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.

Note: while reviewing the claim, take notes about more information or clarification required from the customer. Refer to the notes when contacting the customer to request more information.

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

• Yes, see Table 2 > Step 1
• 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 details.

If the customer's benefit status line shows the customer's benefit status as AGE/CUR the claim assessment has already been completed:

• update the claim status to Not Required
• procedure ends here

If the customer is in receipt of Farm household allowance (FHA/CUR) contact the customer’s Farm Household Allowance Case Officer (FHCO). The FHCO may contact the customer to discuss their circumstances.

To contact the customer’s FHCO:

• In Process Direct, go to the FHA Farm Customer Summary (FCS) screen
• Get the FHCO name
• Contact the FHCO directly via MS Teams or email

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

• Select and to view the Claim Summary and supporting documents 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

For paper claims check the date the document was scanned.

Check customer tasks, relevant DOCs (including the Progress of Claim DOC) and Notes by selecting .

Note: check the partners record if applicable. If the partner has also lodged a claim, review the claim details for both the customer and partner to complete decision making.

Go to Step 4.

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

• Yes, if the Service Officer is:
• not trained to assess Pension Bonus, go to Step 5
• trained to assess Pension Bonus, go to Step 6
• No, go to Step 7

To unassign the work item and recategorise for allocation to a Pension Bonus Scheme (PBS) trained Service Officer in:

• 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
• Select Submit

See Work Optimiser for staff.

Procedure ends here.

For more details, see Initial contact by customers claiming Pension Bonus Payment (PBP) and Qualification and assessment of Pension Bonus Payment (PBP).

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

Not claiming Pension Bonus but registered

• If customer is registered for Pension Bonus and 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 they do want to apply for the Pension Bonus
• If they do not wish to claim PBP and no longer satisfy the work test, refer to Cancellation of membership for Pension Bonus Scheme (PBS)
• Document any details obtained or requested verbally. See Request information verbally
• If the customer has not yet spoken with a Financial Investment Service (FIS) Officer, refer the customer to a FIS Officer

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.

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

Go to Step 7.

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.

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 details
• 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. Service Officers must allocate the claim to themselves
• When a claim is started through ACC and submitted on a later date, the Date Submitted will default to the original Date of Receipt (DOR) entered
• Service Officers must:
• see Table 2 > Step 11 in Viewing and processing online and Assisted Customer Claim (ACC)
• check the date of claim submission, and if necessary
• correct the DOR and annotate the Progress of Claim DOC
  Note: if an ACC claim has been submitted by a staff logon, always check the correct Date of Receipt has been applied
• Go to Step 9

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 show 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 show within the text
• Go to Step 9

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 details apart from the CRN, personal details, and receipt date. Add the claim details 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. Service Officers must allocate the claim to themselves
• Go to Step 8

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.

Common screens that may need updating via SWE:

• personal details such as name, address, phone number (CPDS, ADS, TDS)
• interpreter details 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

Note: Service Officers must correct customer contact details before contacting the customer for more details.

Go to Step 9.

Check the Assessment Date (start date) appears on the Pensions Assessment (PNA) screen. The PNA may auto populate as the Date of Receipt (DOR) and need to be changed to the correct assessment date. See:

• Start Day
• Backdating provisions for claim lodgement
• Transfer to Age Pension

If the customer has indicated in the claim that they are vulnerable or 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

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.

Contact dates can be viewed on the Pre-Claim Vulnerable Circumstance (PRECLM) screen. See Intent to claim and vulnerable customers for background and processing details.

Note: take a note of the claim start date, as this will be the claims Date of Event (DOE).

Go to Step 10.

Service Officers must check the claim details against the existing customer details.

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

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.

Note: Service Officers must action these changes in a separate activity outside of the NCL activity.

If changes to the customer or their partner’s nominee arrangement are required, see Adding or rejecting a nominee request or Cancelling a nominee arrangement.

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 details

Go to Step 11.

This is a Family and Domestic Violence interaction point. See Separating safely - protecting personal details.

These details must be reviewed/updated before processing the claim.

On the TS screen:

• Link Summary (LS) shows linked records, such as nominees and the customer’s partner (including any Relationship Qualifier Code)
• The Marital Status (MS) table on the LS shows the customer's relationship details
• If MS 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 details provided by the customer in their claim
• 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
• Take care when recording a relationship qualifier code. Service Officers must record the correct code based on the customer's current circumstances. See Table 3 on the Resources page in Assessment of relationship status - processes, roles and responsibilities
• For help with coding, see Process Direct navigation, common screens and functions

If a customer advises the death of their partner occurred before the date of the claim and the records are linked, complete the death action. See Notification of death.

