Coding periodic compensation payments and raising debts 117-03010020

The Compensation Management System (CMS) can only be updated in Customer First (CF). Search Workspace for Compensation Management Summary.

If the compensation claim in CMS is:

• open (active)
• select the incident to view the current rate of compensation income
  Note: STP Paid Leave - Worker's Compensation income can be viewed on the STP Employer Wage Items (EMGI) screen in Process Direct
• go to Step 2
• closed, no periodic compensation is currently recorded, or action cannot be completed for another reason, go to Step 10

To:

• change existing ongoing rate of periodic compensation, go to Step 3
• stop ongoing periodic compensation, go to Step 6
• stop ongoing periodic compensation from a future date, go to Step 9

Go to Compensation Management Summary in Workspace and select:

• Periodic payments
• the relevant Claim ID
• Change Details under Ongoing Details

The following fields will display in edit mode; however, some can only be changed by Compensation Recovery Team (CRT) staff:

• Compensation Payer Incident Reference ID, key the compensation payer’s reference number if required
• Incident after CAP grant, can only be changed by CRT, refer to CRT for action go to Step 10:
• Yes, treat as ordinary income
• No, treat as direct deductions
• Compensation paid in Australian currency, defaults to 'Yes'. If the change is for a Foreign Periodic Compensation claim, refer to CRT for action, go to Step 10
• Change To Date and From Date:
• To Date: end date the previous rate and add a line for new details
• From Date: the actual date the rate changed
• Leave the end date blank
• Gross Amount: the gross rate of the periodic payments:
• Note: the Pre-injury Average Weekly Earnings (PIAWE) rate may not equal the gross rate of periodic compensation. PIAWE refers to the customer’s average weekly earnings before their injury and is used by compensation payers to calculate the gross rate of periodic compensation. Where the gross periodic compensation amount is unclear refer the case to CRT, see Step 10
• Payment Frequency: select from the dropdown box
• Reason ceased: select from the dropdown box
• Recipient Assessment/Pension Rate and Recipient Assessment CAP Qualified: can only be changed by CRT. If the compensation recipient has changed payment streams (for example, JobSeeker Payment to Disability Support Pension) staff must change this field. Refer to CRT for action if required, go to Step 10
• Complete Source and Receipt date
• Select Continue, the Assessment Results (AR) screen will display any positive or negative adjustments

If an arrears payment has been created:

• determine if arrears are payable. See Payment of arrears after reassessment and stopping a payment
• adjust or suppress arrears, if required

To adjust or suppress arrears:

• select the Rate Details (RATS) screen
• under Daily Rate Component (RAC) select the period that requires correction:
• To suppress arrears, select Zero all Adjs
• To adjust the amount, key the correct amount for the relevant component/s
• In Man Adj Rsn field, select ADJ from the dropdown box
• Select Continue
• repeat steps for all periods that require correction

Will customer and/or partner’s CAP be rejected, cancelled, or reduced?

• Yes:
• make genuine attempts to contact the customer and any affected party prior to finalising the activity. See Advising verbally of an unfavourable decision
• there are language and interpreter services available for customers who may need an immediate telephone interpreter or indigenous language interpreter. See Interpreter Services
• record details of each contact attempt on a Fast Note
• go to Step 5
• No:
• select Finalise
• if the AR screen does not show the option to Finalise, go to Step 5
• if the activity is submitted for a QOL check, transfer the activity to Regional Office Code (ROC) CTN. This makes sure a Compensation Recovery Officer (CRO) checks the activity in a timely manner
• record the details of the update on a Fast Note
• procedure ends here

If the AR screen does not show the option to Finalise

• select the started activity on the Activity List (AL) screen
• go to the CMMAR screen
• press [Enter] until AR presents
• select Finalise
• select Continue

Has a debt been created?

• Yes, record the details of the update on a Fast Note and transfer the debt shell to Compensation Recovery region key CTN
• No, record the details of the update on a Fast Note

Note: if the activity is submitted for a QOL check, transfer the activity to Regional Office Code (ROC) CTN. This makes sure a Compensation Recovery Officer (CRO) checks the activity in a timely manner.

Procedure ends here.

