Investigating a No Show, No Pay Failure 001-17091300

• Start of investigation, go to Step 2
• Community Development Program (CDP) participant has provided evidence for an outstanding failure investigation, see Table 2

Process Direct:

For customers who submit an online claim or a Service Officer has completed the Assisted Customer Claim (ACC) workflow:

• Go to the Participation Compliance Hub (BIPCW) screen
• From the Outstanding compliance actions table, select the appropriate Compliance Investigation
• The Compliance investigation workflow screen will display

For customers currently receiving a payment:

• Go to the BIPCW screen
• Enter the customer's CRN, select Go
• In the customer's record key go to the BIPCW screen
• From the Outstanding compliance actions table, select the appropriate Compliance Investigation
• The Compliance investigation workflow other related information screen will display which will enable CDP participant information to be viewed while working through the investigation and includes links to:
• Provider report
• Provider recorded information
• Recent non-compliance
• Services Australia rate estimator
• Address history
• Recent activities and exemptions
• Circumstances impacting compliance
• Medical certificates
• Select Next

A contact trigger is recorded when the No Show, No Pay failure is generated, preventing the CDP participant from reporting until contact is made with the PST regarding the failure.

A No Show, No Pay failure cannot be investigated without talking to the CDP participant, unless it has been established the failure is invalid.

Relevant CDP participant information and details of the failure will be presented on the Other related Information screen.

A 'View Circumstances' link is provided to access the Circumstances Impacting Compliance screen. This must be viewed to determine if there is a current family relationships/domestic violence circumstance recorded. If there is, a PST-skilled social worker consult must be done as part of the investigation. See Accessing a PST-skilled social worker

Natural justice requires the CDP participant to be given an opportunity to:

• explain the reasons that prevented them from attending the job interview and/or
• discuss any factors they believe impacted their behaviour, or ability to control their behaviour

All decisions must be based on fact, which is substantiated with suitable evidence as required. The Participation Solutions Team (PST)-skilled Service Officer is responsible for ensuring there is enough evidence to establish the facts of the case.

This may include further contact with an employer, the CDP participant's provider, a specialist or third party, or obtaining and considering other evidence the CDP participant may provide. For further information, see Gathering information and weighing evidence to establish facts for a compliance investigation.

A summary of relevant information provided by the CDP participant that relates to the non-compliance event must be recorded in the Compliance Investigation workflow.

The PST-skilled Service Officer (WNPPD) will be prompted to:

• record if an interpreter was used or not
• check and update CDP participant phone and email details
• Select Next to navigate to the Compliance Investigation screen

Navigate to the Investigation screen.

The Compliance Investigation screen will be pre-populated with details of the failure.

The PST-skilled Service Officer with Participation Failure Decision (PFDEC) or 8 Week Non-Payment Period Decision (WNPPD) security resources, will be prompted to:

• read the privacy statement to the CDP participant
• outline the failure under investigation
• access and review the Provider Report

Check if the provider has discussed the failure with the participant. If appropriate, record the excuse the CDP participant gave the provider in the free text field.

Discuss with the CDP participant their explanation and record any additional information provided in the appropriate free text field.

Consider the reasons given.

Note: a PST skilled Service Officer must consult with a PST-skilled Social Worker where the participant presents with family and domestic violence or has a current Family relationships/Domestic violence circumstance recorded. See Accessing a PST-skilled social worker.

Select the most appropriate response to the question:

• 'Does the participant's statement suggest ongoing circumstances directly contributed to the failure?'

If the answer is 'Yes' or 'Unsure', a link to the Circumstances Impacting Compliance screen will allow the screen to be viewed and circumstances updated if required. See Circumstances impacting job seeker compliance.

Go to Step 3.

Record the CDP participant's main excuse for the failure (or the reason the Service Officer has determined is the main reason) on the Compliance Investigation screen.

The categories displayed will only include options appropriate to the failure type.

• Select a category
• Select a reason that best describes the reasons the CDP participant has given

Additional information may display depending on the responses. Additional information may include:

• Details of reported income
• Medical certificates and exemptions
• Rate Estimator

Is the CDP participant a principal carer?

• Yes, go to Step 4
• No, go to Step 5

For CDP participants who are principal carers, use the Rate Estimator to determine financial suitability (see Financial suitability test for suitable work for principal carers) and record the following:

• Net fortnightly income excluding employment costs and income for the job
• Net fortnightly income including employment costs and income for the job
• Is the participant (more than $50.00 per fortnight) financially better off if they accept the job?

Go to Step 5.

See:

• Non-attendance or inappropriate conduct in a job interview
• Assessing reasonable excuse for non-compliance with mutual obligation requirements

Is this an acceptable reason that warrants further investigation?

Note: when certain excuses are selected, the answer to this question will be set to 'No'.

• Yes or Unsure, further investigation is required. Go to Step 6
• No, further investigation is not required. See Table 3

Does the excuse indicate it had a direct and significant impact on the failure?

• Yes or Unsure, further investigation is required. Go to Step 7
• No, further investigation is not required. See Table 3

Does the excuse indicate it was within the participant's control and they could have avoided the failure?

• Yes, further investigation is not required. See Table 3
• No or Unsure, further investigation is required. Go to Step 8

Does sufficient evidence already exist to confirm the excuse for the failure?