Note: take note if a Member of a Couple (MOCA) or Separated Under One Roof (SUOR) assessment is required.

Does the customer have a partner?

• Yes, go to Step 12
• No, go to Step 14

The Privacy Act 1988 regulates how Services Australia collects information about a claimant (or their partner). When a customer advises they are partnered, the relationship status must be confirmed with both parties.

Partner confirmation can be completed online using a Temporary Access Code (TAC).

If the customer's partner has used the TAC this will show as a digital image classified as DMODP and can be viewed from the Claim Overview full screen view. See Viewing Centrelink customers' digital images.

There may be circumstances where partner confirmation is not needed, including where an Age Pension combined partner claim has been lodged.

See, Confirming a partnered relationship.

Note: if a DMODP has not been provided and is required for the claim, take a note that partner confirmation is required (verbally or Partner details (Mod P) form).

Go to Step 13

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 14
• 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, create a manual Q164 (request for customer to contact) 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
• Go to Step 14

A customer qualifies for Age Pension if they have reached Age Pension age and they satisfy the residence requirements for Age Pension.

See Qualification for Age Pension and Early claims.

Note: take note if the start date should be adjusted or if more information is required to determine the customers residency status.

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

• Yes, go to Step 15
• 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, go to Step 16
• 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
• Check if an Identity Review has been completed as part of an Alternative Identity assessment
• Code details of identity documents uploaded once linkage has been completed. See Identity Confirmation and Coding identity documents
• If the customer is not able to confirm or establish their identity and cannot achieve a Confirmed Identity status, consider if exceptional circumstances apply and determine if there is a valid reason to complete an Alternative Identity assessment by phone
  Note: for customers unable to provide a Commencement of Identity (CoI) document, consider using agency resources to verify birth or arrival on behalf of the customer. See Commencement of Identity
• Close the Customer Summary Window and 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.

See Verifying the date of birth or age of a customer or child.

Take note if more Identity documents are required. These can be requested along with other information required.

Go to Step 16.

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

The PDI screen contains details about 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 there is more than one date of event, select Add to create more rows
• Change provisional details by coding over the details, or delete

See Assessing Age Pension (Blind) claims.

Go to Table 2.

An assessment must be finalised before it can be determined if more information is required for the claim. That is, if the customer's responses within the claim indicate they are:

• not in a relationship, but may be living with another person. A MoC assessment may be required
• separated but still living with their previous partner. A Separated under one roof (SUOR) assessment may be required

Note: the outcome of the MoC or SUOR assessment:

• will determine the relationship status, and
• is required before determining if more documents are required for the claim assessment

Is a MOCA assessment required?

• Yes,
• see Confirming the need for a Member of a Couple (MoC) assessment
• procedure ends here until MOCA completed
• No, go to Step 2

Customer is claiming Pension Bonus Scheme (PDB/REG)

Service Officers must:

• offer Pension Bonus Scheme (PBS) registered customers FIS Officer contact, and
• DOC their response

See Qualification and assessment of Pension Bonus Payment (PBP)

Customer requests Superannuation exemption

• All customers over Age Pension age and claims to be unable to access their superannuation, regardless of their employment status, may submit an application for an exemption to be considered
• If a customer either mentions or requests an exemption for a superannuation investment, see Exempting superannuation investments

See Financial Information Service (FIS) about:

• other reasons to refer a customer, and
• how to refer to a FIS Officer

Go to Step 3.

To stream the claim for Age Pension and determine if more information is required before the claim assessment:

• Review the claim information and take notes (that is, in OneNote/Word document) of income and assets declared by the customer
• Review streaming notes taken in Table 1
• Review evidence provided:
• supporting documents
• information from previous Service Officers in DOCs (including the Progress of Claim DOC)
• information identified on the partners record (that is, in DOCs and scans)
• Determine if more information is required to support the claim assessment

For more details about making accurate decisions, see Table 1 in Recording reasons for decisions.

Go to Step 4

• Determine if supporting documentation/evidence provided is acceptable and/or if more details should be requested. See Documents required for Centrelink new claims for help making this decision
• A new claim under the income and assets tests must be complete with all required documents supplied except where more documents will not change the outcome of the claim
• If more information is required for a specialist referral, Service Officers must request, and the customer must return before referral to the specialist team

Service Officers must not make duplicate requests for information for a claim.

