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Customer compensation and act of grace payments 109-07040000



Case studies - Child Support Program

Table 1

Program

Scenario

Child Support Program

Mr AA considered the agency incorrectly assessed the amount of child support he was required to pay the other parent. Mr AA claimed he was advised a system glitch was responsible for his child support case incorrectly ending and that the agency had failed to investigate the facts of his case for several years.

The compensation investigation determined Mr AA was advised the child support assessment had ended when the child left the care of both parents. The agency later identified Mr AA’s child support assessment ended in error due to the agency incorrectly reflecting the child was no longer in the care of the other parent.

The agency corrected the child’s care record to reflect the child was in the other parent’s 100 percent care at the time when the child support case had been incorrectly ended. Mr AA’s child support assessment was reinstated, and arrears were added to Mr AA’s account.

The compensation investigation determined defective administration occurred when the agency failed to comply with Operational Blueprint procedure, Eligibility Cuba Process Help, and incorrectly ended the child support assessment.

The agency considered there was an unreasonable lapse in complying with existing administrative procedures, but an administrative remedy for the agency's error was provided when the care was corrected and child support assessment reinstated. There was no financial loss, as the entitlement was correctly calculated based on the income and care levels of both parents. No compensation was payable under the Compensation for Detriment Caused by Defective Administration (CDDA) Scheme.

Case studies - Disabilities (DSP)

Table 2

Payment

Scenario

Disability Support Pension (DSP)

Miss U lodged a claim for DSP. The medical reports provided with Miss U’s claim did not confirm either that her medical conditions had been fully treated and stabilised, or that she had any ongoing functional incapacity. Miss U’s DSP claim was rejected based on the available medical evidence.

Over 18 months after her original DSP claim was rejected, Miss U lodged another claim for DSP, which was granted. Miss U considered she provided the same supporting medical evidence for both claims and therefore, the decision to reject her first DSP claim was defective administration. Miss U made a claim for compensation for arrears of DSP from the date of her first claim.

The compensation investigation confirmed Miss U provided additional medical information with her second DSP claim, including reports from treating doctors dated after her original claim.

The compensation investigation determined there was no error in the rejection of Miss U’s first DSP claim, because the supporting medical evidence provided for that claim did not show she met DSP eligibility at the time of claim. The medical reports provided with the second DSP claim reflected further diagnosis, treatment and stabilisation of Miss U medical conditions. Miss U’s Compensation for Detriment Caused by Defective Administration (CDDA) Scheme claim was refused.

Case studies - Families (CCS, DOP, FTB, PPL and PPS)

Table 3

Payment

Scenario

Child Care Subsidy (CCS)

Ms O lodged a claim for CCS and Additional Child Care Subsidy (ACCS) for 2 children, claiming she was in temporary hardship. She provided a protection order application, and a supporting letter from her psychologist advising of her experience with domestic violence.

It was considered Ms O was eligible for CCS at 85% and 95% for her children respectively. Her claim for ACCS was rejected as the event was more than 6 months in the past. A few weeks later, Ms O was advised incorrectly by a Service Officer that her ACCS had been approved.

Ms O received an invoice from her childcare centre, as they had not received confirmation of the grant of ACCS. Ms O contacted the agency and was advised that the ACCS claim had been rejected.

Agency Operational Blueprint procedure, Processing Additional Child Care Subsidy (ACCS) (Temporary Financial Hardship) applications, confirms where a claim has a rejected outcome, a Service Officer must make 1 genuine attempt to contact a customer to advise them about the adverse decision. Ms O’s customer record confirms she was not advised of the rejection of her claim and a letter was not sent.

The compensation investigation determined there had been a specific and unreasonable lapse in complying with existing administrative procedures that would normally have applied to Ms O’s circumstances. However, the decision to reject Ms O’s ACCS claim was not defective as she did not meet the qualifying criteria for the payment. There were no additional losses suffered by Ms O because of being incorrectly advised she would receive the payment. No compensation was offered under the Compensation for Detriment Caused by Defective Administration (CDDA) Scheme, as Ms O had suffered a financial disappointment rather than an actual financial loss in the circumstances.

Child Care Subsidy (CCS) – immunisation requirement

The agency sent Ms P a letter confirming her child needed to be up to date with their immunisations by a confirmed date to remain eligible for CCS. The agency then sent Ms P a reminder letter approximately one month before the deadline. The letter advised that Ms P would need to reclaim CCS if her child was not immunised by the confirmed date.

