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First contact about a decision and the internal review process 109-03000000

This page contains information to help Service Officers when a customer makes initial contact about a Centrelink decision that has been made.

A separate procedure applies if the customer has an existing request for a Subject Matter Expert (SME) explanation or application for a formal review of the decision.

On this page:

Service Officer contact guide

Customer has further information

Give the customer their internal review options

Customer has lodged an Explanation or formal review of a decision form (SS351 or SY054)

Service Officer contact guide

Table 1

Step	Action
1	Customer contact about a decision Service Officers making an outbound call to a customer to discuss an unfavourable decision about to be made, go to Advising verbally of an unfavourable decision Service Officers taking an inbound call or face-to-face enquiry from a customer, go to Step 2 If the customer has lodged a new Explanation or formal review of a decision (SS351) or ABSTUDY and Assistance for Isolated Children (AIC) Explanation or formal review of a decision (SY054) form or Service Officer has been allocated a form work item, see Table 4
2	Check why the customer has contacted Ask the customer questions to understand their enquiry and identify the decision they are contacting about. If the customer has previously either applied for a formal review of the decision or requested a SME explanation of the decision, see Request for a Subject Matter Expert (SME) explanation or application for a formal review. If the customer is contacting about: an SS351 (Explanation or formal review of a decision) or SY054 (ABSTUDY and Assistance for Isolated Children (AIC) Explanation or formal review of a decision) form that has been lodged, see Table 4 a decision about a debt automatically raised due to corrected or updated earnings for one entitlement period, see Explaining and actioning negative adjustments on a customer’s record a Compliance Intervention Process decision, see Information for Service Delivery and Smart Centres about Compliance Intervention Processes. These include: Earned Income Intervention (EII) Unearned Income Intervention (UII) Study Load Interventions (SLI) Qualification Interventions Relationship Status Interventions (RSI) a decision made under the Targeted Compliance Framework or Job Seeker Compliance Model, see Non-compliance with compulsory requirements - review and appeals a family assistance care decision, see Internal review process for care decisions a family assistance reconciliation decision, see: Enquiries about Family Tax Benefit (FTB) reconciliation or lump sum claim for FTB Customer enquires about Child Care Subsidy (CCS) reconciliation outcome for CCS an Emergency Management payment decision, see Emergency Management – internal review process. This includes: High-Risk Settings Pandemic Payment (HRSPP) Pandemic Leave Disaster Payment (PLDP) COVID-19 Disaster Payment Australian Government Disaster Recovery Payment (ADGRP) Disaster Recovery Allowance (DRA) New Zealand Disaster Recovery Payment (NZ DRP) New Zealand Disaster Recovery Allowance (NZ DRA) a rejected Crisis Payment claim, see Reviewing and reassessing Crisis Payment (CrP) a decision relating to changed, missing or cancelled child care attendance data, go to Step 3 For all other decisions, go to Step 4.
3	Decision relates to changed, missing or cancelled child care attendance data This is data that a child care provider has given to the Department of Education. If it relates to legacy Child Care Benefit (CCB) or Child Care Rebate (CCR): If the customer has not been able to resolve the issue with the child care provider, refer to Customer queries CCMS information If Families and Child Care - Business Process and Design Branch has finalised a referred enquiry, and the customer would like to discuss the decision, go to Step 4 If it relates to Child Care Subsidy (CCS) or Additional Child Care Subsidy (ACCS), see CCS and ACCS - Viewing attendance reports If the customer is enquiring about a different child care decision, go to Step 4.
4	Discuss the decision Review the customer’s record to get a clear understanding of the decision and why it was made. Discuss and explain the decision and answer any questions the customer has. Make every attempt to resolve the customer's enquiry, applying First Contact Resolution principles. Where a Service Officer does not have the required skills, follow approved business process to transfer the call to a staff member with the required skills. See Resources for examples of referrals to relevant business areas. Check for: coding errors, for example incorrect income and asset figures or incorrect date of effect applied to the decision calculation errors when the customer’s enquiry is about a debt incorrect or out of date information the customer can confirm, example earnings details carried over from a previous claim incorrectly applied policy or procedures Reassess the decision to fix errors. If this is not done, there can be adverse date of effect issues for the customer if the decision is later changed under the internal review process. Note: if the decision relates to a real estate valuation, see Reassessing the value of real estate and other assets. A customer can request another valuation, unless the current valuation source is Full Onsite Valuation (ONS). If the valuation source is not ONS discuss the option to have a full onsite valuation completed. After discussing the decision and fixing any errors, invite the customer to provide more information: if the customer has given or wants to give more information about the decision, go to Table 2 if the customer has not given or does not want to give more information about the decision, give the customer their internal review options. Go to Table 3 if the customer would like to make a complaint, see Managing complaints and feedback