See Rejecting a claim for Age Pension, if the customer:

• has provided inappropriate or irrelevant documentation to allow the submission of their online claim, or
• fails to respond to a request for information within the time allowed

Note:

• if employment income does not meet either the 1WE or 2WE exception or the Pension Monthly Exception Rule the income is variable employment income
• if no more information is required, except for payslips for variable employment income, no more information is required at this stage

Is more information required?

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

• Before issuing a request for information, Service Officers must attempt to contact the customer to explain the request and get details verbally if possible
• Note all attempts made and all details 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 details.
  Note: existing customer details may have changed, check the claim for current details

For online claims:

• where details have 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 different 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 detail 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 different times on the same day where possible
• If the details 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 different times on the same day where possible
• if the details 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 with relationship management, if it meets Hold to User new claim criteria. For more details on holding claims to user and with relationship management see Work Optimiser for staff.

If:

• a referral to any of the following required, go to Step 6:
• Complex Assessment Officer (CAO)
• Compensation Clearance
• International Services (CIS) for foreign pension coding, or
• request for a valuation
• no referral is required, go to Step 7

Complex Assessment Officer (CAO) referral

See Identifying and making suitable referrals to the Complex Assessment Officer (CAO).

Compensation clearance

See Coding Compensation and damages (Mod C) to request a clearance.

Foreign pension coding

• See Table 3 in Foreign Pension coding
• Do not refer to CIS for an International Agreement country assessment. If the customer lived or is in an Agreement country or an E510RS message 'Assessment under agreement country required before rejecting NSR' , see Table 1 > Step 14
• Do not hold a claim for Age Pension due to the customer claiming a Comparable Foreign Payment (CFP). See Foreign pensions

Valuation

• If the claim requires a property valuation Service Officers must process outside Process Direct. To request the valuation:
• apply the Handover function, and
• see Valuation of real estate and other assets
• If non-property assets require valuation, see Valuation of real estate and other assets

Some referrals automatically change the new claim status to On Hold, and a DOC records with the 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 complete.

Is a referral, clearance or valuation required before the claim assessment?

• Yes,
• make relevant referrals/requests
• go to Step 7
• No, go to Step 8

The Age Pension Progress of Claim (POC) DOC is the central point of all information relevant to the claim assessment.

Service Officers must update the POC DOC with any information relevant to the claim assessment if the claim cannot be finalised on the day of allocation.

Annotate the POC DOC with details about:

• Information requested and the reason/s why
• Any referrals, clearances or valuations made
• Any information obtained verbally from the customer that is applicable to the assessment of the claim
• Any contact made by the customer / their nominee and what was discussed
• Details of any determinations already made (i.e. Start Date is not the same date as the claims DOR, Alternative Identity assessment)

Make sure the claim has been held for an appropriate time. That is, allow extra time for mail delivery or allow for an extended CAO referral period.

Procedure ends here until all information (including completed referrals and clearances) is available and the claim can be assessed.

If a customer is receiving the Age Pension as a Home Equity Access Scheme (HEAS) loan-only payment (identified by a benefit status of AGE/CZR-PLS) a referral to the HEAS team is required.

Does the benefit status line show AGE-CUR-PLS?

• Yes, staff must:
• update Income and Asset details provided from claim via a change of circumstances (CoC) transaction. See Coding income and assets for Centrelink payments and services for help
• send a Fast Note to the HEAS National team - Complex Assessment Officers (CAO) to advise that a HEAS only customer has claimed a pension. Use Fast Note - select Auto Text, use Complex Assessment > Request for CAO action > CAO Home Equity Access Scheme
• procedure ends here
• No, for claims:
• processed in Process Direct, go to Table 3
• in Customer First or Customer Record, go to Table 4

Select Process.

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

• Select messages to view/update the relevant details. An error or warning will show if details have not loaded correctly from the online claim or ACC
• The Task Selector will show 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 details have 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. If there is no entry with Service Reason Code AGE, create an entry from the claim start date.

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 details.

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

Go to Step 2.

The Pensions Assessment (PNA) screen shows 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.

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

• A customer's start date may be backdated to an earlier day than the day on which they lodged a completed claim if the person is qualified and the claim is made:
• after a partner's claim
• after childbirth
• by an incapacitated customer
• after the death of a partner
• when a contact has indicated an intention to claim for a customer experiencing a vulnerable circumstance
• A customer’s start date may be after the date they lodged a completed claim if the person is qualified and/or payable within 13 weeks of the original claim date. See Early claims
• If an Age Pension claim is lodged after becoming qualified for Age Pension and the transfer provisions apply, the date of effect may be backdated
• 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.