• Yes, further evidence is not required. See Table 3
• No, go to Step 9

When further evidence is required to reach a decision, the Service Officer needs to ensure evidence collected is specific to the incident, and will influence the outcome of the decision under the applicable legislation and policy.

When the Service Officer selects either:

• No - Phone call required to confirm the excuse for failure, or
• No - Have requested participant provide evidence

the following may display:

• Evidence due date
• Who do you need to contact about the participant's excuse

Summary of evidence requested/provided

The summary of evidence free text field should be used, when presented, to document the evidence provided or requested.

When evidence has been requested, a future date is set for its return, using the Save and Exit workflow. Select 'Pending evidence from customer' option, and enter due date for the requested evidence. This will remove the contact trigger and ensure it is re-instated on the Evidence due date + 1.

Is evidence required and a future date is set for the return?

• Yes, procedure ends here
• No, see Table 3

On the Decision and Penalty screen record a response to questions as they present.

Note: the response to these questions may be automatically set and not able to be changed depending on previous responses in the Compliance Investigation workflow.

Have you confirmed the job is not suitable, or it is explicitly precluded by social security law?

• Yes, go to Step 5
• No, go to Step 2

Have you identified any significant errors or omissions in the report submitted by provider?

• Yes, go to Step 5
• No, and the No Show, No Pay investigation is for:
• non-attendance at an activity or a job interview, go to Step 3
• inappropriate behaviour at a job interview, go to Step 4

Are you satisfied there is a reasonable excuse for the failure?

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

Are you satisfied the behaviour was inappropriate and within their control?

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

Using the responses provided in the Compliance Investigation workflow, the decision to reject a failure will be automatically selected on the Decision and Penalty screen.

PST-skilled Service Officers must be satisfied the decision is correct under the Social Security (Administration) Act 1999. If not satisfied the decision is correct, review the answers recorded within the Compliance Investigation workflow for correctness.

PST-skilled Service Officers must ensure the appropriate rejection reason is recorded.

When rejecting a PR as it does not contain the required information, or clarification is needed from the provider (and contact was unable to occur), use one of the following rejection codes:

• IVA - Returned for update - insufficient evidence/documentation, or
• IVH - Returned for update - incorrect incident date

For all other rejections, select the appropriate rejection reason.

Clearly record an explanation for rejecting the compliance action in the free text area provided.

Record further information for the provider to explain the reason for rejection, if appropriate.

Note: any information recorded can be obtained by the CDP participant under the Freedom of Information Act 1982. The information which can be lawfully provided by Services Australia to Employment Services Providers is covered by Section 202 of the Social Security (Administration) Act 1999.

Go to Step 8.

Using the responses provided in the workflow, the decision to apply a failure will be automatically selected on the Decision and Penalty screen.

PST-skilled Service Officers must be satisfied the decision is correct under the Social Security (Administration) Act 1999. If not satisfied the decision is correct, review the answers recorded within the Compliance Investigation workflow for correctness.

Inform the CDP participant of the failure decision and their review and appeal rights.

Note: any information recorded can be obtained by the CDP participant under the Freedom of Information Act 1982. The information which can be lawfully provided by Services Australia is covered by Section 202 of the Social Security (Administration) Act 1999.

The PST skilled Service Officers record a response to:

• Have you verbally notified the participant of the failure decision and appeal rights?
• Have they indicated they intend to immediately appeal the decision?

Does the CDP participant want apply for a formal review of the decision?

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

The following message will display:

'The participant has requested a review of the decision to apply the failure. Ensure appropriate action is taken to record the request for the review.'

See Non-compliance with compulsory requirements - review and appeals.

The PST-skilled Service Officer will be required to complete any outstanding reviews or assessments of existing circumstances impacting compliance. See Circumstances impacting job seeker compliance.

Due to system limitations, QMA may not display all workflow pages if the failure investigation is completed over more than one contact.

Any pages not displaying in QMA can be viewed through the Compliance Investigation workflow by selecting the Date of Event (DOV) of the submitted failure.

Check if CDP participant 's payment needs to be restored.

A payment suspension (participation) will be imposed at the time an appointment related connection failure is generated unless there is another suspension in place at that time.

The Participation Compliance Hub will display a message and a Manual Follow Up (MFU) will be generated to prompt restoration of the CDP participants payment when a payment suspension (participation) has been imposed and the CDP participant:

• has agreed to re-engage, or
• is not required to re-engage (including when the failure is rejected as invalid and no contact has been made with the CDP participant)

If the CDP participant has refused to re-engage then the suspension will continue, however, the CDP participant will still be issued with a re-engagement requirement.

If a CDP participant terminates a call, or the call is disconnected, before Services Australia can discuss re-engagement, their payment should remain suspended.

See Restoring payment where a payment suspension (participation) has been imposed for Community Development Program (CDP) participants.

When the following message presents: 'The application of this failure will result in the generation of an automatic CCA. Based on the CCA guidelines in Operational Blueprint, does the CCA need to be generated immediately?', a response must be selected from either:

• 'Yes - generate CCA immediately'
• 'No - system should generate CCA overnight'

If a CCA is generated immediately, it will be displayed on the Participation Compliance Hub on the Outstanding Compliance Actions table.

For more information, see Generating and preparing for a Comprehensive Compliance Assessment (CCA).