Before stopping ongoing periodic payments:

• the customer must provide a valid reason why the compensation payments have stopped to make sure they are not in breach of their requirements under section 1166. For examples where a customer may have breached their requirements, see Reasonable action to claim compensation. Some examples include:
• compensation claim withdrawn or ceased voluntarily without a valid reason
• customer failed to attend a medical or rehabilitation appointment without a valid reason
• if it is not clear why the payments have stopped, complete a Periodic compensation update required Fast Note for the Compensation Recovery Team (CRT) to investigate further, go to Step 10
• ask the customer to provide supporting documents, for example, a letter from the compensation payer advising payments to have ceased, the reason and showing the date they were paid up to and including
• scan supporting documents to the customers record

Go to Compensation Management Summary in Workspace:

• Select:
• Periodic Payments
• relevant Claim ID
• Change Details under Ongoing Details
• Update the following fields:
• To Date: the date compensation was paid up to and including. The system will cease assessing compensation from the day after this date. For examples of determining the correct date to use, see Resources
• Reason Ceased: select from the dropdown box

Note: Recipient Assessment/ Pension Rate and Recipient Assessment CAP Qualified can only be changed by CRT. Refer to CRT if action required, go to Step 10.

• Complete Source and Receipt Date
• Select Continue, the Assessment Results (AR) screen will display any positive or negative adjustments

If an arrears payment has been created:

• determine if arrears are payable. See Payment of arrears after reassessment and stopping a payment
• adjust or suppress arrears, if required

To adjust or suppress arrears:

• select the Rate Details (RATS) screen
• under Daily Rate Component (RAC) select the period that requires correction:
• To suppress arrears, select Zero all Adjs
• To adjust the amount, key the correct amount for the relevant component/s
• In Man Adj Rsn field, select ADJ from the dropdown box
• Select Continue
• repeat steps for all periods that require correction

Select Finalise and Continue, the CMS screen will display.

If the AR screen does not show the option to finalise:

• select the started activity on the Activity List (AL) screen
• go to the CMMAR screen
• press [Enter] until AR presents
• select Finalise and Continue

Record details on a Fast Note.

Note: if the activity is submitted for a QOL check, transfer the activity to Regional Office Code (ROC) CTN. This will make sure the activity is checked by a Compensation Recovery Officer (CRO) in a timely manner.

Procedure ends here.

Periodic compensation coding cannot be completed for a future end date. Set a review to key the periodic compensation end date the day after the payments stop.

In Customer First, create a manual review on the Review Registration (RVR) screen and complete the fields as follows:

• Service Reason: CMM
• Review Reason: FOR
• Due Date: day after periodic payments is due to stop
• Source: INT
• Date of Receipt: today's date
• Notes: 'Periodic payments paid up to DD/MM/YYYY'
• Keywords: CMM0054
• Workgroup: leave blank
• Position: leave blank
• Transfer to Region: CTN

The review will mature on the Due Date keyed in the RVR activity. Workload Management will allocate the review for manual action. Record all action taken on Periodic compensation update required Fast Note.

Scan any supporting documents to customer record, for example, a letter from compensation payer advising payments to have ceased.

Procedure ends here.

Create a Fast Note requesting that Compensation Recovery Team (CRT) assess the new periodic payments. Use Fast Note – select Auto text, use Compensation > Referral to Compensation Team > Periodic compensation update required.

Include:

• Source: Where has the information come from
• Date of Receipt: date of the 'Source' document or information was received
• Reason: add comments on why this has been referred rather than being completed in the first instance. For example:
• CMS record is closed
• no periodic payments previously recorded
• compensation coding cannot be completed for another reason

Scan supporting documents to the customer record, for example:

• Compensation and damages (Mod C)
• letter from the compensation payer advising payments to have commenced, changed or ceased
• Compensation remittance/Payment advice

Procedure ends here.

If the compensation claim in CMS has a status of:

• closed, go to Step 2
• active, go to Step 3

To reactivate a closed compensation claim, see Reactivating a compensation claim.

Once the claim is active, go to Step 3.

To:

• change existing ongoing periodic compensation, go to Step 4
• stop ongoing periodic compensation, go to Step 6
• coding no reasonable action, go to Step 9
• add new ongoing periodic compensation, go to Step 13
• add new arrears of periodic compensation, see Table 3
• key foreign periodic compensation, go to Step 17
• key arrears from a retrospective rate increase, see Table 3

Go to Compensation Management Summary in Workspace and select:

• Periodic Payments
• the relevant Claim ID
• Change Details under Ongoing Details

The following fields will appear in edit mode and can be changed:

