Processing claims for Age Pension and Pension Bonus 065-03030050

For claims, request or search for the claim work item via Inbox.

Select the work item to view the Customer and Activity Information table on the Transaction Summary (TS) screen.

For new claims, Service Officers must stream the claim on the day allocated and a progress of claim note must be created and/or updated, if the claim cannot be immediately finalised.

Has the claim been streamed previously by another Service Officer (see Progress DOC for details)?

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

The claim status must be In Process before it can be processed.

Is the claim status In Process?

• Yes, go to Step 3
• No, for claim status definitions and action to take, see Process Direct navigation, common screens and functions

To reassess a previously rejected claim:

• If rejected FSD, FRC or POI, see Request to reassess a rejected claim
• To re-index the claim, refer to directions for SAP online claims in Indexing, re-indexing and cancelling claim activities

Note: the claim should not be re-opened until the customer provides all requested information.

Check the customer's benefit status line.

If the customer's benefit status is:

• AGE/CUR indicating that the claim assessment has already been completed, update the claim status to Not Required. Procedure ends here
• AGE/CZR PLS indicating the customer is currently receiving Age Pension as a loan-only payment under the Home Equity Access Scheme (the Scheme), a full assessment of their income and assets must be undertaken to determine if eligible to receive a payable rate of Age Pension. Claims must then be referred to the Home Equity Access Scheme National team to review the customer's circumstances and determine the appropriate course of action prior to claim finalisation

To review the information provided by the customer in the online claim or ACC:

• Select and to view the Claim Summary in a new window. If it is blank, press [F5] to refresh the page

To view paper claims and scanned supporting documents:

• select links at the bottom of the expanded Claim Summary, or
• select Quick link from the bottom of the open Process Direct window, or
• select Documents from the Icon Menu

Check the date the document was scanned. There may also be older documents not related to the claim.

Check customer tasks, DOCs and Notes by selecting .

Is the customer claiming Pension Bonus or is the customer a registered member of the Pension Bonus Scheme (check if Benefit Status is PDB/REG)?

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

Is the Service Officer trained to assess Pension Bonus?

• Yes, for more information, see Initial contact by customers claiming Pension Bonus Payment (PBP) and Qualification and assessment of Pension Bonus Payment (PBP)
• No, see Table 7

Only Service Officers trained in Pension Bonus assessments should complete the following.

Claiming Pension Bonus but not registered

From 1 July 2014 the Pension Bonus Scheme closed to new registrations. A customer may incorrectly claim the Pension Bonus if not registered by lodging a paper claim SA002. The online claim only presents Pension Bonus questions to customers registered in the PBS.

• To reject a Pension Bonus claim from a person not registered in the PBS, go to the PBP screen in the AGE/NCL activity and enter the calculation Period End Date (normally the date before the customer claims Age Pension). The PBP claim will be rejected, reason PBR (PBS Not Registered). Note: this cannot be done in Process Direct
• If the PBP screen was not entered as part of the AGE/NCL it can be done in a separate activity by using the Pension Bonus Claim Assessment script in Customer Record

Not claiming Pension Bonus but registered

• If customer registered for Pension Bonus has not claimed Pension Bonus with their Age Pension claim, Service Officers must contact the customer to discuss the qualification and assessment of PBP and confirm that they do want to apply for the Pension Bonus. See Request information verbally and Cancellation of membership for Pension Bonus Scheme (PBS)
• If the customer has not yet spoken with a Financial Investment Service (FIS) Officer, refer the customer to FIS Officer

If they do not wish to claim PBP and no longer satisfy the work test, cancel their PBS membership in the scheme reason NBC - no bonus claimed with Age Pension. An automatic cancellation letter will be issued to the customer.

Note: if a customer has lodged a registration for PBS (SA319) before 1 July 2014 which was not actioned at the time, escalate to ICT via mySupport to index the Pension Bonus registration from the original lodgement date.

Check the type of Age Pension claim that has been allocated. If 2 separate single claims for customer and partner are allocated, the oldest claim must be processed first.

Age Pension combined partner online claim

• Combined claims (sometimes referred to as 'dual claims') are allocated as a single work item
• Do not process an Age Pension combined partner online claim as 2 separate individual claims as the data for the partner claim may be lost
• To identify an Age Pension combined partner online claim:
• A specific message will display in the claim header in Process Direct 'This claim is Customer Partner Combined claim'
• Check for a keyword of DUALCLM
• View the claim note or AGE OLC Claim Progress DOC, where the words 'Awaiting partner review' will display within the text
• Go to Step 8

Online claim/ACC submitted

• When an online claim or ACC is submitted, an Age Pension claim work item is created in Process Direct containing the claim information
• If 2 separate individual claims are received for a partnered couple these should be processed as individual claims. If the partner's claim has not been allocated for processing, locate the partner's claim via WLM and assess the claim as appropriate
• Due to a known issue, the Date Submitted will default to the original Date of Receipt (DOR) entered, where:
• the claim was started through ACC, and
• submitted on a later date
• Service Officers must check the date of claim submission and if necessary, correct the DOR. See Table 2, Step 11 in Viewing and processing online and Assisted Customer Claim (ACC)
• Go to Step 8

Paper Claim for Age Pension (SA002) lodged

• When an SA002 is scanned to the customer's record, a SOA shell work item is generated. SOA shell contains no claim information apart from the CRN, personal details, and receipt date. Add the claim information into the SOA shell using the scanned claim and documentation
• If both the customer and partner have claimed on the same claim form, the single SOA shell should be transformed to a combined customer-partner claim by using > Combined claim switch > select Switch to combined claim. This is to make sure correct assessment of the claim and any items that impact both parties, for example, Work Bonus/Rent Assistance. This action can be reversed to return the claim to an individual claim if 'switched' in error
• If the same paper claim is scanned to both customer and partner records, 2 SOA shells are created. Once one of the SOA shells has been switched to a combined claim, the other SOA needs to be set to 'Not required'. If the partner's claim has not been allocated for processing, locate the partner's claim via WLM and assess the claim as appropriate
• Go to Step 7

Paper International Age Pension claim (AUS140) lodged

• These claims are processed by Centrelink International Services (CIS) staff with the appropriate skills. See Claims for Australian payments under International Agreements
• Procedure ends here

The Assessment Date (or start date) of the claims is based on the:

• date of receipt, and/or
• deemed date of claim (DDOC) where the customer has contacted to advise of an intention to claim and considered to have vulnerable circumstances

Update Date of Receipt (DOR) if a SOA shell work item has been created with an incorrect date. Updating the receipt date will automatically regenerate the claim. The date of receipt must be updated on the Transaction Summary (TS) screen before selecting Process. Select and Update DOR.

