Rejecting a Mobility Allowance (MOB) claim 008-05020030

When making an unfavourable decision, the Decision Maker (DM) must give the customer:

• an explanation of the decision
• an opportunity to provide further information, or evidence relevant to the decision, and
• their review and appeal rights, see Request for an explanation, quality check or review

Contact is not needed for some streamline reject decisions if the customer is not vulnerable or at risk, or prior contact has been made to request required information verbally or in writing. Go to Step 5.

Otherwise, make a genuine attempt to contact the customer. If the customer is subscribed, issue a pre-call notification (SMS only) between 8 am to 8 pm using the customer's local time to let them know a Service Officer will call them today from a private number. See Centrelink letters online and Electronic Messaging.

If the customer wants to withdraw their claim before it is processed, see Withdrawal of claims.

The customer's residence qualification will be automatically assessed as long as the residence information is correctly recorded.

If the residence information is already recorded from a previous claim, no further information will be necessary. If residence information is incomplete, the datalink with the Department of Home Affairs will need to be activated to obtain the necessary information. For assistance, see Activating the Department of Home Affairs datalink and contingency procedures if datalink is unavailable.

Residence information must still be recorded if the rejection is for any other reason. If residence details are not recorded, the system will override any other rejection and the claim will reject for a residence related reason.

If the customer has passed away, they may still be eligible for payment from date of claim to date of death.

Has the customer died and was eligible for MOB payment from the date of claim to the date of death?

• Yes:
• The customer remains eligible for any arrears which, once calculated, are paid to their estate
• Finalise MOB new claim. See Processing claims for Mobility Allowance (MOB) in Process Direct
• Process death action
• Procedure ends here
• No, the claim will be rejected. Go to Step 4

Streamline rejection

Full claim coding is not required if the claim is to be streamline rejected. Streamline rejection codes for Mobility Allowance are:

• FRC - Failed to reply to correspondence
• IMP - Imprisoned
• RCO - Not a charitable organisation
• RDE - Client is deceased
• RGE - Not gainfully employed
• RNV - Non-vocational training

Automatic rejection

Most claims will automatically reject when all details from the claim are coded, and show that the customer is not eligible. An automatic rejection ensures:

• the correct letter is issued
• all claim details are available should the customer ask for a review

Manual rejections

In some cases a claim will need to be manually rejected.

For:

• streamline rejections in Process Direct, go to Step 5
• manual rejections in
• Process Direct, go to Step 6
• Customer First, go to Step 7
• automatic rejections, finalise the claim. Go to Step 10

For streamline rejections, any changes to circumstances that may impact a customer's and/or partner's current payments or benefits must be updated as part of the streamline rejection process. The updates must be applied after all actions have been completed on the Benefit Action (BA) screen. This includes updating the relationship status if verified.

From the Transaction Summary (TS) screen

• Select Process
• Use Super Key to go to the Benefit Action (BA) screen
• Select Add New
• On the Create Benefit Action screen:
• Benefit Type Code, Benefit Action and Date of Effect will automatically default
• Select the Streamline Rejection tick box
• Select appropriate Reason code from the drop down box
• Select Save
• Select Assess, this will navigate to the Errors (SWE) screen
• Address all errors
• Select Assess to go to the Entitlement (ELD) screen
• Ensure the correct rejection reason is displaying
• Select Finalise, the Finalisation Note will appear, if extra information is required add this to the Note. For reason FRC, all outstanding documents must be listed
• Select Finish

Procedure ends here.

The customer's record status must be either New Claim (NCL) or Assessed (ASS) for the rejection activity to be accepted.

From the Transaction Summary (TS) screen, select Process.

Make sure all coding is complete for the claim assessment.

Use Super Key to go to the Benefit Action (BA) screen

• Select Add New
• On the Create Benefit Action screen
• Benefit Type Code, Benefit Action and Date of Effect will automatically default
• Select appropriate Reason code from the drop down box
• Select Save
• Select Assess, this will navigate to the Errors screen (SWE) screen
• Address all errors
• Select Assess to go to the Entitlement (ELD) screen
• Ensure the correct rejection reason is displaying
• Select Finalise, the Finalisation Note will appear, add any relevant extra information

Procedure ends here.

Note: the customer's record status must be either New Claim (NCL) or Assessed (ASS) for the rejection activity to be accepted.

To reject the customer's claim for MOB:

• Enter the appropriate system type 'ISS' in the Sys: field. Type 'SVMOB' in the Nxt: field and press [Enter]
• 'S'elect the NCL activity on the Activity List (AL) screen and press [Enter]
• Go to the BA screen
• In the Svc Rsn: field, type 'MOB'
• In the Action: field, type 'REJ'
• In the Reason: field, type
• 'RCO' - if their voluntary work is not for a charitable organisation
• 'RDE' - if the customer died and was not eligible for payment
• 'RNV' - if the training they are undertaking is not vocational
• 'ROT' - Rejected - Other ('ROT') should only be used where there is no other alternative. If it is used, the reasons for the rejection should be clearly recorded on a DOC in the summary line and text
• or see Cancellation, suspension and rejection codes for Mobility Allowance (MOB) including Period of Grace reasons
• In the Effect Date: field, type the rejection date
• Press [Enter]
• Record the details on a DOC. Ensure the DOC sets out the full reason(s) for the rejection of the MOB claim. If rejection reason is FRC or FSD decision DOC must list all documents not provided at the time of rejection
• Finalise the activity via the Assessment Results (AR) screen
• Advise the customer of the outcome

Check if the rejection reason requires a manual letter. A manual letter will be required if a Manual Follow Up (MFU) activity has been created on the Activity List (AL) screen the day after the rejection activity is finalised.

Is there is a MFU activity on the AL screen requiring a manual letter to be sent to customer?

• Yes, go to Step 9
• No, procedure ends here

Send a manual rejection/cancellation/suspension (Q134) letter to the customer, giving the reason(s) for rejecting the claim and advising of the steps in the review and appeals process.

A claim for MOB will automatically reject when the customer does not meet all the eligibility criteria and the MOB new claim is coded as required.

Automatic rejection reasons cannot be entered manually.

See Processing claims for Mobility Allowance (MOB) in Process Direct.

Note: the MOB system will select the first entered reason for rejection in field order. This is not always appropriate when the second entered reason is more significant than the first.