• Compensation Payer Incident Reference ID: key the compensation payer’s reference number if required
• Incident after CAP grant:
• Yes, treat as ordinary income
• No, treat as direct deductions
• Compensation paid in Australian currency: defaults to 'Yes'. If 'No' is selected, go to Step 17
• Change To Date and From Date:
• To Date: end date the previous rate and add a line for new details
• From Date: the actual date the rate changed
• Leave the end date blank
• Gross Amount: the gross rate of the periodic payments:
• Note: the Pre-injury Average Weekly Earnings (PIAWE) rate may not equal the gross rate of periodic compensation. PIAWE refers to the customer’s average weekly earnings before their injury and is used by compensation payers to calculate the gross rate of periodic compensation. Where the gross periodic compensation amount is unclear refer the case to CRT, seek clarification from the compensation payer
• Payment Frequency: select from the dropdown box
• Reason ceased: select from the dropdown box
• Recipient Assessment Benefit/Pension Rate and Recipient Assessment CAP Qualified fields:
• For more details, see Effect of periodic compensation on partner’s income support payment
• For coding, see Resources
  Note: if the Recipient Assessment CAP Qualified field is YES, check to see if the compensation recipient has been granted an income support payment in a different payment stream. Change the Recipient Assessment Benefit/Pension Rate field if compensation recipient has transferred from a Benefit payment stream to a Pension payment stream. For example, transferred from JobSeeker Payment to Disability Support Pension
• Complete Source and Receipt date
• Select Continue, the Assessment Results (AR) screen will display any positive or negative adjustments

Determine if any arrears or calculated debt are correct. Consider adjusting the AR screen, considering any previously suppressed arrears for the same period.
See:

• Payment of arrears after reassessment and stopping a payment, or
• Explaining and actioning negative adjustments on a customer’s record

If a debt is expected but is not created within the AR screen, a manual debt shell may need to be created.

Is the assessment result, including any arrears or calculated debt, correct?

• Yes, see Table 4 > Step 4
• No, see Table 4 > Step 1

Periodic compensation coding cannot be completed for a future end date. Set a review to key the end date the day after the payments stop.

In Customer First, create a manual review on the Review Registration (RVR) screen and complete the fields as follows:

• Service Reason: CMM
• Review Reason: FOR
• Due Date: day after periodic payments is due to stop
• Source: INT
• Date of Receipt: today's date
• Notes: 'Periodic payments paid up to DD/MM/YYYY’
• Keywords: CMM0054
• Workgroup: leave blank
• Position: leave blank
• Transfer to Region: CTN

The review will mature on the Due Date keyed in the RVR activity. Workload Management will allocate the review for manual action. Record all action taken on Compensation Progress Doc Fast Note.

Compensation Recovery Team (CRT) must make sure the customer has taken reasonable action to claim compensation. Failure to take reasonable action to claim compensation for a compensable event can be a breach of section 1166 of the Social Security Act 1991.

Compensation Review Officers (CRO) must investigate the customer's record to establish the reason a claim for compensation has been stopped. See Reasonable action to claim compensation.

The CRO must make genuine attempts to phone the customer when:

• the reason for not pursuing compensation is unclear, or
• it is clear the customer is not pursuing compensation for reasons such as:
• compensation claim withdrawn or ceased voluntarily without a valid reason
• customer failed to attend a medical or rehabilitation appointment without a valid reason

CROs must consider any vulnerabilities or sensitivities that may impact the customer. See Identifying customer vulnerability and risk issues.

Has the customer taken reasonable action?

• Yes, go to Step 11
• No, go to Step 8

If the CRO is satisfied that the customer may be entitled to compensation, and the customer has not taken reasonable action to claim or get compensation:

• Tell the customer of their obligation to pursue compensation
• Ask the customer to provide evidence of either they:
• are pursuing a compensation claim
• have pursued a compensation claim and are not eligible for compensation
• Tell the customer that their income support payment may be suspended/cancelled/rejected as a result
• Issue a Q912 Enforcement of Compensation Rights letter
• Record all details in the Compensation Reasonable Action Fast Note and set a review for 23 days to allow the customer to respond
• In Customer First, create a manual review on the Review Registration (RVR) screen and complete the fields as follows:
• Service Reason: CMM
• Review Reason: FOR
• Due Date: 23 days from today
• Source: INT
• Date of Receipt: today's date
• Notes: ‘Investigate reasonable action breach of s1166’
• Keywords: CMM0054
• Workgroup: leave blank
• Position: leave blank
• Transfer to Region: CTN
• Once the manual review has been created, stop the ongoing compensation. Go to Step 11

Has the customer responded to the Q912 and/or reasonable action to claim compensation has been taken?