Make sure the correct Assessment Date (start date) appears on the Pensions Assessment (PNA) screen.

Common screens that may need updating via SWE:

• personal information such as name, address, phone number (CPDS, ADS, TDS)
• interpreter information and language details (OCD)
• Office Code (OC)
• Payment Destination (PAS). Select to add or update a customer's payment destination. Update customer's BSB, account number, account title. Benefit system and payment method will automatically populate
• Alternative identity (POI) if required

If the customer has indicated in the claim, they are in a crisis this can be confirmed by:

• Checking the Keyword icon for vulnerable (URGVULN) or in financial hardship (URGFINH)
• Checking the claim and customer record to see if there is evidence of a crisis situation or the need for special help

Pre-Claim Vulnerable Circumstance (PRECLM) screen:

Where the customer has pre-claim vulnerable circumstances recorded within the 8 weeks before their intent to claim contact date the system will automatically calculate the start date. See Intent to claim and vulnerable customers for background and processing information.

Service Officers must check the claim details against the existing customer details. Amend where required.

If the customer has died, see Processing a claim after the death of a customer.

If changes to the customer's contact details are required, these updates need to be applied before assessing the claim. For assistance with updating address details including accommodation, see Updating address details.

If the customer or their partner has requested to add or cancel a nominee arrangement, see Adding or rejecting a nominee request or Cancelling a nominee arrangement.

This is a potential family and domestic violence interaction point please review Family and domestic violence.

Access any Display on Access (DOA) alerts for specific warnings or messages on the customer's record.

This includes:

• if the customer is income managed. See Identifying and assisting income managed customers for assistance
• the Customer Incident Management System (CIMS), and
• the Managed Service Plan (MSP). See Customer aggression - Managed Service Plan (MSP) for more information

A superannuation exemption may apply if the:

• owner of a superannuation investment has reached Age Pension age, and
• fund restricts full access to the superannuation, while they are employed

See Exempting superannuation investments for more information.

These details must be reviewed/updated.

On the TS screen:

• Link Summary (LS) shows linked records, such as nominees and the customer’s partner (including any Relationship Qualifier Code)
• Marital Status (MS) table shows the customer's relationship details. For help with coding, see Process Direct navigation, common screens and functions
• If the customer's partner has used the TAC to confirm the relationship through the 'Partner Confirmation Logon' service on the Services Australia website, this will display as a DMODP tile and can be viewed under scanned documents. Note: this does not apply where an Age Pension combined partner claim has been lodged
• Before linking to a partner, make sure the partner's record is in the same Environment. For help with coding environment transfers and relationships, see Inter-environment change of address
• Assess if the customer is a member of an illness separated couple
• If there could be a ‘special reason’ not to treat a partnered person as a member of a couple, see Treatment of a partnered person as single under Section 24 new determinations
• If the customer’s relationship status needs to be updated, and manual coding on the claim has already been started, select and regenerate the claim. This will reset the claim to only contain the information provided by the customer in their claim

Note: if the customer's responses within the claim indicate they are not in a relationship, but may be living with another person, then a Member of a Couple (MoC) assessment may be required. If the customer advises they are separated but still living with their previous partner then a Separated under one roof (SUOR) assessment may be required. An assessment must be finalised before the claim can be processed as the outcome will determine the coding required on the MS screen.

If a customer advises the death of their partner and the records are linked, complete the death action. See Initial notification of death.

Is the Age Pension claimant single, or has a partner who either has also claimed Age Pension (including as part of a combined partner claim online or paper), or is in receipt of an income support payment?

• Yes, go to Step 13
• No, and if their partner may also be eligible for Age Pension or another service, attempt to contact the customer (who lodged the Age Pension claim) to check if their partner intends on Claiming Age Pension
• If the customer can be contacted, use the appropriate conversation to invite the partner to complete a claim for Age Pension and DOC the outcome, or
• If the customer is unable to be contacted, issue a Q164 and DOC the record with the contact attempts and that the suggestion has been made for the partner to complete a claim for Age Pension

Does the customer meet the age and residence requirements for Age Pension, or will they qualify within 13 weeks of claim lodgement?

For more information see Qualification for Age Pension, Residence assessment for customers claiming Age Pension and Early claims.

• Yes, go to Step 14
• No, see Rejecting a claim for Age Pension
  Note: do not request documents if the claim will be rejected

On the TS screen, check the customer's Identity Status.

If the Identity Status is:

• Confirmed, see Table 2
• Not confirmed, undertake the following:
• Select the Not Confirmed link to open a Customer Summary window
• Select Identity Confirmation > Identity Confirmation Dashboard from the Task Selector
• Code the identity documents or consider applying alternative identity. See Identity Confirmation, Alternative Identity or Verifying the date of birth or age of a customer or child
• Close the Customer Summary window to return to the claim
• Select SAP Refresh to update the Identity Status

The presence of a proof of age document on the Identity Summary or the (Proof of Identity Details (POI) screen or in a DOC is evidence that details have been checked against the customer's record and are correct.

Go to Table 2.

If the customer has advised compensation details or Department of Veterans' Affairs (DVA) income, see:

• Coding Compensation and damages (Mod C) to request a clearance
• Payments from the Department of Veterans' Affairs (DVA) and referrals to the DVA Clearance Team

If rejecting a customer's claim for one of the following reasons, refer the claim to the DVA Clearance Team for review. See Checking DVA income coding and referring work to the DVA Clearance Team table:

• Service Pension/Income Support Supplement (DVA)
• DSS Age Pension paid by DVA (AGC)

Note: for DVA income already recorded, resulting in either claim rejection, rate change or no impact, a DVA clearance must be obtained before finalising the claim.

Determine whether supporting documentation/evidence provided is acceptable and/or if further information should be requested. See Documents required for Centrelink new claims for guidance on making this decision.

A new claim under the income and assets tests must be fully completed with all required documents supplied except where more documents will not change the outcome of the claim.

