in the carer's record + Read more ...

Deceased customer:

  • if a carer has passed away before the finalisation of their new claim, additional coding is required to end-date Electronic Messaging (EM) subscriptions within the new claim
  • finalise the activity via the Assessment Results (AR) screen

Does warning message W223FY FTB estimate on FTI/FTF is not reasonable appear on the AWE screen, or is the carer in receipt of Family Tax Benefit (FTB) or Child Care Subsidy (CCS) and require a revised income estimate to include CP?

7

Care Receivers for Assessment (SCRA) screen + Read more ...

After the AR screen has been displayed, key 'SCRA' in the Next field and press [Enter].

The SCRA screen must be used for selection of care receivers for assessment for CP child.

The assessment rules that may allow grant of the payment are determined by the combination of care receivers selected.

Care receivers are listed in the following priority order, with the highest scores (as displayed) first:

  • Terminally ill is 'Y'es
  • Highest Care Needs Assessment (CNA) score
  • Highest Adult Disability Assessment Tool (ADAT) score

Warnings will display in the following circumstances:

  • if one 'non-grandfathered' child is selected, the assessment for this claim will be 'MST' (mainstream care)
  • if one 'grandfathered' child is selected, the assessment for this claim will be 'MSG' (mainstream care - grandfathered)
  • if one lower ADAT score adult and one or more children are selected, confirm that this is multiple care. The assessment displayed will be 'MUL' (multiple care)
  • 2 or more 'grandfathered' children are selected - confirm that this is combined care. The assessment type displayed will be 'CMG' (combined grandfathered)
  • 2 or more 'non-grandfathered' children are selected - confirm that this is combined care. The assessment type displayed will be 'CMB' (combined)
  • there is no valid assessment type for these combinations. Claimants should test their eligibility under other criteria for, if one of the following is selected:
    • one adult (with an ADAT score of 25 or more and a THP score of 10 or more) and any number of children are selected, or
    • more than 4 children are selected, or
    • one adult with more than 2 children
  • an incomplete CSAT referral exists as a PEN/CRF activity and is not completed

This screen also displays the:

  • THP score total for the care receiver
  • CNA score total for the care receiver
  • ADAT score is the total score for the adult care receiver

To insert a new occurrence, or correct an existing provisional occurrence, 's'elect the care receiver/s.

8

Care Assessment Results Summary (SCRR) screen + Read more ...

This screen displays the assessment results summary for the selected carer. It displays the assessment type and the list of care receivers included in the assessment, and the result.

Note: if the carer has not been through an assessment and does not have historical data, the screen will be blank.

The following fields:

  • Assessed Type, displays the type of assessment stream under which this carer was assessed:
    • 'MUL' - Multiple
    • 'CMB' - Combined
    • 'MST' - Mainstream
    • 'MSG' - Mainstream - grandfathered
    • 'CMG' - Combined - grandfathered
  • Qual Indicator, indicates whether the carer is qualified either provisionally ('y'es or 'n'o) (lower case) or confirmed ('Y'es or 'N'o) (upper case)
  • Qual Reason, displays the expanded qualifying and non-qualifying reason codes

The Resources page contains a table where the most recent medical report causes the cancellation of CA.

Check the AR screen. If:

  • the previous income support payment was not cancelled (when applicable)
  • there is no BTR activity, or
  • the arrears look incorrect

9

Arrears appear incorrect + Read more ...

If the arrears look incorrect, make sure the previous income support payment was cancelled from the correct date and CP was granted from the correct date.

If the previous income support payment was not cancelled

This is done via the Benefit Action (BA) screen, using field help ('?') for relevant values. In the following fields:

  • SvcRsn, key the previous payment code
  • Action, key 'CAN' (cancel)
  • Reason, key the reason code. Use field help ('?') for valid values
  • Effect Date, key the relevant date
  • key footer details
  • press [Enter]

For more information, see Cancellation of Payments (CLK).

Make sure the cancellation activity is finalised on the Assessment Results (AR) screen before continuing with this procedure.

No BTR activity

If there is no BTR activity at AR it usually means there is a limiting date error and the case needs to be referred to Centrelink Payments Support Team (CPST). A limiting date error would usually result in Carer Payment being granted from an incorrect date.