• Yes, record that reasonable action has been taken in the Compensation Reasonable Action Fast Note. Procedure ends here
• No, when a decision has been made that a customer has not reasonably pursued their compensation claim, approval must be sought from a delegated officer. The delegation to determine if the customer has not taken reasonable action is held by an APS5 or above within Compensation Recovery operational teams

Once approval has been given:

• CRO must
• make genuine attempts to phone the customer and advise them of the outcome. See Advising verbally of an unfavourable decision
• record the decision detailing all action taken in the Compensation Reasonable Action Fast Note
• The approving delegated officer (APS5 or above) must also record their decision within the Compensation Reasonable Action Fast Note

Review all details on the Clearance Details screen:

• Select Clearance Reason of No reasonable action to claim from the dropdown box
• Where applicable, select Advice Not Issued for:
• Issue Rights and Obligations Notice Customer
• Issue Rights and Obligations Notice Solicitor
• Issue Preliminary Notice
• Complete Source and Receipt fields
• Select Continue to go the Assessment Results (AR) screen
• Check the result is correct

Once updates are complete, check for any compensation activities created because of the assessment and action where appropriate, including activities:

• CLE 'clear to pay’ or ‘not clear to pay'
• CLR 'Compensation Management System/Clerical Review'
• REA 'Review net amount received for assets and investment income'

Cancel activities where not required. Do not refer to a service centre, other Zone teams or smart centre.

The compensation claim will remain open for 28 days. If no action is taken in this time, the CMS will finalise the compensation claim and update the status to ‘closed’. The compensation claim will remain in CMS with a status of ‘closed’ until it is reactivated and the clearance reason changed.

If the customer or partner are current and receiving a CAP, the CRO must suspend payment FCC (Failed to claim compensation). Record the suspension details in the Compensation Reasonable Action Fast Note.

Does the payment need to be suspended?

• Yes, go to Step 10
• No, procedure ends here

Each payment type has its own suspension rules. Before actioning suspension make sure the customer's correct system and environment is selected, then follow the correct suspension process for the payment type being suspended, see Suspension of payments (CLK). Create a separate Suspend Cancel Reason Fast Note on the customer's record.

CRO must consider any vulnerabilities or sensitivities that may impact the customer. See Identifying customer vulnerability and risk issues.

For partnered customers, where periodic compensation payments impact both the customer and partner CAP, suspend both. Where suspension applies to both customer and partner, the process must be done in each customer's record.

Annotate the Compensation Reasonable Action Fast Note on the customer's record detailing what action has been taken and what further information is required to complete the Clearance and restore the customer payments.

To suspend the customer's payment in Customer First, go to Benefit Action (BA) screen and code the following fields:

• Svc Rsn: payment type customer is receiving
• Action: SUS (suspend)
• Reason: choose the correct suspension reason
• FCC (Failed to claim compensation)
• Press [Enter] and the date of effect will default or enter the date of effect of the suspension in the Effect Date: field. See Suspension of payments (CLK)
• Complete Source and Date of receipt
• Go to the Assessment Results (AR) screen
• Finalise the activity
• Automatic notification of suspension letter will be sent to customer
• The FCC suspension has been recorded in the Compensation Reasonable Action Fast Note

Procedure ends here.

Go to Compensation Management Summary in Workspace:

• Select:
• Periodic Payments
• relevant Claim ID
• Change Details under Ongoing Details
• Update the following fields:
• To Date: the date compensation was paid up to and including. The system will cease assessing compensation from the day after this date. See Resources for examples of determining the correct date to use
• Reason Ceased: select from the dropdown box
• Complete Source and Receipt Date
• Select Continue, the Assessment Results (AR) screen will display any positive or negative adjustments

If an arrears payment has been created:

• determine if arrears are payable. See Payment of arrears after reassessment and stopping a payment
• adjust or suppress arrears, if required

To adjust or suppress arrears:

• select the Rate Details (RATS) screen
• under Daily Rate Component (RAC) select the period that requires correction:
• To suppress arrears, select Zero all Adjs
• To adjust the amount, key the correct amount for the relevant component/s
• In Man Adj Rsn field, select ADJ from the dropdown box
• Select Continue
• repeat steps for all periods that require correction

Select Finalise and Continue, the CMS screen will display.

If the AR screen does not show the option to finalise:

• select the started activity on the Activity List (AL) screen
• go to the CMMAR screen
• press [Enter] until AR presents
• select Finalise and Continue, the CMS screen will display

Staff must:

• consider if preliminary notice is required to be issued
• record details on a Fast Note

If the customer is no longer pursuing compensation and has taken reasonable action to claim compensation, finalise the claim in CMS:

• Issue Preliminary Notice to the Compensation Payer if one has not been previously issued for this claim
• Go to Finalise Claim screen
• Change the Finalise Reason code to No further compensation claim proceeding

Procedure ends here.

Before adding new ongoing periodic compensation, check if the customer has declared earnings, this may include paid leave for the same period.

The customer’s earnings will need correction if the period they are reporting for overlaps with the periodic compensation. This includes when paid leave components will be recredited because of the arrears of periodic compensation.

Check the Employer Wage Items (EMGI) / Employment Income Paid Details (EAPP) screens to confirm if earnings, including paid leave components, are recorded.

If the customer has been paid both earnings and compensation for the same period, contact the customer and request payslips if required. The payslips will show the exact amounts for each component required for the reassessment.