If the customer and/or their partner has employment income, the customer must provide details of all employment income paid from the date eligible for Age Pension. Note: this can be provided either verbally, or by supplying payslips until the claim is finalised.

The customer has provided a completed claim with all the relevant information required for assessment.

• Yes, go to Step 3
• No:
• Before issuing a request for information, Service Officers must attempt to contact the customer to explain the request and obtain information verbally if possible
• Note all attempts made and all information given during this contact in the Progress of claim Note/DOC
• Make sure the customer's and/or nominee's contact details are coded correctly before contacting the customer and issuing a request for information

For online claims:

• where information has already been requested through the claim or by a Service Officer, but has not been provided by the customer, see Rejecting a claim for Age Pension
• where the customer has intentionally provided non-claim related documentation to allow their claim to be submitted, see Rejecting a claim for Age Pension
• submitted under a claim submission exception and/or where there is evidence the customer may be in a crisis or need special help:
• see Calling a customer or returning a customer's call
• where applicable, send a pre-call SMS
• make 2 attempts to contact, at separate times on the same day where possible
• check if the customer needs more time to meet the requirements due to their circumstances
• Request the information and allow extra days for mail delivery. See also, Documents required for Centrelink new claims
• where more information is needed to assess the claim and there is no existing request:
• see Calling a customer or returning a customer's call
• where applicable, send a pre-call SMS
• make 2 attempts to contact, at separate times on the same day where possible
• If the information cannot be provided verbally, request the information in writing and allow extra days for mail delivery. See also, Documents required for Centrelink new claims

For incomplete paper claims:

• see Calling a customer or returning a customer's call
• where applicable, send a pre-call SMS
• make 2 attempts to contact, at separate times on the same day were
• If the information cannot be provided verbally, request the information in writing and allow extra days for mail delivery. See also, Claims received that are incomplete or incorrect
  Note: if the customer (and partner if applicable) have only signed a paper claim form on the last page of the form (following the Pension Bonus questions), the claim can be accepted as signed

See Request for Information (RFI) letter for:

• list of document types
• additional text options

Select Generate print preview to review the RFI before sending to the customer.

The Request for Information (RFI) will place the new claim on hold. If the claim status needs updating manually change the status to On Hold via the Status icon until the customer responds or after the allowed time. See Requesting information (CLK).

The claim can be held to user if it meets Hold to User new claim criteria. For more information on holding claims to user see Work Optimiser for staff.

Procedure ends here until customer has responded to the request for information or the due date for return of information has passed.

If a referral to one of the following is required, follow the below process:

• Complex Assessment Officer (CAO)
• Financial Information Service (FIS) Officer
• Confirming the need for a Member of a Couple (MoC) assessment
• International Services if:
• a customer wants to dispute information, or a Service Officer thinks that the data received through the Immigration Datalink is incomplete or incorrect, the matter must be referred to Centrelink International Services (CIS) to investigate the issue
• assistance is required for residence assessment or foreign pension coding
• Home Equity Access Scheme if:
• a customer is receiving Age Pension as a HEAS loan-only payment (identified by a benefit status of AGE/CZR-PLS)
• update income and assets details provided from claim via a change of circumstances (CoC) transaction, see Coding income and assets for Centrelink payments and services for assistance
• claim must then be referred to the Home Equity Access Scheme National team to review the customer's circumstances and determine the appropriate action prior to claim finalisation
• To create an open work item, use Fast Note and select Auto text > Complex Assessment > Request for CAO action > CAO Home Equity Access Scheme

Note: some referrals will automatically change the new claim status to On Hold, and a DOC will be recorded with Customer Referral work item ID.

If the claim status needs updating manually, change the status to On Hold via the Status icon for the required duration. The claim status will update to In Process when all referrals are completed.

Note: if a property valuation is required for a Pension Bonus claim, the entire claim including the valuation request must be processed in Customer First or Customer Record.

Is a property valuation required for the claim (see Valuation of real estate and other assets for assistance)?

• Yes, if the claim requires a property valuation it must be processed outside Process Direct. Apply Handover function (See Table 4, Step 2). To request the valuation, follow the process in Valuation of real estate and other assets
• No, go to Step 5

If:

• all requested information has been returned, and clearances, valuations and referrals have been completed, the claim is ready to be processed. See Table 3
• the claim has come off hold and the referral, clearance or valuation remains open:
• confirm the assessment is still required and has not been completed
• refer to progress notes and determine if the assessment is pending a request for information
• update the Progress of claim Note/DOC and return the status to On Hold for a minimum of 14 days. If required, allow for the longer duration pending the outcome, and/or extra days for mail delivery. See Requesting information (CLK)
• procedure ends here until required valuations, clearances, referrals are completed and/or response received to a request for information
• the customer has not provided all requested information at claim submission, or fails to respond to the request for information within the time allowed, go to Rejecting a claim for Age Pension

Note:

• if customer’s benefit status is AGE/CZR-PLS, the Age Pension claim cannot be processed as a NCL activity due to system limitations. See Table 5, Step 1
• if a property valuation is required before finalising the claim, process the valuation request in Customer First or Customer Record. See Table 5, Step 2
• if a property valuation is required for a Pension Bonus claim, process the entire claim including the valuation request in Customer First or Customer Record. See Table 5, Step 2

Select Process.

The Errors (SWE) screen will display a Message Log and Task Selector:

• Select messages to view/update the relevant details. An error or warning will display if information has not loaded correctly from the online claim or ACC
• The Task Selector will display a flag against screens that contain provisional data (data uploaded from the online claim or ACC or updated by staff)
• Select the screens to be checked/updated
• Select Next

The Task Selector does not list all screens that may contain provisional or confirmed data. Check the Claim Overview to see if other information has been provided that may need to be updated. To check confirmed data, go to the individual screens via the Super Key field.

Check the POI screen shows an entry with Service Reason Code AGE.

For paper claims (SOA shells), select the screens to manually code details from the claim. Check all screens including the TRCIAS screen to make sure claim is not assessed using outdated information.

For help, see Process Direct navigation, common screens and functions.

The Pensions Assessment (PNA) screen displays the Age Pension Age Date and the Pension Assessment Date.

The Assessment Date automatically determines from what date the claim will be assessed. This is based on the date the claim was submitted, the date customer reached Age Pension age and recorded contact dates for claimants that have vulnerable circumstances - see Intention to claim for vulnerable customers in Table 1, Step 6.