Customer has further information

Table 2

Step	Action
1	Customer has further information The customer has given or wants to give further information relating to a decision. If they have provided information not yet actioned, go to Step 2 If they have information to provide, go to Step 3
2	Customer has provided further information related to the decision, not yet actioned If the information relates to: a claim rejected for the following reasons, see Request to reassess a rejected claim: FRC (failed to reply to correspondence FSD (failed to supply documents) POI (proof of identity) IME (insufficient / no medical evidence for DSP) FRP (failed to report) Procedure ends here any other decision: reassess the decision by taking into account the new information, following First contact resolution principles. Note: if this is not done, there can be adverse date of effect issues for the customer if the decision is later changed under the internal review process explain the reassessment outcome to the customer document the reassessment and details of the customer discussion on a DOC or Note on the customer's record give the customer their internal review options. Go to Table 3
3	Customer has further documents or information to provide Tell the customer: You should lodge <further information> as soon as you can, preferably within 7 days. You can upload documents using our online services. 'A Service Officer will consider the information and advise you of the outcome. However, there are other options available if you don’t understand or don’t agree with the decision. Give the customer their internal review options. See Table 3.

Give the customer their internal review options

Table 3

Step	Action
1	Give the customer their internal review options Staff using Services Australia Workspace must use the automated message to give the customer their internal review options, unless it is inappropriate to do so. If appropriate, go to Step 2. There may be circumstances where playing the automated message is not appropriate, for example when using an interpreter. In such cases, staff must read the Internal Review Options message to the customer. Staff must also read the relevant internal review timeframes to the customer. Staff who are not using Services Australia Workspace should give the information to the customer themselves. Go to Step 3.
2	Automated message Tell the customer: A recorded message will now be played which will provide you with information about your internal review options. It won’t take very long and I’ll be listening with you. Locate and play the automated message: In Services Australia Workspace, select the cassette icon. The automated messages list will appear Select the automated message, then select play. The message is also available in: Arabic Cantonese Dari Mandarin Vietnamese Note: when the automated message is finished, the pop-up box will close automatically. Tell the customer the timeframes for applying for a formal review that apply to their payment type. For: ABSTUDY or Assistance for Isolated Children, go to Step 4 Child Care Subsidy (including Additional Child Care Subsidy), go to Step 5 Debts, go to Step 6 Family Tax Benefit, go to Step 7 AGDRP, NZ DRP, DRA or NZ DRA, go to Step 8 Paid Parental Leave (including Dad and Partner Pay), go to Step 9 Tertiary Access Payment (TAP), go to Step 10 Generic (for other decisions not listed), go to Step 11
3	Internal review options message Tell the customer: If you do not understand, or disagree with a decision we have made, there are two options available to you. One option is to ask for an explanation of the decision. An experienced staff member will contact you to explain the decision, answer your questions, and correct any errors if needed. This usually takes around 14 days. You can still request a formal review after receiving an explanation. Another option is to apply for a formal review of the decision. A Formal Review is completed by an Authorised Review Officer, an independent officer within Services Australia who was not involved in the original decision. We aim to finish a formal review within 49 days from the date you applied, however, we currently have a high number of formal review applications in our queue. This means it may take longer than usual to get to your application. There are timeframes to apply for a formal review of decisions for some payment types. After this message, the timeframes that apply to your payment type will be explained. Tell the customer the timeframes for applying for a formal review that apply to their payment type. For: ABSTUDY or Assistance for Isolated Children, go to Step 4 Child Care Subsidy (including Additional Child Care Subsidy), go to Step 5 Debts, go to Step 6 Family Tax Benefit, go to Step 7 AGDRP, NZ DRP, DRA or NZ DRA, go to Step 8 Paid Parental Leave (including Dad and Partner Pay), go to Step 9 Tertiary Access Payment (TAP), go to Step 10 Generic (for other decisions not listed), go to Step 11
4	ABSTUDY or Assistance for Isolated Children timeframes Tell the customer: You can apply for a formal review of a decision about ABSTUDY or Assistance for Isolated Children at any time. If you would like to provide further information about the decision we have made, you can upload documents via your Express Plus mobile app or Centrelink online account. You can let me know your preferred option now, or you can ask for more information about your options. Does the customer want more information about their internal review options? Yes, go to Step 12 No, go to Step 13
5	Child Care Subsidy (including Additional Child Care Subsidy) timeframes Tell the customer: You must apply for a formal review of a Child Care Subsidy or Additional Child Care Subsidy decision within 90 days from the date we tell you about the decision. If you would like to provide further information about the decision we have made, you can upload documents via your Express Plus mobile app or Centrelink online account. You can let me know your preferred option now, or you can ask for more information about your options. Does the customer want more information about their internal review options? Yes, go to Step 12 No, go to Step 13