Contact the customer to establish if the paid leave components will be recredited to them as because of the compensation payment:

• If it is clear the employer will replace paid leave components with compensation and recredit paid leave back to the customer, exclude this income from the earnings assessment on the EAPP screen
• If it is not clear the employer will replace the paid leave components with compensation, continue processing the update. Tell the customer if there is a change in the situation to notify immediately, and give evidence

If the customer reports compensation income as employment income:

• correct the earnings before recording any periodic payments
• Compensation Recovery staff must not make any corrections to the STP recorded data on the EMGI screen
• and correction of earnings must be completed in the EAPP screen, see:
• Process Direct, see Table 5 > Step 5 in the Recording and correcting employment income details
• Customer First/ Customer Record, see Table 5 > Step 6 in the Recording and correcting employment income details

If this creates an arrears payment, supress the arrears. See Payment of arrears after reassessment and stopping a payment.

Record all earnings and/or leave payment changes on a Fast Note.

If compensation is ongoing tell the customer to:

• not report any periodic compensation payments as earnings, and
• report any changes in the rate of compensation, including gradual return to work

Go to Step 14.

If a customer and/or partner are only claiming or renewing a Low Income Health Care Card (LIC), record periodic payments on CMS. Income is assessed over an 8 week period for Low Income Health Care Cards.

Where a customer and/or partner have claimed or received a Compensation Affected Payment (CAP), record periodic payments.

If periodic payments commenced before the start date or date of lodgement of claim for CAP, record:

• from the start date of CAP, or
• from the date of lodgement of claim, or
• the date a completed claim is submitted, or
• from an earlier date if backdating provisions apply

See Claim lodgement of Centrelink claims and Backdating provisions for claim lodgement.

Note: staff can refer to Assisted Customer Claim, Pre-Claim Circumstances Summary (PRECLM in Process Direct or CUPC in Customer First), Medical History Summary (Process Direct) and Medical Conditions Summary (Customer First) to determine the correct date to use.

If periodic payments commenced after the start date or date of lodgement of a claim for a CAP, record from the date periodic payments commenced.

If more details are required to confirm historic periodic compensation payments:

• request the required details. For details about requesting compensation information, see Actioning a compensation clearance
• key current periodic compensation from date paid to plus one (DPT+1) of the CAP

Go to Compensation Management Summary in Workspace and select:

• Periodic Payments
• relevant Claim ID
• Add New Ongoing Details

The following fields will appear in edit mode and can be changed:

• Compensation Payer Incident Reference ID: key the compensation payer’s reference number if required
• Incident after CAP grant:
• Yes, treat as ordinary income
• No, treat as direct deductions
  See Treating periodic compensation payments as a direct deduction or income
• Compensation paid in Australian currency: defaults to 'Yes'. If 'No' is selected, go to Step 17
• Change To Date and From Date:
• To Date: end date the previous rate and add a line for new details
• From Date: the actual date the rate changed
• Leave the end date blank
• Gross Amount: the gross rate of the periodic payments:
• Note: the Pre-injury Average Weekly Earnings (PIAWE) rate may not equal the gross rate of periodic compensation. PIAWE refers to the customer’s average weekly earnings before their injury and is used by compensation payers to calculate the gross rate of periodic compensation. Where the gross periodic compensation amount is unclear refer the case to CRT, seek clarification from the compensation payer
• Payment Frequency: select from the dropdown box
• Reason ceased: select from the dropdown box
• Recipient Assessment Benefit/Pension Rate and Recipient Assessment CAP Qualified fields:
• For more details, see Effect of periodic compensation on partner’s income support payment
• For coding, see Resources
• Gradual return to work: defaults to ‘No.’ Change to ‘Yes’ and add the relevant start date if required
• Complete Source and Receipt date
• Select Continue, the Assessment Results (AR) screen will display any positive or negative adjustments

Determine if any arrears or calculated debt are correct. Consider adjusting the AR screen, taking into account:

• previously suppressed arrears that were incorrectly included
• other undetermined debts that fall within the compensation debt period, and where the compensation debt has resulted in NIL entitlement

See:

• Payment of arrears after reassessment and stopping a payment, or
• Explaining and actioning negative adjustments on a customer’s record

If a debt is expected but is not created within the AR screen, a manual debt shell may need to be created.

Is the assessment result, including any arrears or calculated debt, correct?

• Yes, see Table 4 > Step 3
• No, see Table 4 > Step 1

Components of foreign payments may not be compensation and must be keyed elsewhere, for example:

• on the Foreign Income/Asset Details (FID) screen, key family allowance components of Italian INAIL payments as Type 'OIN'
• see Foreign income and assets

Make sure the Compensation paid in Australian currency field is 'No'.