If applicable, the Assessment Date can be changed manually. For example:

• vulnerable circumstances exist, the customer was not qualified on the contact date passed from Process Direct and was qualified on a later contact date before the claim was submitted
• other backdating provisions apply (these may apply in addition to intent to claim provisions)
• the customer is qualified but not payable on the date they submitted their claim, but their income or assets change will be within 13 weeks of the original claim date
• inappropriate claim or incorrect claim provisions apply

To change the Assessment Date, select the Calendar and select the new assessment date. For help with calculating the start date, see Start Day.

A customer can qualify for Age Pension (Blind) if they are qualified for Age Pension and assessed as permanently blind.

The PDI screen contains details in relation to the customer's impairment and exemptions that may apply.

• Event date - in most cases for new claims this will be the same date as the Pension Assessment Date and can be selected by keying the date into the field or using the Calendar
• Blind Indicator
• Blind income and assets exempt
• Severely disabled code

The PDI screen is not pre-populated from the online claim. If the customer is claiming Age Pension (Blind), verification will be requested from the customer as part of the claim lodgement process. Check the verification against the claim summary and update within the claim if needed.

• Select Add to insert a new row for coding the provisional details
• If more than one date of event needs to be recorded, select Add to create additional rows
• Provisional details can be changed by coding over the information, or deleted

For more information, see Assessing Age Pension (Blind) claims.

The customer's Australian residence qualification will be automatically assessed based on the residence information recorded.

Residence information must be recorded if the claim is to be rejected for a reason other than residence, otherwise the system will override any other rejection reason, and the claim will incorrectly reject for a residence related reason.

For coding help, see Residence and Portability screens.

The customer must generally also be in Australia when the claim is made, or meet an exception to the lodgement inside Australia rule. View whether the customer was in Australia on the lodgement date on the Immigration Advised Movements Screen (RSIM) screen.

See Residence assessment for customers claiming Age Pension.

Is the customer residentially qualified for Age Pension and in Australia when the claim was made?

• Yes, go to Step 7
• No, go to Step 5

Note: if a customer will satisfy the Age Pension 10 years qualifying residence period within 13 weeks of submitting the claim, then their claim should not be rejected. The claim should be held and processed when qualified, see Start Day and Early claims.

The customer may be qualified under an agreement if:

• residence requirements are not met but the customer has lived in an agreement country, or
• the customer was in an agreement country when the claim is deemed to be made

If there is evidence the customer was in an agreement country when the claim is deemed to be made, attempt to confirm and 'DOC' this. If confirmed, follow the process below to refer to International Services. If not confirmed, allow the claim to reject. Go to Step 6.

Has the customer lived or is in an Agreement country or an E510RS message 'Assessment under agreement country required before rejecting NSR' displays?

• Yes, the customer may be qualified under an agreement. Do not reject the claim
• These claims are only processed by Centrelink International Services (CIS) staff with the appropriate skills. See Claims for Australian payments under International Agreements
• Code all relevant residence screens
• Check the Agreement country is recorded on the Country of Residence (CRES) screen
• Make sure identity is confirmed. See Identity Confirmation
• Check only required work items are left open
• Categorise the claim in Work Optimiser to a CIS new claim work item Age Pension ZALL_AGE_CISNCL
• Annotate the Claim notes or new claim progress doc stating that the claim has been referred to International Services (CIS) for agreement assessment. Note: no separate referral is necessary
• Procedure ends here
• No, go to Step 6

Is the claim to be rejected?

• Yes, see Rejecting a claim for Age Pension. Procedure ends here
• No, go to Step 7

For information about recording details, see Coding income and assets for Centrelink payments and services. Note: employment income is coded in later steps.

For information about the assessment, see:

• Assessment of assets for Centrelink payments
• Assessment of income for Centrelink payments
• Assessing and coding the Real estate details Mod R
• Foreign Pension coding - coded by International Services
• Assessing superannuation
• Exempting superannuation investments
• Adding or updating an account-based income stream
• Managed investments - adding a new investment
• Adding shares and securities
• Assessing Deprivation/Gifting
• Assessing and coding the Business details for sole traders and partnerships MOD F

Where the CAO assessment has been completed, check the CAO assessment DOC for any actions that the Service Officer must complete.

Does the customer and/or partner have employment income?

• Yes, go to Step 8
• No, go to Step 10

Employment income paid to the customer and/or partner from the Pension Assessment Date (PNA) must be assessed before finalising the claim.

Where the customer (or partner) has ongoing employment income:

• they must report every 2 weeks, unless
• they meet a continuous income exception

STP data from employers who have reported payroll details in the previous 8 weeks for the customer may be presented to customers or staff within Online Claims and Assisted Customer Claims (ACC). See Single Touch Payroll (STP) in Centrelink claims:

• if the question ’Do you work for (employer)’ is displayed in the claim slider, a STP employer has been presented
• the STP Employer Update (EMCF) screen in Process Direct contains further details
• the customer must confirm the STP data before it can be accepted and coded on the record

Where STP data present or provisional coding of a variable frequency in the claim is assessed, the customer will be automatically placed on reporting. See Reporting Regime Details (RPRD) screen.

Go to Step 9.

See Start Day and Early claims

Is the customer qualified for Age Pension?

• Yes, go to Step 10
• No, and the customer will become qualified for Age Pension on a day in the future that is:
• within 13 weeks of the date of claim lodgement, the claim is to be held:
• add the keyword: URGISP for priority allocation when due
• update the Progress of claim Note/DOC with the hold reason including the change of circumstance expected to be confirmed (if applicable)
• to allow for the assessment of employment income in the first entitlement period to occur, Hold the claim for the reason ‘Customer to Provide Information’ until 15 days after the PNA date
• procedure ends here until due date
• not within 13 weeks of the date of claim lodgement, reject the claim. See Rejecting a claim for Age Pension

After saving updates, return to the SWE screen to view errors, warnings, and messages in the Message Log. These messages inform of the items that need to be resolved to prepare to finalise the claim.

Select at top right to launch the Digital Assistant (DA). Key the error message into the DA for help.

See Using Digital Assistance Roxy in Process Direct.

Once all errors have been resolved, see Table 4 to assess and finalise Age Pension claim.

Select Assess. If there are any further errors, they will present on the Errors (SWE) screen. For help, see Using Digital Assistant Roxy in Process Direct.