6	Debts timeframes Tell the customer: You can apply for a formal review of a debt decision at any time. This does not apply to Tertiary Access Payment debts. For Tertiary Access Payment debts, you must apply for a formal review within 90 days from when we tell you about the decision. We can pause debt repayments until your request for an explanation or review is complete. To pause your debt repayments please advise me now. If you would like to provide further information about the decision we have made, you can upload documents via your Express Plus mobile app or Centrelink online account. You can let me know your preferred option now, or you can ask for more information about your options. Does the customer want more information about their internal review options? Yes, go to Step 12 No, go to Step 13
7	Family Tax Benefit timeframes Tell the customer: You should apply for a formal review of a Family Tax Benefit decision within 52 weeks from the date we tell you about the decision. If you are also a Child Support customer and the decision affects your child support assessment, you should apply for a formal review within 28 days from the date we tell you about the decision. If you would like to provide further information about the decision we have made, you can upload documents via your Express Plus mobile app or Centrelink online account. You can let me know your preferred option now, or you can ask for more information about your options. Does the customer want more information about their internal review options? Yes, go to Step 12 No, go to Step 13
8	AGDRP, NZ DRP, DRA or NZ DRA timeframes Tell the customer: AGDRP or NZ DRP You can apply for a formal review at any time. DRA or NZ DRA If you want to ask for a formal review, you should apply as soon as possible. If the application is delayed and we can change the decision, we may not be able to pay you the 13 week entitlement in full, or any back payment. Tell the customer: If you would like to provide further information about the decision we have made, you can upload documents via your Express Plus mobile app or Centrelink online account. You can let me know your preferred option now, or you can ask for more information about your options. Does the customer want more information about their internal review options? Yes, go to Step 12 No, go to Step 13
9	Paid Parental Leave (including Dad and Partner Pay) timeframes Tell the customer: You should apply for a formal review of a Parental Leave Pay or Dad and Partner Pay decision within 28 days after the day we make the decision. You cannot apply for a review of a decision about who is responsible to pay your Parental Leave Pay. If you would like to provide further information about the decision we have made, you can upload documents via your Express Plus mobile app or Centrelink online account. You can let me know your preferred option now, or you can ask for more information about your options. Does the customer want more information about their internal review options? Yes, go to Step 12 No, go to Step 13
10	Tertiary Access Payment timeframes Tell the customer: You must apply for a formal review of a Tertiary Access Payment decision within 90 days from when we tell you about the decision. If you would like to provide further information about the decision we have made, you can upload documents via your Express Plus mobile app or Centrelink online account. You can let me know your preferred option now, or you can ask for more information about your options. Does the customer want more information about their internal review options? Yes, go to Step 12 No, go to Step 13
11	Generic timeframes Tell the customer: You should apply for a formal review within 13 weeks from the date we tell you about the decision. You can still apply for a formal review after 13 weeks, but if we can change the decision, you may only get your entitlement from the date you applied for a formal review. If you would like to provide further information about the decision, we have made you can upload documents via your Express Plus mobile app or Centrelink online account. You can let me know your preferred option now, or you can ask for more information about your options. Does the customer want more information about their internal review options? Yes, go to Step 12 No, go to Step 13
12	Give the customer more information about their internal review options The customer may want more information about their internal review options. Refer to the internal review message in Step 3 if needed. Further information may include: the customer has the option to request a SME explanation or apply for a formal review the estimated timeframes for expected contact they do not have to choose now, they can contact at another time and request an explanation or apply for a formal review the timeframes to apply for a formal review, see Request for a Subject Matter Expert (SME) explanation or application for a formal review if they choose to request an explanation, they can change their mind and apply for a formal review at any time Go to Step 13.
13	Document the discussion and take further action if needed Customer Service Delivery Group (CSDG) Service Officers (such as Service Centres/Face to Face, Smart Centres Operations) Document the discussion with the customer, run the Internal Review/Explanation script and select Document decision discussion If the customer wants to request an explanation, record the request for an explanation If the customer wants to apply for a formal review, record the application for a formal review Non-CSDG Service Officers (such as Intelligence, Fraud Investigations and Payment Assurance Operations teams) Document the discussion with the customer. Do not select Document decision discussion in the Internal Review/Explanation script If the customer wants to request an explanation, record the request for an explanation If the customer wants to apply for a formal review, record the application for a formal review Procedure ends here.