Go to Compensation Management Summary in Workspace and select:

• Periodic Payments
• the relevant Claim ID
• Change Details under Ongoing Details
• Add a new line for extra lines

Complete the following fields:

• Compensation Payer Incident Reference ID: key the compensation payer’s reference number if required
• Incident after CAP grant:
• Yes, treat as ordinary income
• No, treat as direct deductions
• Compensation paid in Australian currency field: 'No'
• Country of Payment: select the country from the dropdown box
• From date: the start date of the periodic payments
• To date
• Foreign Amount: the amount paid in foreign currency
• Select Retrieve Exchange Data. This will convert the foreign payment amount into Australian dollars
• Exchange Rate: the system will populate
• Gross Amount: the system will populate in $AUD
• Payment Frequency: select from the dropdown box
• Recipient Assessment Benefit/Pension Rate and Recipient Assessment CAP Qualified fields:
• For more details, see Effect of periodic compensation on partner’s income support payment
• For coding, see Resources
• Complete Source and Receipt date
• Select Continue. The Assessment Results (AR) screen will display any positive or negative adjustments

Historical exchange rates can be located on the Foreign Exchange Summary (RDFXS) screen. See Foreign currency and exchange rates.

The customer will get a Compensation Foreign Exchange letter every 3 months. It shows the exchange rates used.

Determine if any arrears or calculated debt are correct. Consider adjusting the AR screen, considering any previously suppressed arrears for the same period.
See:

• Payment of arrears after reassessment and stopping a payment, or
• Explaining and actioning negative adjustments on a customer’s record

If a debt is expected but is not created within the AR screen, a manual debt shell may need to be created.

Is the assessment result, including any arrears or calculated debt, correct?

• Yes, see Table 4 > Step 3
• No, see Table 4 > Step 1

Has the customer and/or partner received a Compensation Affected Payment (CAP) or Low Income Card (LIC) in the period the arrears payment represents?

• Yes, go to Step 2
• No:
• do not record arrears of periodic payments on the Periodic Payment Details screen
• record the details on a Fast Note
• record the end date of the periodic payment on the Claim Details screen
• send a Q928 nil charge notice to the Compensation Payer
• procedure end here

Before adding new ongoing periodic compensation, check if the customer has declared earnings, this may include paid leave for the same period.

The customer’s earnings will need correction if the period they are reporting for overlaps with the periodic compensation. This includes when paid leave components will be recredited as a result of the arrears of periodic compensation.

Check the Employer Wage Items (EMGI) / Employment Income Paid Details (EAPP) screens to confirm if earnings, including paid leave components, are recorded.

If the customer has been paid both earnings and compensation for the same period, contact the customer and request payslips if required. The payslips will show the exact amounts for each component required for the reassessment.

Contact the customer to establish if the paid leave components will be recredited to them as because of the compensation payment:

• If it is clear the employer will replace paid leave components with compensation and recredit paid leave back to the customer exclude the income from the earnings assessment on the EAPP screen
• If it is not clear the employer will replace the paid leave components with compensation, continue with processing the update. Tell the customer if there is a change in the situation to notify immediately, and give evidence

If the customer has reported compensation income as employment income:

• correct the earnings before recording any periodic payments
• Compensation Recovery staff must not make any corrections to the STP recorded data on the EMGI screen
• and correction of earnings must be completed in the EAPP screen, see:
• Process Direct, see Table 5 > Step 5 in the Recording and correcting employment income details
• Customer First/ Customer Record, see Table 5 > Step 6 in the Recording and correcting employment income details

If this creates an arrears payment, supress the arrears. See Payment of arrears after reassessment and stopping a payment.

Record all earnings and/or leave payment changes on a Fast Note.

If compensation is ongoing tell the customer to:

• not report any periodic compensation payments as earnings, and
• report any changes in the rate of compensation, including gradual return to work

Go to Step 3.

Go to the Claim Summary and select the relevant Claim ID.

Check the following screens and update if necessary:

• Clearance Details
• Incident Details
• Claim Details
• Solicitor Details
• Compensation Payer

Make sure the compensation payer's details are correct and, includes their reference number.

For non-current customers, make sure the customer address is current and correct. See Updating address details.

Go to Compensation Management Summary in Workspace and select:

• Periodic Payments
• relevant Claim ID

Check the Arrears Details screen:

• if there are periodic payments recorded for the same period, see Changing and deleting periodic compensation debt details. Procedure ends here
• if there are no periodic payments recorded for the same period, go to Step 4

Is the compensation recipient partnered, and only the partner received a Compensation Affected Payment (CAP) during the period the arrears payment represents?