Go to Step 3.

See:

• Pensions income and assets tests, and
• Rates and Thresholds index:
• Pension Income Free Area and disqualifying limits, and
• Pension Asset Free Area and disqualifying limits

After review, is the claim likely to reject due to either assets or income (not including variable employment income) being above the relevant disqualifying limit?

• Yes, go to Step 6
• No, go to Step 4

If the customer (or partner) has ongoing:

• employment income they must report every 2 weeks, unless they meet a continuous income exception
• income and they are required to report, their employment income is considered variable. That is, even where they are paid the same amount of employment income each pay period

Single Touch Payroll (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 the Online Claims and Assisted Customer Claims (ACC). See Single Touch Payroll (STP) in Centrelink claims.

Customers are automatically placed on reporting where employment income is declared within an Online or ACC, or where STP data is present. See Reporting screens.

Is the customer required to report?

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

A claim with variable employment income:

• must not be granted before the first Entitlement Period End Date (EPED), and
• must have all employment income for outstanding entitlement periods assessed

If the Entitlement Delivery (RAD) screen does not have a provisional EPED code in the claim, select Assess to determine the first entitlement period end date.

If the claim cannot be finalised, cancel the AGE/NCL activity on the AL screen in Process Direct.

Where a combined online claim with variable employment income has been lodged, the claimants have different start dates. The claim must be held at the last start date to make sure both customers payability can be determined at date of qualification.

Has the first EPED of the claim period passed?

• Yes,
• see Table 5 and record employment income details
• once employment income is coded, go to Step 6
• No, Hold claim:
• add the keyword: URGISP for priority allocation when due, see Process Direct navigation, common screens and functions
• update the Progress of claim Note/DOC with the hold reason
• hold the claim with reason Customer to Provide Information until the first EPED, or 14 days after the Pensions Assessment (PNA) date if the EPED is unknown
• procedure ends here until due date

For:

• recording details, see Coding income and assets for Centrelink payments and services. Employment income is coded in later steps.
• details about the assessment, see:
• Assessment of assets for Centrelink payments
• Assessment of income for Centrelink payments
• Assessing and coding real estate details
• Foreign income and assets
• 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

When a CAO assessment has been completed, check the CAO assessment DOC for any actions that Service Officers must complete.

Once all income and asset are coded, select Assess and go to Step 7.

After saving updates, return to the Errors (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 select Assess.

If there are any further errors, they will show on the SWE screen. For help, see Using Digital Assistant Roxy in Process Direct.

If the customer has declared DVA income or a DVA error and/or warning is presented, see Payments from the Department of Veterans' Affairs (DVA) and referrals to the DVA Clearance Team to get a DVA clearance before assessing the claim.

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

The ELD screen shows the outcome of the claim and payment dates. Do not finalised the claim.

Note: if an E510RS message Assessment under agreement required before rejecting NSR shows, go to Table 1 > Step 14.

Once all errors and, if required, a DVA clearance has been obtained, go to Step 8.

Sometimes a claim activity must 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.

See Using Digital Assistance Roxy in Process Direct.

Is a handover to Customer First or Customer Record required?

• Yes,
• see Table 5 in Process Direct navigation, common screens and functions
• once handover is complete, go to Table 4
• No, go to step 9

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, 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, go to Step 10
• No, go to Step 12

If a change of circumstances with the customers income and/or assets occurred within 13 weeks of the date of claim lodgement, and the customer will become payable:

• adjust the start date of a claim, and
• grant the claim

Note: if the claim is rejecting due to residency, see Table 1 > Step 14.

Will the claim be rejected?

• Yes, reject the claim. See Rejecting a claim for Age Pension
• No, go to Step 11

If the change of circumstances has occurred within 13 weeks of claim lodgement and the change is:

• due to a reduction or cessation of employment income:
• change the Assessment Date on the PNA screen to the first Entitlement Period Start Date (EPSD) in which the customer is payable
• go to Step 12
• not due to a reduction or cessation of employment income:
• change the Assessment Date on the PNA screen to the date the change of circumstances is due to occur
• go to Step 12

If the change of circumstances is due to occur within 13 weeks of claim lodgement and the change is:

• due to a reduction or cessation of employment income:
• add keyword URGISP for priority allocation when due, see Process Direct navigation, common screens and functions
• Hold the claim for the reason Customer to Provide Information to the first Entitlement Period Start Date (EPSD) in which the customer is payable
• procedure ends here until due date
• not due to a reduction or cessation of employment income:
• add keyword URGISP for priority allocation when due, see Process Direct navigation, common screens and functions
• Hold the claim for the reason Customer to Provide Information until the date the change of circumstance is due to occur
• procedure ends here until due date

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 the 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 before 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.