Note: if an E510RS message 'Assessment under agreement required before rejecting NSR' displays, see Table 3, Step 5.

After fixing any errors, select Assess again to go the Entitlements (ELD) screen.

The ELD screen displays the outcome of the claim and payment dates.

Sometimes a claim activity may need to be processed in Customer First/Customer Record and the Handover to CF/CR function may be required. This is to apply an approved workaround for a known issue/error or gaps in Process Direct.

Before using the Handover function, staff must refer to Using Digital Assistance Roxy in Process Direct and the Handover function table in Process Direct navigation, common screens and functions for required actions.

Is a handover to Customer First or Customer Record required?

• Yes, to commence a handover see the Handover function table. Once completed see Table 5, Step 2
• No, go to Step 3

Check outcome of claim on the ELD screen and make sure the provisional data contains the expected results.

Note: there is a known system issue for Age Pension customers with vulnerable circumstances - the system incorrectly grants from the Age Pension Age Date if this date falls between the contact date and the date the claim was submitted. Check if the Assessment Date has changed after selecting Assess in Process Direct.

• If there was a later contact on the PRECLM screen before the claim was submitted and the customer was qualified on that contact date, then make this the Assessment Date, otherwise
• Change the Assessment Date (via PNA screen) to the date of receipt of the claim (unless other backdating provisions or deemed claim provisions apply)

Will the Age Pension claim be rejected?

• Yes:
• the customer will become payable due to a change of circumstances that is within 13 weeks of the date of claim lodgement, the claim is to be held:
• add the keyword: URGISP for priority allocation when due
• update the Progress of claim Note/DOC with the hold reason including the change of circumstance expected to be confirmed
• Hold the claim for the reason ‘Customer to Provide Information’ until the date the change of circumstance is due to occur, to allow updates to be coded
• procedure ends here until due date
• there is no expected change in circumstances due to occur within 13 weeks of the date of claim lodgement, reject the claim. See Rejecting a claim for Age Pension
• No, and the customer and/or partner:
• have employment income, go to Step 4
• do not have employment income, go to Step 7

Has the first Entitlement Period End Date (EPED) of the claim period passed?

• Yes, see Table 8 and record employment income details
• No, Hold claim:
• add the keyword: URGISP for priority allocation when due
• update the Progress of claim Note/DOC with the hold reason
• Hold the claim for the reason ‘Customer to Provide Information’ until the first EPED after the PNA date, when employment income details for the first entitlement period can be assessed
• procedure ends here until due date

The ELD screen shows the outcome of the claim.

Will the Age Pension claim be rejected?

• Yes, go to Step 6
• No, go to Step 7

Employment income caused the claim to be rejected and:

• has since reduced or ceased and customer is payable within 13 weeks of the date of claim lodgement:
• change the Assessment Date on the PNA screen to the first Entitlement Period Start Date (EPSD) in which the customer is payable. See Start Day
• select Assess to view and resolve any errors displayed in the Message Log
• select Assess again
• go to Step 7
• has not reduced or ceased, reject the claim. See Rejecting a Claim for Age Pension

If neither of these options has occurred, see Rejecting a Claim for Age Pension.

Check outcome of claim on the ELD screen and make sure the provisional data matches the expected results.

Check income and asset details from relevant Date of Events (DOV) on the following screens.

• Pensions Income and Asset Summary (PIAS)
• Pension Assessable Asset Summary (PAAS)
• Factors Affecting Rate (PFAR)
• Pension Rate Calculation (PRC)

If customer and/or partner have employment income:

• Review the application of the Work Bonus for pensioners of Age Pension age via the Employment Income Assessment – Work Bonus (EIA) Screen
• the system will automatically apply the Work Bonus and any balance to discount the customer's eligible income prior to applying the income test on the PFAR screen
• If neither the customer nor partner are in receipt of a social security payment, do not code any employment income before the PNA date
• Do not code any employment income for the current entitlement period, because the customer will include this when they complete their first report
• If customer is required to report:
• check the Reporting Regime Details (RPRD) screen to place the customer on reporting
• stimulate outstanding reporting dates via the Report Ind Y/N field on the Reporting Results (RR) screen for passed entitlement periods where employment income has been coded
• see Reporting screens

If required, check the following screens, and make any necessary updates such as manual rate adjustments on the Daily Rate Component (RAC) and Daily Rates Summary (RATS) screens:

• Payment Delivery Summary (RAD)
• Payment Summary (PS)
• Rate Summary (RATS)
• Rate Component (RAC)
• Assessment Consequences (ASC)

For claims where the customer is deceased, see Processing a claim after the death of a customer to adjust arrears manually before finalising.

Note: if the customer is also claiming Pension Bonus Payment and no basic amount of Age Pension or pension supplement basic is payable, no Pension Bonus Payment will be payable. The customer may wish to withdraw both claims until an amount of Age Pension or pension supplement basic is payable. See Qualification and assessment of Pension Bonus Payment (PBP). The customer should be referred to a Financial Information Service (FIS) Officer.

Go to Step 8.

If the customer is under income management (Benefit status INM) and they have an arrears or lump sum payment entitlement, do not make any changes to the customer's record to allow this payment to be made. Refer to the appropriate process in Income Management to request income management to be turned on for the arrears payment before it is made.

If assessing a claim for an Age Pension (Blind) customer, the ELD screen may not indicate Age Pension (Blind) will be granted. When the claim has been finalised, the Benefit Status Line will show AGB/CUR.

If assessing an early claim for an Age Pension, the ELD screen may not indicate that Age Pension has been granted. When the claim has been finalised, the Benefit Status Line will show AGE/ASS.

Once the claim outcome is correct, select Finish.

The Claim Finalisation DOC will appear, see Recording reasons for decisions.

Edit or add any extra details required. For example, discretionary decisions including references to Operational Blueprint.

Select Finalise to complete the claim, a confirmation dialog box will appear. Select OK. If a checklist of scans displays, mark as complete using the tick boxes to close scans off the customer's record.

Note: If a customer has received Crisis Payment and a change has occurred, a manual reassessment of Crisis Payment may be required. For more information, see Reviewing and reassessing Crisis Payment (CrP).

If the customer is deceased, a manual grant letter (Q999) must be issued. The grant letter must be issued to the:

• 'Executor of the Estate' (if known) address
• 'Estate of the Late <customer's name>' at the deceased customer's last known address

The Resources page contains an example of suitable text for these letters.