• Yes, go to Step 6
• No, go to Step 5

Staff must check the record to see if a Preliminary Notice has been sent to the compensation payer before coding the compensation.

Note: if a Preliminary Notice has been incorrectly issued, contact the compensation payer and tell them to disregard the notice. If a written response is required by the compensation payer, send them a Q928.

Has a preliminary notice been sent?

• Yes, go to Step 6
• No, contact the compensation payer to determine if funds have been released to the customer:
• If funds have been released, send a Q928 Nil charge letter to the compensation payer and raise the debt to the customer under Section 1184F. Go to Step 6
• If funds have not been released, change the preliminary notice advice issued field to manual, go to Step 6

Go to Compensation Management Summary in Workspace and select:

• Periodic Payments
• relevant Claim ID
• Add New Arrears Details

Note: CMS does not allow breaks between arrears periods. If there is a break between periodic compensation arrears periods, each period must be keyed in a separate activity to create a separate debt activity.

The following fields will appear in edit mode and can be changed:

• Compensation Payer Incident Reference ID: key the compensation payer’s reference number if required
• Incident after CAP grant:
• Yes, treat as ordinary income
• No, treat as direct deductions
• Compensation paid in Australian currency: defaults to 'Yes'. If 'No' is selected, see Table 2 > Step 13
• From Date: key the start date of the arrears. Key the entire period for which the compensation payer is liable. This makes sure any automatic advice sent to the compensation payer relates to the entire period of the arrears. For details about the Employer Excess/Liability period, see Resources. Note: if the customer is getting a Low Income Card (LIC) only, see Low Income Health Care Card (LIC) income test
• To Date: end date the previous rate and add a line for new details
• The final line of the To Date must be:
• the end date of the arrears if the periodic payments are not continuing
• the date of receipt or date paid to of the CAP, whichever is later, if the periodic payments are continuing and customer and/or partner are no longer in receipt of a CAP
• the date paid to of the CAP, if the periodic payments are continuing, and customer and/or partner are currently in receipt of a CAP
• Gross Amount: the gross rate of the periodic payments:
• Note: the Pre-injury Average Weekly Earnings (PIAWE) rate may not equal the gross rate of periodic compensation. PIAWE refers to the customer’s average weekly earnings before their injury and is used by compensation payers to calculate the gross rate of periodic compensation. Where the gross periodic compensation amount is unclear refer the case to CRT, seek clarification from the compensation payer
• Payment Frequency: select from the dropdown box
• Recipient Assessment Benefit/Pension Rate and Recipient Assessment CAP Qualified fields:
• For more details, see Effect of periodic compensation on partner’s income support payment
• For coding, see Resources
• Issue Advice: select from the dropdown box, see Resources for coding
• If there is NIL charge, make sure this field is changed to ‘M’ and issue a Q928
• S1184H debt: select 'Yes' if the compensation payer is in breach of an earlier notice. An automatic section 1184H debt advice will go to the compensation payer
• Complete Source and Receipt Date
• If periodic compensation is continuing, and customer and/or partner are in receipt of a CAP:
• record ongoing payments in Ongoing Details
• key From Date as date paid to plus one of the CAP
• Select Continue, the Assessment Results (AR) screen will display any negative adjustments

For details about which payments are included in compensation calculations, see Compensation and Supplementary payments.

Determine if any arrears or calculated debt are correct. Take into account:

• previously suppressed arrears that were incorrectly included
• other undetermined debts that fall within the compensation debt period, and where the compensation debt has resulted in NIL entitlement

See:

• Payment of arrears after reassessment and stopping a payment, or
• Explaining and actioning negative adjustments on a customer’s record

If a debt is expected but is not created within the AR screen, a manual debt shell may need to be created.

Is the arrears or calculated debt, correct?

• Yes, and it is a:
• payer charge, see Table 4 > Step 3
• customer debt, see Table 4 > Step 4
• partner debt only, go to Step 9
• No, see Table 4 > Step 1

Send a Q928 Nil charge letter to the compensation payer and raise debt to the partner under section 1223(1) of the Social Security Act.

See Raising periodic compensation charges for partnered customers.

Record the details on a Fast Note.

Partner contact may be required prior to debt raising. For contact requirements, see Debt raising support for customers.

For more details about actioning debt activities, see General debt raising information.

Procedure ends here.

