Child Medical Reviews for Carer Allowance (CA) (child) 009-08060100

CA entitlement is based on the medical condition of the child, and the need for care due to the condition at the time of the claim or review. In some cases, the child may qualify the carer for CA at the time of claim, but once the child reaches a certain developmental milestone, it is deemed that the condition may no longer need the level of care needed to qualify the carer for payment.

Child Medical Reviews (CMR) apply to carers in receipt of CA child only or CP (XWP) carers receiving payment level CA (child). The review process coincides with patterns of childhood development and detects changes in care arrangements. Carers are exempt from the medical review if CA was granted less than 12 months before the scheduled review date, or if they have been medically reviewed in the last 12 months.

Reviews will be carried out for carers who are assessed under the CA combined care rules, if 1 or both care receivers reach the developmental milestones. Carers who receive CP and CA under the CP combined care assessment or multiple care assessment will be reviewed manually.

All CMRs use the Disability Care Load Assessment (Child) Determination (DCLAD) (2020) to review carers and care receivers.

The frequency of medical reviews for children with certain illnesses will vary because they are regarded as 'recognised disabilities' up until the child turns a certain age. A medical review will be scheduled at this time, to determine ongoing eligibility. Where entitlement to CA continues, a subsequent medical review date for these cases will occur at the next applicable age related review.

For the purposes of CA (child), developmental milestones are the stages of a child's development at which the child should be able to perform additional functional abilities according to their chronological age.

A CMR will auto-start when the child is within 12 months of the following development milestones:

• 4 years and 8 months
• 10 years
• 13 years

If the carer is a member of a couple, and one receives CA and the other receives CP for the same care receiver, these carers will not receive a CMR.

CP (XWP) carers will be subject to Child Medical Reviews for CA (child) if they get payment level CA (child) or care for a child care receiver who qualifies for CA HCC only. CP (XWP) is CP that is paid under grandfathering provisions for ceased Wife Pension carers.

A carer who is grandfathered as CP (XWP) remains qualified for CP (XWP) provided they continue to get payment level CA without a break in entitlement. This means that if the carer’s only or last payment level CA is suspended, cancelled or changed to CA HCC only as a result of a review or for any reason, CP (XWP) will auto-cancel. Qualification for CP (XWP) is permanently lost if they have a break in payment level CA entitlement. See Transfer from Wife Pension (WP) to Carer Payment (CP).

CA Health Care Card (HCC) only reviews are included in the CMRs. The purpose of a CA HCC only review is to determine:

• a carer's ongoing entitlement to CA HCC only or
• whether a carer may have become eligible for CA at payment level

See Carer Allowance (CA) (child) Health Care Card (HCC) only reviews.

From 20 September 2018, a $250,000 a year adjusted taxable income test applies to CA payment and CA HCC only customers.

Carers are not subject to a CA income review while they are exempt from providing their income details for the CA income test. An exception applies if the carer is only exempt because they or their partner receive FTB, in this case they may need to complete a CA income review triggered from the data matching process with the Australian Taxation Office (ATO).

See Reviews of Carer Payment and/or Carer Allowance.