Does the claim have variable employment income?

• Yes, and:
• Employment income has not yet been assessed and coded for the claim, go to Step 5
• Employment income has been assessed and coded for the claim, go to Step 13
• No, go to Step 13

• 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:
• see 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 show, 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 show
• Select OK
• If a checklist of scans shows, 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. See Reviewing and reassessing Crisis Payment (CrP).

If the customer is deceased, go to Step 14. Otherwise procedure ends here.

If the customer is deceased, issue a manual grant letter (Q999). Issue the grant letter 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.

Go to the activity list (AL) screen.

Select 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 show ‘Identity Confirmed’ for Service Reason Code AGE, otherwise refer to the Identity Confirmation process.

Once contact details are updated, go to Step 3.

The Pensions Assessment (PNA) screen shows the Start 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.

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

• A customer's start date may be backdated to an earlier day than the day on which they lodged a completed claim if the person is qualified and the claim is made:
• after a partner's claim
• after childbirth
• by an incapacitated customer
• after the death of a partner
• when a contact has indicated an intention to claim for a customer experiencing a vulnerable circumstance
• A customer’s start date may be after the date they lodged a completed claim if the person is qualified and/or payable within 13 weeks of the original claim date. See Early claims
• If an Age Pension claim is lodged after becoming qualified for Age Pension and the transfer provisions apply, the date of effect may be backdated
• 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.

Go to Step 4.

See:

• Pensions income and assets tests, and
• Rates and Thresholds index:
• Pension Income Free Area and disqualifying limits, and
• Pension Asset Free Area and disqualifying limits

Is the claim likely to reject due to either assets or income (not including variable employment income) being above the relevant disqualifying limit?

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

If the customer (or partner) has ongoing:

• employment income they must report every 2 weeks, unless they meet a continuous income exception
• income and they are required to report, their employment income is considered variable. That is, even where they are paid the same amount of employment income each pay period

Single Touch Payroll (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 the Online Claims and Assisted Customer Claims (ACC). See Single Touch Payroll (STP) in Centrelink claims.

Customers are automatically placed on reporting where employment income is declared within an Online or ACC, or where STP data is present. See Reporting screens.

Is the customer required to report?

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

A claim with variable employment income:

• must not be granted before the first Entitlement Period End Date (EPED), and
• must have all employment income for outstanding entitlement periods assessed

If the Entitlement Delivery (RAD) screen does not have a provisional EPED code in the claim, select Assess to determine the first entitlement period end date.

If the claim cannot be finalised, cancel the AGE/NCL activity on the AL screen in Process Direct.

Where a combined online claim with variable employment income has been lodged, the claimants have different start dates. The claim must be held at the last start date to make sure both customers payability can be determined at date of qualification.

Has the first EPED of the claim period passed?

• Yes,
• see Table 5 and record employment income details
• once employment income is coded, go to Step 7
• 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 with reason Customer to Provide Information until the first EPED, or 14 days after the Pensions Assessment (PNA) date if the EPED is unknown (that is, Early claims. This is when employment income details for the first entitlement period can be assessed
• procedure ends here until due date

On the Pension Task Selector (PTS) screen, select any other relevant screens that have not already been preselected.

For recording details, see Coding income and assets for Centrelink payments and services. Employment income is coded in later steps.

• details about the assessment, see:
• Assessment of assets for Centrelink payments
• Assessment of income for Centrelink payments
• Assessing and coding real estate details
• Foreign pension coding
• 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

When a CAO assessment has been completed, check the CAO assessment DOC for any actions that Service Officers must complete.

Once all income and asset are coded, go to Step 8.

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, see Table 1 > Step 14
• Select [Enter] again to go to the AR screen
• Go to Step 9

Check outcome of claim on the AR 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, 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, go to Step 10
• No, go to Step 12

If a change of circumstances with the customers income and/or assets occurred within 13 weeks of the date of claim lodgement, and the customer will become payable:

• adjust the start date of a claim, and
• grant the claim

If the customer has advised within the claim of a change in circumstances expected on a future date that is within 13 weeks of the date of claim lodgement, put the claim On Hold.