A manual debt calculation may be required when:

• the arrears period is before 20 September 2001
• the Assessment results (AR) screen has a before the limiting date (BLD) line
• no debt on the AR screen where one is expected
• calculated debt is incorrect

All debts that can be calculated via the system and explained using Debt Explanation (ADEX) must be calculated in that manner:

• A reassessment or refresh activity can be keyed on the Benefit Action (BA) screen, which may trigger the overpayment to auto calculate
• In some cases, the Limiting Date may be moved to allow the system to calculate the debt:
• Check the Limiting Date (LMTD) screen
• For details on moving limiting dates, see Resources.
  Note: in cases where the limiting date can be moved, the CMS activity will need to be cancelled prior to LMTD coding
• If there is NIL entitlement to income support payments due to the rate of compensation:
• the PS Tool may be used calculate the overpayment
• see Rates and Thresholds index

If these steps are unsuccessful, complete a manual calculation, see Using the MultiCal debt calculator.

When calculating a new debt, consider all undetermined and previously investigated debts where the debt periods overlap.

Staff must review:

• all previously investigated debts on the Debt List (OPDL) screen, and
• debts listed in the Debt Explanation (ADEX) as a related activity

Debts that staff must add back into the compensation debt include those that:

• were previously waived. See Reversal of waivers
• have been finalised ‘no debt’ unless they are not legally recoverable. See Finalised 'no debt' (FND) or 'zeroing' debts that are not legally recoverable
• are currently undetermined. See Actioning an undetermined debt on the Debt Management and Information System (DMIS)

Once the manual debt is calculated, manually adjust the AR screen where practical.

Select the Rate Details (RATS) screen and select the period that requires correction under Daily Rate Component (RAC):

• To increase or decrease the adjustments:
• key the correct amount for the relevant component/s
• only update the components that are incorrect
• record debt amounts as a negative figure
• To zero the amount or suppress arrears select Zero all Adjs
• In Man Adj Rsn field, select ADJ from the dropdown box
• Select Continue
• Repeat steps for all periods that require correction

Where it is not practical to adjust the AR screen, or the system has not created a debt:

• an existing debt needs to be changed, see Changing account details on debts raised in the Debt Management and Information System (DMIS)
• a new debt record will need to be created
• see Create a new debt record manually on the Debt Management and Information System (DMIS)

Note: for a compensation payer charge, a manual recovery notice will need to be issued. Change the Issue Advice field to Manual in CMS.

Garnishee can be considered to recover outstanding debts. See Garnishee of compensation payments to recover debts.

An unfavourable decision is a decision that is averse to the customer and/or partner. This includes:

• rejection of a claim
• cancellation of payment
• rate reduction
• raising a customer and/or partner debt

Will the assessment result in an adverse decision?

• Yes, and:
• adverse decision relates to a debt only, go to Step 6
• all other adverse decisions, go to Step 5
• No, go to Step 6

Prior to finalising the activity:

• make genuine attempts to contact to the customer and/or partner. See Advising verbally of an unfavourable decision
• there are language and interpreter services available for customers who may need an immediate telephone interpreter or indigenous language interpreter. See Interpreter Services
• consider any vulnerabilities or sensitivities that may impact the customer. See Identifying customer vulnerability and risk issues
• record details of each attempt on a Fast Note

Compensation Recovery Team (CRT) staff must avoid placing a customer in financial hardship. When arrears of periodic compensation have not yet been released staff must consider:

• when the compensation payer will release the arrears to the customer, and
• when the next income support payment is due to be paid, and
• placing activity on hold until after the next entitlement period of the Compensation Affected Payment (CAP)

If compensation is ongoing:

• customer must be advised not to report periodic compensation payments as earnings, and
• report any changes in the rate of compensation, including gradual return to work

• Select Finalise
• Select Continue, the CMS screen will display
• record the details on a Fast Note

If the Assessment Results (AR) screen is not displayed:

• select the started activity on the Activity List (AL) screen
• go to Next
• press [Enter] until AR presents
• press [Enter]

Consider if a preliminary notice is required to be issued.

Do not send a preliminary notice if the compensation recipient:

• has ongoing periodic payments, and
• claims or is getting a Compensation Affected Payment (CAP)

This is because the compensation payer has already accepted liability.

Note: in the Compensation Payer details screen, the Preliminary Notice ‘Issue Advice’ field was previously updated to ‘Manual’ to allow a compensation payer charge to be raised. Change this field to ‘Not issued’ to make sure future reviews are created correctly.

If the periodic compensation has ceased, finalise the compensation claim in CMS. See Finalisation of compensation claims (CLK).

Do not finalise a claim when the:

• periodic payments are continuing, and
• CAP continues to be paid to the customer and/or their partner, or a Low Income Health Care Card (LIC) is current

This will allow the rate of periodic compensation to be changed.

Letters to third parties are issued according to the service they are registered for:

• CBOS (Centrelink Business Online Services)
• Fax
• Mail

For more details about sending compensation recovery letters to third parties, see Compensation letters.

Customer contact may be required prior to debt raising. For contact requirements, see Debt raising support for customers.

For more details about actioning debt activities, see General debt raising information.