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Recognised disability medical reviews for Carer Allowance (CA) (child) 009-08040010

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This page contains information to assist Service Officers in addressing enquiries relating to Recognised Disability medical reviews for Carer Allowance (CA) (child).

On this page:

Recognised Disability Medical Review for CA (child)

Actioning Medical reviews for CA (child)

Recognised Disability Medical Review for CA (child)

Table 1: this table describes the process for addressing medical review enquiries for CA (child).

Expand table

Step

Action

1

Determine reason for contact

If contact is about:

2

Severe Multiple and Physical Disability including Seizures Review Manual Follow-up (MFU) matures

Processing Team: Typically done by specialised processing teams in a service centre or Smart Centre. Unless otherwise stated, staff may complete this step if they are trained.

Reviews will be carried out for carer customers receiving CA. Customers receiving Carer Payment (CP) will not be reviewed.

The SMS MFU will mature on the Activity List (AL) screen. Search the Activity Search (AYS) screen to locate the activity.

  • Activity, key CRA/AAC
  • Review Reason Code, key Med Cond of SMS - 6 mths
  • Keywords, key * REVIEW

The Service Officer will be required to contact the customer to check if any circumstances have changed and whether they wish to be assessed for payment under the new Disability Care Load Assessment Determination (DCLAD) (2010).

Issue the letter and forms for the DCLAD (2010) assessment:

  • Review of Carer Allowance - Care Needs Assessment (for a child under 16 years) (SA420)
  • Review of Carer Allowance - Medical Report including functional assessment (for a child under 16 years) (SA403)

Code an MFU to check the forms are returned in 21 days.

When the medical review forms are returned, see Table 2 > Step 1.

3

SMS review - MFU matures at 21 days

Processing Team: Typically done by specialised processing teams in a service centre or Smart Centre. Unless otherwise stated, staff may complete this step if they are trained.

Have the forms been returned?

  • Yes, see Table 2 > Step 1
  • No, send a reminder letter and re-issue the forms. Set a further MFU for another 21 days

4

SMS review - MFU matures at 42 days

Processing Team: Typically done by specialised processing teams in a service centre or Smart Centre. Unless otherwise stated, staff may complete this step if they are trained.

Have the forms been returned?

5

Re-issue the forms

If the customer has not received the forms, or has lost them, it may be necessary to re-issue them.

The printable versions of the forms are:

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

If necessary, re-issue the forms:

Phone contact: Typically done by Smart Centre staff. Staff may complete this step if they are trained. use the Mail Forms workflow, or

Face-to-face contact: Typically done by service centre staff. Staff may complete this step if they are trained. manually to customer

When review forms are returned, see Table 2 > Step 1.


Actioning Medical reviews for CA (child)

Table 2: this table describes the process for actioning Medical reviews for CA (child).

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Step

Action

1

Check the review forms when they are returned

Face-to-face contact: Typically done by service centre staff. Staff may complete this step if they are trained.Processing Team: Typically done by specialised processing teams in a service centre or Smart Centre. Unless otherwise stated, staff may complete this step if they are trained.

If the customer is lodging forms at the service centre, check that both parts of the review have been lodged:

  • Review of Carer Allowance - Care Needs Assessment (for a child under 16 years) (SA420) or SA423 if manually issued
  • Review of Carer Allowance - Medical Report including functional assessment (for a child under 16 years) (SA403) or SA429 if manually issued

Check the forms are completed and signed.

2

Register the return of the medical review

Register the returned review on the system to prevent the next auto-action (for example, reminder, suspension, cancellation).

To register the return of the medical review:

Face-to-face contact: Typically done by service centre staff. Staff may complete this step if they are trained. If the carer is lodging forms at the service centre, scan the review forms. Check the review has been removed from the Future Activity List (FAL) screen on either the care receiver's and/or carer's records to prevent possible suspension/cancellation. If not, mature the review on FAL screen manually. Procedure ends here.

Phone contact: Typically done by Smart Centre staff. Staff may complete this step if they are trained.If a carer calls as a result of receiving a medical review reminder and the medical review can be found scanned onto the carer's record, telephony staff can mature the review from the Future Activity List (FAL) screen if it has not been removed from the FAL screen already. Procedure ends here.

Processing Team: Typically done by specialised processing teams in a service centre or Smart Centre. Unless otherwise stated, staff may complete this step if they are trained. For Processing Service staff, go to Step 3.

3

Child Medical Details (CDMD) screen

Processing Team: Typically done by specialised processing teams in a service centre or Smart Centre. Unless otherwise stated, staff may complete this step if they are trained.

Check the CDMD screen. If the care receiver has:

  • chronic respiratory disease requiring home oxygen, go to Step 4
  • a condition where the child is dependent for his or her health on an external apparatus/machine called a ventilator to assist with breathing, either on a continuous or intermittent basis, go to Step 5
  • a gastroenterological condition or other medical condition requiring total parenteral nutrition for an extended period, with medical treatment and medical supervision required for at least 12 months, go to Step 6
  • any other condition, go to Step 7

4

Home oxygen

Processing Team: Typically done by specialised processing teams in a service centre or Smart Centre. Unless otherwise stated, staff may complete this step if they are trained.

Does the care receiver still require home oxygen?

  • Yes, the care receiver still has a recognised disability and the carer retains entitlement to CA. Go to Step 7
  • No, the care receiver no longer has a recognised disability. Ensure the Care Needs Assessment (CNA) has been returned. Entitlement to CA will be determined under the DCLAD (2010). Go to Step 7

5

External apparatus/machine

Processing Team: Typically done by specialised processing teams in a service centre or Smart Centre. Unless otherwise stated, staff may complete this step if they are trained.

Is the care receiver still in hospital and dependent for his or her health on an external apparatus/machine called a ventilator to assist with breathing, either on a continuous or intermittent basis?

  • Yes, the care receiver still has a recognised disability and the carer retains entitlement to CA. Go to Step 7
  • No, the care receiver no longer has a recognised disability. Ensure the CNA has been returned. Entitlement to CA will be determined under the DCLAD (2010). Go to Step 7

6

Total parenteral nutrition

Processing Team: Typically done by specialised processing teams in a service centre or Smart Centre. Unless otherwise stated, staff may complete this step if they are trained.

Does the care receiver still require total parenteral nutrition for an extended period, with medical treatment and medical supervision?

  • Yes, the care receiver still has a recognised disability and the carer retains entitlement to CA. Go to Step 7
  • No, the care receiver no longer has a recognised disability. Ensure the CNA has been returned. Entitlement to CA will be determined under the DCLAD (2010). Go to Step 7

7

Process the forms

Processing Team: Typically done by specialised processing teams in a service centre or Smart Centre. Unless otherwise stated, staff may complete this step if they are trained.

Process forms, and:

  • complete any updates of circumstances
  • calculate the DCLAD (2010)
  • finalise the review by completing the CDRV screen. Payment will be assessed based on the DCLAD (2010) and customer informed of outcome

Payment will be:

  • cancelled if medical review details are not updated
  • assessed based on the DCLAD (2010) and customer informed of outcome