An Age Pension claim submitted by an AGE/CZR PLS recipient, cannot be processed as a NCL activity due to system limitations. Upon allocation of the referral, HEAS CAO's will review circumstances, contact customer to discuss impact of change and DOC action taken.

A Fast Note will be sent by the CAO for further action by Service Officer:

• If Age pension is payable (i.e. income and assets are below the applicable cut off thresholds):
• HEAS review has been completed by CAO
• create manual grant DOC, using Fast Note. Select Auto Text use Older Australians > Claims > Grant AGE NCL
• change claim status in Process Direct to Not Required
• if pension payments have not started from date of claim, manually calculate the pension arrears and pay via PYAJ. See Using the Payment Adjustment (PYAJ) screen for more details
• create OLA letter Q011 to customer (and correspondence nominee if applicable)
• If pension is not payable (i.e. income and assets are above the applicable cut off thresholds)
• HEAS review has been completed by CAO and customer has elected to remain as HEAS only
• create manual reject DOC, use Fast Note - select Auto Text, use Older Australians > Claims > Reject AGE NCL
• change claim status in Process Direct to Not Required
• create OLA rejection letter Q134 to customer (and correspondence nominee if applicable)

Procedure ends here.

Go to the activity list (AL) screen.

'S'elect the claim activity and immediately place 'on hold' for one day.

Re-select the 'held' claim activity and resume processing.

Note: when a claim is handed over, it creates a new work item for Workload Management (WLM) allocation. By placing the claim on hold, it prevents the new work item allocating to another Service Officer.

At the Customer Details Task Selector (CDTS) screen, select any other relevant screens which have not already been preselected and complete any required updates, for example, address, and contact details.

Before linking to a partner, check both records are in the same Environment. If required, action an Inter-environment change of address (ICoA).

Check that the POI/POIS screens display ‘Identity Confirmed’ for Service Reason Code AGE, otherwise refer to the Identity Confirmation process.

The Pensions Assessment (PNA) screen shows the Start Date.

The Start Date automatically determines the date when the claim will be assessed from. This is based on the date the claim was submitted, the date customer reached Age Pension age and recorded contact dates for claimants that have vulnerable circumstances. See Intention to claim for vulnerable customers.

If applicable, the Assessment Date can be changed manually, for example:

• vulnerable circumstances exist. The customer was not qualified on the original contact date in Process Direct but was qualified on a later contact date before the claim was submitted
• other backdating provisions apply (these may apply in addition to intent to claim provisions)
• the customer is qualified but not payable on the date they submitted their claim, but their income or assets will change within 13 weeks of the original claim date
• inappropriate claim or incorrect claim provisions apply

The Start Date can be changed via the PNA screen. For help with calculating the start date, see Start Day.

A customer can qualify for Age Pension (Blind) if they are qualified for Age Pension and assessed as permanently blind.

The PDI screen contains details of the customer's impairment and exemptions that may apply:

• Event date - in most cases for new claims this will be the same date as the Pension Assessment Date and can be selected by keying the date into the field or using the Calendar
• Blind Indicator
• Blind income and assets exempt
• Severely disabled code

The PDI screen is not pre-populated from the online claim. If the customer is claiming Age Pension (Blind), verification is requested from the customer as part of the claim lodgement process. Check the verification against the claim summary and update within the claim if needed:

• Select Add to insert a new row for coding the provisional details
• If more than one date of event needs to be recorded, select Add to create additional rows
• Provisional details can be changed by coding over the information, or deleted

See Assessing Age Pension (Blind) claims.

The customer's Australian residence qualification will be automatically assessed based on the residence information recorded.

Residence information must still be recorded if the claim is to be rejected for a reason other than residence, otherwise the system will override any other rejection reason and the claim will incorrectly reject for a residence related reason.

For coding help, see Residence and Portability screens.

The customer must generally also be in Australia when the claim is made, or meet an exception to the lodgement inside Australia rule. View whether the customer was in Australia on the lodgement date on the Immigration Advised Movements Screen (RSIM). See Residence assessment for customers claiming Age Pension.

Is the customer residentially qualified for Age Pension and in Australia when the claim was made?

• Yes, go to Step 9
• No, go to Step 7

Note: if a customer will satisfy the Age Pension 10 years qualifying residence period within 13 weeks of submitting the claim, then their claim should not be rejected. The claim should be held and processed when qualified, see Start Day and Early claims.

The customer may be qualified under an agreement if:

• residence requirements re not met but the customer has lived in an agreement country, or
• they were in an agreement country when the claim is deemed to be made

If there is evidence the customer was in an agreement country when the claim is deemed to be made, attempt to confirm and 'DOC' this. If confirmed, follow the process below to refer to International Services. If not confirmed, allow the claim to reject. Go to Step 8.

Has the customer lived or is in an agreement country or an E510RS message 'Assessment under agreement country required before rejecting NSR' displays?

• Yes, the customer may be qualified under an agreement. Do not reject the claim
• These claims are only processed by Centrelink International Services (CIS) staff with the appropriate skills. See Claims for Australian payments under International Agreements
• Code all relevant residence screens
• Check the Agreement country is recorded on the Country of Residence (CRES) screen
• Make sure identity is confirmed. See Identity Confirmation
• Check only required work items are left open
• Categorise the claim in Work Optimiser to a CIS new claim work item Age Pension ZALL_AGE_CISNCL
• Annotate the claim notes or new claim progress doc stating that the claim has been referred to International Services (CIS) for agreement assessment
  Note: no separate referral is necessary
• Procedure ends here
• No, go to Step 8

Will the claim be rejected?

• Yes, see rejecting a claim for Age Pension. Procedure ends here
• No, go to Step 9

At the Pension Task Selector (PTS) screen, select any other relevant screens which have not already been preselected. See Claiming income support payments from Centrelink.

For information about recording details, see Coding income and assets for Centrelink payments and services. Note: employment income is coded in later steps.

For information about the assessment, see:

• Assessment of assets for Centrelink payments
• Assessment of income for Centrelink payments
• Assessing and coding the Real estate details Mod R
• Foreign Pension coding - coded by International Services
• Assessing superannuation
• Exempting superannuation investments
• Adding or updating an account-based income stream
• Managed investments - adding a new investment
• Adding shares and securities
• Assessing Deprivation/Gifting
• Assessing and coding the Business details for sole traders and partnerships MOD F

Where the CAO assessment has been completed, check the CAO assessment DOC for any actions that the Service Officer must complete.

