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Continuing payment pending review (PPR) 109-04010000

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This document outlines the process for continuing payments to a customer while an adverse decision is under review. This is called payment pending review (PPR).

Quality check or review requested before 15 May 2021

On this Page:

Determining if payment can be continued pending review

Ending a payment pending review (PPR)

Determining if payment can be continued pending review


Table 1

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Step

Action

1

Identifying if PPR may apply

PPR is considered:

  • at the time a customer requests a Subject Matter Expert (SME) quality check
  • when the SME finalises the quality check and the customer requests a review by an Authorised Review Officer (ARO)
  • when a customer requests PPR after lodging an appeal with the Administrative Review Tribunal (ART) first review

If PPR was not applied at those times and should be considered, request action using a Fast Note - select Auto Text, use Appeals > Consider Payment Pending Review – non-DSP > Consider PPR for ARO/ART - non-DSP. Record the relevant information in the body of the Fast Note, including:

  • the decision
  • whether the customer applied for a formal review or an ART review, and
  • the APL number

Use the Service Reason: field to select the correct payment type for which PPR is to be applied. This will make sure the work item created by the Fast Note is sent to the team responsible for the decision under review.

PPR can be applied while the review is in progress but the customer must request PPR within 13 weeks of being notified in writing of the:

  • original decision
  • SME quality check outcome, or
  • ARO decision

PPR cannot apply if:

  • the decision was not to suspend, cancel or reduce a payment
  • the decision did not depend on the exercise of discretion or the holding of an opinion, or
  • it is more than 13 weeks after the decision was made

If the customer requests PPR for these circumstances:

  • create a DOC on the customer’s record to note the customer asked for PPR, and the decision has been made not to apply PPR, explain why
  • issue a Q888 or Q999 letter to notify the customer that a decision has been made not to apply PPR and to advise of their appeal rights. See Resources for example letter text

If PPR is requested for a:

2

Decide if PPR applies

Consider all of the customer’s circumstances when deciding whether to apply PPR. This includes but is not limited to considering if the decision will:

  • create financial hardship for the customer
  • significantly affect the customer or their family in other ways. For example, the customer or a family member has a medical condition and could not afford treatment if payment stopped, or the customer is likely to be evicted if unable to pay rent

For further examples of when PPR may be applied, see the Resources page.

Note: to apply PPR while an ART review is in progress, evidence is required that an ART review has been requested. This will be an ‘ART request for statement’ (ART1REQ) uploaded into document tools and an ART1 request DOC on the customer’s record. If there is no ‘ART request for statement’ or ART1 request DOC, PPR cannot be applied

Considering the customers circumstances, does PPR apply?

  • Yes, go to Step 3
  • No,
    • Advise the customer
    • Create a DOC on the customer’s record stating the customer asked for PPR, that the decision has been made not to apply PPR and explain why
    • Issue a Q888 or Q999 letter to notify the customer that a decision has been made not to apply PPR and include appeal rights. See Resources for example text. Procedure ends here

3

Apply and record the PPR decision and advise the customer

Services Officers and SMEs record the PPR indicator in the APL system when running the Internal Review/Explanation script. If PPR is being applied after the script is run, manually update the PPR field in the APL system record. There are limited payments and reasons for which a PPR indicator can be recorded in the APL system. If a PPR indicator cannot be recorded, this does not mean PPR does not apply.

Note: AROs do not make PPR decisions and cannot record PPR.

  • Take the required action to reverse the decision under review. For example, restore the suspended payment, re-grant the cancelled payment, or increase the rate to the amount previously paid
  • Create a Display On Access (DOA) DOC on the customer’s record and include the following:
    • the decision under review
    • the APL number
    • that PPR is being applied
    • the stage of review (SME quality check, ARO review or ART first review)
    • why PPR is being applied. For example, the reasons why the decision would cause the customer financial hardship
  • Create a future activity or work item to check if the review is complete and to end PPR. Include the keyword PAYPEND
  • Resubmit the activity or work item for a month’s time:
    • If the review is not finalised when the activity or work item falls due, it is to be resubmitted for a further month until the review is finalised
    • If the review is finalised when the activity or work item falls due, see Ending PPR table
  • Advise the customer that PPR will be applied
  • Issue a Q888 or Q999 letter to the customer. See the Resources page for example letter text. Procedure ends here

Ending a payment pending review (PPR)


Table 2

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Step

Action

1

Ending PPR due to a change in circumstances

PPR is ended where an unrelated change in circumstances means the customer no longer faces the same level of financial hardship or a new determination results in lower or no entitlement, regardless of the effect of the decision under review.

  • Take the required action to reapply the decision. End PPR from the date the decision to end is being made (today).
  • DOC the customer’s record to note that PPR is ended and why.
  • Issue a Q888 or Q999 letter to notify the customer that PPR is ended. See the Resources page for example letter text. Procedure ends here

2

Ending PPR for other reasons

If PPR is ended due to:

  • a completed SME quality check, the SME will end PPR if the customer does not request a review of decision
  • a completed ARO review or ART review, the Appeals and Reviews Branch or Litigation Branch will advise to end PPR via a DOC:
    • If the decision is affirmed or varied, the date PPR is ended is the date on which the review outcome is implemented, so long as implementation occurs within 13 weeks after the date the review is completed
    • If the decision is implemented more than 13 weeks after the review is completed, the date PPR is ended is the last day of the 13 week period after the review was completed
  • the customer withdrawing an appeal or review, the date PPR is ended is the date the customer withdraws the appeal or review
  • the ART dismisses the case without a decision (for example, in cases where the customer does not appear at the hearing or cannot be contacted), the date PPR is ended is the date of the dismissal

When Service Officers need to end PPR they must:

  • Implement the review decision
  • DOC the customer’s record to note that PPR is ended
  • Issue a Q888 or Q999 letter to notify the customer that PPR is ended. See the Resources page for example letter text