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Calculating the start day for an incapacitated customer 106-05010030

This document outlines how the start day is calculated for incapacitated customers claiming payment.

Calculating the start day for an incapacitated customer

This table describes the process steps for calculating the start day when an incapacitated customer claims a Social Security benefit or pension.

Step	Action
1	Claim lodgement + Read more ... Has the customer lodged a claim for a payment? Yes, go to Step 2 No, the actual start day cannot be assessed until the claim is lodged. Procedure ends here
2	Determine deemed date of claim + Read more ... The date of claim lodgement (Date of Receipt) is treated as the date on which the claim is made. Different processes apply for customers in vulnerable circumstances, see Intent to claim and vulnerable customers.
3	Check if incapacity has been continuous + Read more ... Has the incapacity been continuous from the day on which the customer became incapacitated until the day on which the claim is made or deemed to have been made and evidence (medical certificate) of their incapacity has been supplied? Yes, go to Step 4 No, this procedure does not apply. See Start Day
4	Dates of incapacity + Read more ... Use the start date on the medical certificate as the date of incapacity unless it is before the date last worked. The date of incapacity is then the day after the date last worked. If the customer claims the incapacity started on a date earlier than the date on the medical certificate, the date of incapacity can be this date when: the incapacity started less than 4 weeks before the date of the claim, and the customer provides additional medical evidence to support this date
5	Check timing of claim lodgement + Read more ... Has the customer made a claim within 5 weeks of the date on which the incapacity began? Yes, the provisional start day is the first day on which they are qualified for the payment being claimed after the day they became incapacitated for work. The customer may have waiting periods or an Income Maintenance Period which would need to be added to the provisional start day. Process claim. Procedure ends here No, further assessment is required to determine if claim can be backdated. A warning for this will appear on the Start Date Calculator (NDC) screen when coding JobSeeker Payment (JSP), Youth Allowance (YA). Go to Step 6
6	Determine if the medical condition is the sole or principal cause preventing a claim being made earlier + Read more ... If there is more than one possible cause for the delay, it is necessary to establish the main cause. In determining whether the medical condition is the main cause consider whether: the medical condition prevented the customer from getting to an office, and the customer had control of their personal affairs and was capable either of making a claim or instructing others to make a claim on their behalf Is the customer’s medical condition the sole or principal cause which prevented them from making a claim? Yes, go to Step 7 No, the claim cannot be backdated due to incapacity. See Start Day. Procedure ends here
7	Customer’s medical condition is the sole or principal cause preventing them from making a claim + Read more ... The provisional start day can be backdated to the date the customer was qualified for a period up to 4 weeks prior to the date on which the claim is made. Process the claim. The correct start day must be manually coded. Override the system calculated start day on the relevant screen. The customer may have waiting periods or an Income Maintenance Period which would need to be added to the provisional start day.