Does the customer and/or partner have employment income and reporting requirements?

• Yes, go to Step 10
• No, go to Step 12

Employment income paid to the customer and/or partner from the Pension Assessment Date (PNA) must be assessed before finalising the claim.

Where the customer (or partner) has ongoing employment income:

• they must report every 2 weeks, unless
• they meet a continuous income exception

STP data from employers who have reported payroll details in the previous 8 weeks for the customer may be presented to customers or staff within Online Claims and Assisted Customer Claims (ACC). See Single Touch Payroll (STP) in Centrelink claims:

• if the question ’Do you work for (employer)’ is displayed in the claim slider, a STP employer has been presented
• the STP Employer Update (EMCF) screen in Process Direct contains further details
• the customer must confirm the STP data before it can be accepted and coded on the record

The customer and/or partner must be manually placed on reporting via the Reporting Regime Details (RPRD) screen in Customer First or Customer Record.

Go to Step 11

See Start Day and Early claims

Is the customer qualified for Age Pension?

• Yes, go to Step 12
• No, and the customer will become qualified for Age Pension on a day in the future that is:
• within 13 weeks of the date of claim lodgement, the claim is to be held:
• add the keyword: URGISP for priority allocation when due
• update the Progress of claim Note/DOC with the hold reason including the change of circumstance expected to be confirmed (if applicable)
• to allow for the assessment of employment income in the first entitlement period to occur, Hold the claim for the reason ‘Customer to Provide Information’ until 15 days after the PNA date
• procedure ends here until due date
• not within 13 weeks of the date of claim lodgement, reject the claim. See Rejecting a claim for Age Pension

After making updates:

• Key AR in Next. The Assessment Warning and Errors (AWE) screen will show with any errors and/or warnings
• Select any errors for more details on how to resolve them
• Warnings do not need to be resolved to proceed to the AR screen

Note: if an E510RS message 'Assessment under agreement required before rejecting NSR' shows, go to Step 7

• Select [Enter] again to go to the AR screen
• Got to Table 6

Check outcome of claim on the Assessment Result (AR) screen and make sure the provisional data contains the expected results.

Will the Age Pension claim be rejected?

• Yes:
• the customer will become payable due to a change of circumstances that is within 13 weeks of the date of claim lodgement, the claim is to be held:
• add the keyword: URGISP for priority allocation when due
• update the Progress of claim Note/DOC with the hold reason including the change of circumstance expected to be confirmed
• Hold the claim for the reason ‘Customer to Provide Information’ until the date the change of circumstance is due to occur, to allow updates to be coded
• procedure ends here until due date
• there is no expected change in circumstances due to occur within 13 weeks of the date of claim lodgement, reject the claim. See Rejecting a claim for Age Pension
• No, and the customer and/or partner:
• have employment income, go to Step 2
• do not have employment income, go to Step 3

Has the first Entitlement Period End Date (EPED) of the claim period passed?

• Yes, see Table 8 and record employment income details
• No, Hold claim:
• add the keyword: URGISP for priority allocation when due
• update the Progress of claim Note/DOC with the hold reason
• Hold the claim for the reason ‘Customer to Provide Information’ until the first EPED after the PNA date, when employment income details for the first entitlement period can be assessed
• procedure ends here until due date

The AR screen shows the outcome of the claim.

Will the Age Pension claim be rejected?

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

Employment income caused the claim to be rejected and:

• has since reduced or ceased and customer is payable within 13 weeks of the date of claim lodgement:
• change the Assessment Date on the PNA screen to the first Entitlement Period Start Date (EPSD) in which the customer is payable. See Start Day
• select Assess to view and resolve any errors displayed in the AWE screen
• select Assess again
• go to Step 5
• has not reduced or ceased, reject the claim. See Rejecting a Claim for Age Pension

If neither of these options has occurred, see Rejecting a Claim for Age Pension.

Check outcome of claim on the AR screen and make sure the provisional data contains the expected results.

Check income and asset details from relevant Date of Events (DOV) on the following screens:

• Pensions Income and Asset Summary (PIAS)
• Pension Assessable Asset Summary (PAAS)
• Factors Affecting Rate (PFAR)
• Pension Rate Calculation (PRC)

If customer and/or partner have employment income:

• Review the application of the Work Bonus for pensioners of Age Pension age via the Employment Income Assessment – Work Bonus (EIA) Screen
• the system will automatically apply the Work Bonus and any balance to discount the customer's eligible income prior to applying the income test on the PFAR screen
• If neither the customer nor partner are in receipt of a social security payment, do not code any employment income before the PNA date
• Do not code any employment income for the current entitlement period, because the customer will include this when they complete their first report
• If customer is required to report:
• check the Reporting Regime Details (RPRD) screen to place the customer on reporting
• stimulate outstanding reporting dates via the Report Ind Y/N field on the Reporting Results (RR) screen for passed entitlement periods where employment income has been coded
• see Reporting screens

If required, check the following screens, and make any necessary updates such as manual rate adjustments on the Daily Rate Component (RAC) and Daily Rates Summary (RATS) screens:

• Payment Delivery Summary (RAD)
• Payment Summary (PS)
• Rate Summary (RATS)
• Rate Component (RAC)
• Assessment Consequences (ASC)

For claims where the customer is deceased, see Processing a claim after the death of a customer to adjust arrears manually before finalising.

Note: if the customer is also claiming Pension Bonus Payment and no basic amount of Age Pension or pension supplement basic is payable, no Pension Bonus Payment will be payable. The customer may wish to withdraw both claims until an amount of Age Pension or pension supplement basic is payable. See Qualification and assessment of Pension Bonus Payment (PBP). The customer should be referred to a Financial Information Service (FIS) Officer.

Go to Step 6

If the customer is under income management (Benefit status INM) and they have an arrears or lump sum payment entitlement, do not make any changes to the customer's record to allow this payment to be made. Refer to the appropriate process in Income Management to request income management to be turned on for the arrears payment before it is made.

If assessing a claim for an Age Pension (Blind) customer, the AR screen may not indicate that Age Pension (Blind) has been granted. When the activity has been finalised, the Benefit Status Line will show AGB/CUR.