Note: if the claim is rejecting due to residency, see Table 1 > Step 14.

Will the claim be rejected?

• Yes, reject the claim. See Rejecting a claim for Age Pension
• No, go to Step 11

If the change of circumstances has occurred within 13 weeks of claim lodgement and the change is:

• due to a reduction or cessation of employment income:
• change the Assessment Date on the PNA screen to the first Entitlement Period Start Date (EPSD) in which the customer is payable
• go to Step 12
• not due to a reduction or cessation of employment income:
• change the Assessment Date on the PNA screen to the date the change of circumstances is due to occur
• go to Step 12

If the change of circumstances is due to occur within 13 weeks of claim lodgement and the change is:

• due to a reduction or cessation of employment income:
• add keyword URGISP for priority allocation when due
• Hold the claim for the reason Customer to Provide Information to the first Entitlement Period Start Date (EPSD) in which the customer is payable
• procedure ends here until due date
• not due to a reduction or cessation of employment income:
• add keyword URGISP for priority allocation when due
• Hold the claim for the reason Customer to Provide Information until the date the change of circumstance is due to occur
• procedure ends here until due date

Check outcome of claim on the AR 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 the 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 before 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.

Does the claim have variable employment income?

• Yes, and:
• Employment income has not yet been assessed and coded for the claim, go to Step 5
• Employment income has been assessed and coded for the claim, go to Step 13
• No, go to Step 13

• 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:
• see 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 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 AR screen may not indicate that Age Pension has been granted. When the claim 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 Report Results (RR) screen
• 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. Use Fast Note – select Auto Text > use 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 the claim status has not automatically set to Complete, once the 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. See Reviewing and reassessing Crisis Payment (CrP).

If the customer is deceased, go to Step 14. Otherwise procedure ends here.

If the customer is deceased, issue a manual grant letter (Q999). Issue the grant letter 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.

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

Employment income does not include:

• Allowances paid with employment income for work related expenses
• Leave and termination payments paid by an employer on termination of employment. Note: Income Maintenance Period (IMP) may apply if the partner is in receipt of an IMP affected payment

See Assessment of employment income for Centrelink payments.

Refer to Work Bonus for pensioners of Age Pension age for details of how to assess and apply the Work Bonus and balance for pensioners of Age Pension age.

Where evidence of employment income is provided with a new claim, correct income for past periods if required.

Does the customer and/or partner have employment income?

• Yes, go to Step 2
• No:
• see Table 3 > Step 6 to continue processing the claim in Process Direct, and
• see Table 4 > Step 7 to continue processing the claim in Customer First/Customer Record

All income support payments are calculated on a fortnightly arrears basis, using a 14-day entitlement calculation:

• The Entitlement Period Start Date (EPSD) is the date of the first day in a customer’s entitlement period
• The Entitlement Period End Date (EPED) is the last day of a customer's entitlement period. 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 an income support payment, the claimant’s entitlement period will automatically align with the existing recipient's entitlement period.

If neither the customer nor the partner are receiving a social security payment, the claimant’s entitlement period 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:

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

Count the number of days in the entitlement period.

Go to Step 3.

Employment income is assessed once it is paid by an employer to their employee. This is the 'Date Paid' or 'Pay Date' 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 further details of employment income paid are required to complete the claim assessment, attempt to contact the customer to get the details verbally:

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

If the details cannot be provided verbally, request the details and allow extra days for mail delivery. The request for information (RFI) letter must also include the Payslips - customer - until customer claim is finalised for customer and/or partner document type.

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 details on holding claims to user. Procedure ends here.

Once details of employment income paid from the PNA are available, go to Step 4.

The employment pay period is typically the length of the employer’s pay cycle. This may be different to the number of days the customer actually worked.

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

Go to Step 5.

If the length of the Employment Pay Period (Step 4) is:

• equal to or shorter than the length of the entitlement period (Step 2), record the Income for One Period (IOP) frequency
• longer than the length of the entitlement period, record the Longer than One Period (LOP) frequency

See Table 1 on the Resources page in Recording and correcting employment income details for examples and more details.

Go to Step 6.

Code employment income for the first entitlement period and all entitlement periods that have passed. See Recording and correcting employment income details.

Once employment income is coded see:

• Table 3 > Step 6 to continue processing claim in Process Direct, and
• Table 4 > Step 7 to continue processing in Customer First/Customer Record