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

A Child Medical Review (CMR) starts when the child is within 12 months of the developmental milestone review dates:

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

The following forms system generated and sent to the carer:

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

Issuing of the CMR forms may be delayed for carers returning from overseas.

If the initial carer is cancelled after the review forms have been issued, the review will start immediately on the other carer.

If the forms are not returned, the system automatically sends a reminder letter at 28 days, with no forms:

• suspension at 56 days, the system will automatically:
• suspend CA with the reason, Failed to Reply to Correspondence (FRC), and
• generate a suspension letter which is sent to the carer
• if the carer does not respond, CA will cancel after 13 weeks from issue of review
• a cancellation letter will be sent automatically
• if the carer provides the forms within 13 weeks of the cancellation, conduct a review of the decision

If the carer contacts the agency as they have lost or did not receive the review form, go to Step 3

If the carer has not returned both parts of the medical review, remind them to return the missing form as soon as possible. Ask the carer when they will return the form and note this in a DOC on the carer’s electronic record.

If the carer needs a copy of one or both review form(s), the original forms cannot be printed or issued by mail. To reissue one or both forms, use Mail Forms:

• the replacement form for:
• SA420 - Review of Carer Allowance - Care Needs Assessment (for a child under 16 years) is SA423 - Review of Carer Allowance - Care Needs Assessment (for a child under 16 years)
• SA403 - Review of Carer Allowance - Medical Report including functional assessment (for a child under 16 years) is SA429 - Review of Carer Allowance Medical Report including functional assessment (for a child under 16 years)

The SA423 and SA429 forms can be printed locally or issued manually to the carer.

Note: document the details about issuing new form(s) on the carer’s record. Service Officers must tell the carer that CA will automatically suspend if form(s) are not returned by the due date.

When a carer contacts the agency about the suspension of their CA, the carer must explain the reason for the suspension. The Service Officer must also provide information about the required documentation or tell the carer what is required so CA can be restored. Service Officer’s must document details on the carer’s record.

If the carer requires new review forms, go to Step 3

If the carer is:

• lodging forms at a service centre, scan the review forms
• calling as a result of receiving a medical review reminder, check the review forms are scanned to the carer's record

If both parts of the medical review have been returned by the carer:

• register the documents in the system to prevent the next auto-action (such as reminder, suspension or cancellation)
• 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 or cancellation. To remove the medical review activity from the FAL screen:
• go to Customer Record
• select the review
• key the source code and receipt date
• go to the Activity List (AL) screen where this activity will appear as ‘STA’rted

If both parts of the medical review have not been returned by the carer:

• do not register the documents in the system
• remind them to return the missing form as soon as possible
• ask them when they will return the form and note this in the DOC for the Processing Team
• procedure ends here

Processing staff, go to Step 6

For all other staff, procedure ends here.

Have both parts of the medical review been returned?

• Yes, go to Step 8
• No, go to Step 7

The following forms both need to be returned:

• SA420 - Review of Carer Allowance - Care Needs Assessment for a child under 16 years
• SA403 - Review of Carer Allowance Medical Report for a child under 16 years

However, if the carer was issued one or both replacement forms, one or both of the following replacement form(s) need to be returned:

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

If only one part of the review has been returned and 21 days has passed from the date of issue, do not remove the activity from FAL.

Allow the system to automatically issue the reminder letter at 28 days. The system will automatically suspend the record at 56 days, with a Failed to Reply to Correspondence (FRC) suspension letter issued to the customer. If the carer does not respond, payment will cancel after 13 weeks from issue of review and a cancellation letter will be sent automatically.

If the carer contacts:

• within 13 weeks of the cancellation and both parts of the review have been returned, conduct a review of the decision to cancel
• after 13 weeks of cancellation, the carer must make a new claim for CA

Note: a CP (XWP) carer may lose qualification for CP (XWP) if they no longer qualify for payment level CA after completion of a CA child medical review. See Transfer from Wife Pension (WP) to Carer Payment (CP).

Procedure ends here

Use Customer First to process reviews:

• check if the review has been removed from the Future Activity List (FAL) screen. If not, 'S'elect the next activity from the FAL screen
• the Child Review (CDRV) screen will open and go to the Care Needs Assessment Tool
• calculate the total Disability Care Load Assessment Determination (DCLAD) score. First, see Calculating the treating health professional score for a child under 16 years on or after 1 July 2010
• if the Service Officer completes the Child Medical review (via CDRV screen) and the date signed date is before the forms issued date the payment will cancel
• no finalisation letters will be sent when the customer remains qualified for payment of CA
• Date of Effect for continuation of payments in the Dae of Receipt of the review
• if the carer no longer qualifies for payment of CA, a cancellation letter is auto-sent to the carer
• Date of Effect for cancellation for not attaining a qualifying score is the date of determination
• if the carer is eligible for CA Health Care Card only (HCC only), this information will be included in the letter
• Date of Effect is the date of determination of the review
• if the review forms are returned after cancellation of CA, see Restoration of Carer Allowance (CA)