Customer has lodged an Explanation or formal review of a decision form (SS351 or SY054)

Table 4

Step	Action
1	Customer has lodged an explanation or formal review of a decision form To request a SME explanation or apply for a formal review of a decision, a customer may upload or lodge an Explanation or formal review of a decision (SS351) form, or ABSTUDY and Assistance for isolated Children (AIC) Explanation or formal review of decision (SY054) form If the customer is contacting about a SS351/SY054 form they have already lodged, go to Step 2 If the customer is lodging a new SS351/SY054 form or a Service Officer has been allocated a form work item, see Request for a Subject Matter Expert (SME) explanation or application for a formal review
2	Check if review form has been processed Check the customer’s record to see if the request for a SME explanation or application for formal review of the decision has been recorded. Check the: DL screen for DOCs relating to the request or application ACL screen in the Appeal (APL) system to see if there is an APL record for the explanation or formal review If the form has been processed and the request for a SME explanation or application for a formal review has been recorded: if the explanation of decision/formal review is in progress, tell the customer that their request/application has been received and will be allocated to an experienced officer/Authorised Review Officer to be completed an offer must be made to pause recovery of any debt/s being reviewed until the explanation or review is complete this offer must be documented on the customer’s record if the pause on recovery is accepted, see Table 1 in Recovery of debts pending reassessment, explanation or review of decision the customer may decline the offer and continue making repayments if the explanation of decision/formal review has been finalised, tell the customer about the outcome of their request/application based on the information recorded on the customer’s record If the form has not been processed, record the customer’s request for an explanation or application for a formal review. See Request for a Subject Matter Expert (SME) explanation or application for a formal review. Procedure ends here.