If assessing an early claim for an Age Pension, the AR screen may not indicate that Age Pension has been granted. When the activity has been finalised, the Benefit Status Line will show AGE/ASS.

If customer on reporting and employment income for passed entitlement periods has been coded, stimulate outstanding reporting date on RR screen.

Note: for Age Pension claims also requiring Pension Bonus Claim assessments assess the Pension Bonus Claim in Customer Record and finalise with the Pension Bonus Claim Assessment script.

Once the claim outcome is correct, complete from the AR screen.

• Create a Fast Note. Select Auto Text > Older Australians > Claims > Grant AGE NCL
• Update the DOC adding any details as required. For example, discretionary decisions including references to Operational Blueprint. See Recording reasons for decisions

Follow-up actions in Process Direct for claims finalised in Customer Record and Customer First:

• Check claim status in Process Direct
• If claim status has not automatically set to Complete, when claim is finalised:
• Select the claim transaction and raise an Incident through Roxy
• Choose option 'No, the issue is blocking me' so that claim is placed On Hold for System Investigation/Issue
• retain the work item by using the hold to user function in Work Optimiser
• the claim status will be set to Complete by ICT

Note: If a customer has received Crisis Payment and a change has occurred, a manual reassessment of Crisis Payment may be required. For more information, see Reviewing and reassessing Crisis Payment (CrP).

If the customer is deceased, a manual grant letter (Q999) must be issued. The grant letter must be issued to the:

• 'Executor of the Estate' (if known) address
• 'Estate of the Late <customer's name>' at the deceased customer's last known address

The Resources page contains an example of suitable text for these letters.

Process Direct

• Select Inbox > WLM Worklist from Main Category > Multi select
• Select Unassign with Reason: Capability Adjusted
• Select Add Skill
• Key 50124633 into the empty text box, then select the NV_CLK_All_PDB/Entry option
• Select Submit

Work Optimiser

• Select the work Item from Worklist
• Select Unassign with Reason: Capability Adjusted
• Select Add Skill
• Key 50124633 into the empty text box, then select the NV_CLK_All_PDB/Entry option
• Press Submit

Employment income is income paid in return for personal effort or exertion (e.g. wages) and is defined by an employer/employee relationship.

Employment income does not include:

• allowances that are a reimbursement for work related expenses
• leave payments (including leave loading) and termination payments when employment is not ongoing or terminated

The assessment of employment income within an Age Pension Claim will impact the application of the Work Bonus for pensioners of Age Pension age and the resulting Rate of Age Pension.

Where evidence of employment income is provided with a new claim (payslip/s, a payroll report or a letter from the employer), correct income for past periods if required.

Does the customer and/or partner have employment income?

• Yes, go to Step 2
• No:
• finalising claim in Process Direct, see Table 4, Step 4
• finalising claim in Customer First/Customer Record, see Table 6, Step 3

All ISPs are calculated on a fortnightly arrear’s basis, using a 14-day entitlement calculation:

• Entitlement Period Start Date (EPSD): the date of the first day in a customer’s EP
• Entitlement Period End Date (EPED): the last day of a customer's EP. It cannot be a Saturday or Sunday and is only to be changed in limited circumstances

If one member of the couple is already receiving a social security payment, the claimant’s EP, including the EPSD will automatically align with the existing recipient's EP.

If neither the customer nor the partner are receiving a social security payment, the claimant’s EP starts from the Assessment Date (PNA) of the claim.

When the first EPED of a claim is less than 14 days after the PNA date, Service Officers must code the correct frequency for employment income.

There are several ways to identify the EPED once entitlement is assessed:

• End Date of the Work Bonus assessment period on the Employment Income Assessment – Work Bonus (EIA) Screen
• Reporting Results (RR) screen
• the Centrelink Payments Calendar and the Entitlement Delivery (RAD) and/or Payment Summary (PS) screens

Count the number of days between (and including) the first EPSD and EPED of the claim.

Go to Step 3.

Employment income is assessed once it is paid by an employer to their employee. This is the 'Pay Date' or 'Date Paid' on the customer's payslip.

The customer will need to provide details of all employment income paid from the PNA date up to and including the most recent EPED. If these details are not on the customer’s record, attempt to contact the customer get the details of employment income paid verbally before issuing a request for information (RFI):

• Make sure the customer’s and/or nominee’s contact details are correctly coded before contacting the customer and/or issuing a request for information
• See Calling a customer or returning a customer's call
• Where applicable, send a pre-call SMS
• Make 2 attempts to contact, at separate times on the same day where possible. All attempts made and any information obtained during this contact must be noted in the Progress of claim Note/DOC

If the information cannot be provided verbally, request the information and allow extra days for mail delivery.

Where the request for information (RFI) letter includes a request for the customer to provided payslips from employment, the Payslips – customer – until customer claim is finalised and/or Payslips – partner – until customer claim is finalised document type must also be selected.

The RFI will often place the new claim on hold. If required, manually update the status to On Hold via the Status icon until the customer responds or after the allowed time. The claim can be held to user if it meets Hold to User new claim criteria. See Work Optimiser for staff for more information on holding claims to user.

Once all employment income paid from the PNA date up to and including the most recent EPED have been provided, work out the dates the customer was paid employment income during the EP.

Go to Step 4.

The employment pay period is different to the number of days worked. A customer and/or partner paid fortnightly who works for a single day within that fortnight will have an employment period of 14 days.

• Note the start and end dates of the employment pay period for each date paid
• If the customer was paid employment income for more than one date within the EP, they may need to be combined. See Multiple pays received in a single entitlement period
• Count the number of days between the start and end dates of the employment pay period
• Go to Step 5

Subtract the number of days in employment pay period to assess (Step 4) from the EP (Step 2) and if the length of the Employment Pay Period (Step 4) is:

• longer than the length of the EP, record the Longer than One Period (LOP) frequency
• equal to or shorter than the length of the EP, record the Income for One Period (IOP) frequency

Go to Step 6

To finalise claim in Process Direct:

• Code employment income for the first EP and all EPs that have passed. See Recording and correcting employment income details
• Select Assess
• Go to the ELD screen
• See Table 4 Step 5

To finalise claim in Customer First/Customer Record:

• Code employment income for the first EP and all EPs that have passed. See Recording and correcting employment income details
• Go to the AR screen
• See Table 6 Step 3