The immunisation requirements were not met by the required date, and the agency sent Ms P a letter confirming the child was no longer eligible for CCS. Ms P’s child was immunised a few days later. Ms P did not contact the agency to advise of the updated immunisation status, nor did she lodge a new CCS claim.

A few weeks later, the agency sent Ms P a letter advising CCS was only being paid for her second child. A month later, Ms P lodged a new CCS claim for her first child, which was granted.

Ms P claimed CDDA for the loss of CCS for her first child on the basis she was not aware of the cancellation of CCS for the child or of the need to reclaim the payment after it had been cancelled.

The compensation investigation determined no defective administration occurred as the agency had notified Ms P of CCS immunisation requirements before the payment was cancelled. In addition, the agency had also advised Ms P she would need to lodge a new CCS claim if her first child’s immunisation was not up to date by the identified deadline. Ms P’s CDDA claim was refused.

Double Orphan Pension (DOP)

Mr Q contacted the agency about payment options for his orphaned nephew who had come into his care. Mr Q was told to apply for DOP but was advised he needed verification that he had legal guardianship. Mr Q was yet to receive approval from the courts so did not lodge a DOP claim.

Mr Q contacted the agency’s Kinship Team after contacting his Member of Parliament and was advised of his eligibility to DOP and that legal paperwork was not required. Mr Q’s claim was granted approximately 7 months after he first made contact about available payments.

Agency Operational Blueprint procedure, Initial contact by customers claiming Double Orphan Pension (DOP), provides information about claiming DOP and does not advise of the need for any legal documentation.

The compensation investigation determined defective administration occurred when the agency failed to follow existing administrative procedures that would normally have applied to Mr Q’s circumstances and had provided incorrect advice. Compensation was paid to Mr Q under the CDDA Scheme for the missed DOP in the relevant period.

Family Tax Benefit (FTB)

The agency sent Mr N a letter confirming his FTB had been cancelled as his combined family income was too high. Mr N was advised to check his entitlement at the end of the income year. Mr N contacted by mail advising he was awaiting clarification from the ATO about his income for the relevant financial year. A few months later, Mr N sent a letter to the agency requesting an appointment to discuss his FTB entitlement.

Mr N’s FTB reconciled 6 months later. Approximately 12 months later, Mr N sent correspondence to the agency about unpaid FTB for the previous financial year. Mr N called the agency approximately 18 months later and asked if his FTB entitlement could be backdated to the date of cancellation. Mr N referred to the letters he had previously sent to the agency asking for assistance in relation to his FTB entitlement. A request for a review of the original decision to cancel Mr N’s FTB was made.

The compensation investigation determined there was an unreasonable failure by agency officers to take action in response to Mr N’s enquiries and provide correct advice for his circumstances (such as advising him to lodge a new claim). The agency accepted Mr N has suffered a loss of FTB because of defective administration and compensation was paid for the loss of FTB in the relevant period.

Paid Parental Leave (PPL)

Miss R is the birth mother and initial claimant of PPL who has made a claim for compensation on the basis they were given incorrect information by the agency about the time limit for claiming and being paid PPL days.

The compensation investigation identified 2 contacts with Miss R about PPL during which she was advised that it could be claimed and paid if claimed prior to the child turning 2.

The customer claimed several days before the child’s second birthday and PPL is not payable. Claim requirements for the initial claimant includes that PPL must be claimed before the child’s first birthday.

The compensation investigation determined defective administration occurred when the agency failed to provide Miss R with full and correct advice that was tailored to her circumstances. The provision of incorrect information led to the loss of eligibility to PPL for Miss R. Compensation was offered under the CDDA Scheme for the loss of PPL caused by the agency’s defective administration.

Parenting Payment Single (PPS)

Miss U became a full-time carer to 2 children. She attended a service centre to apply for Family Tax Benefit (FTB). Miss U was not aware of what other payments she may be eligible for. Miss U started her FTB claim online and had to return with documentation. A few months later, Miss U attended the service centre to get an interim pension card and was advised that she was not on PPS and the agency should have informed her to make a claim.

Prior to applying for PPS, she was receiving JobSeeker Payment (JSP) and had difficulty participating in job seeking activities due to having care of 2 children. Miss U had missed several appointments with her job provider due to having 2 children in her care. The job provider informed Miss U they could not understand why she was still in their system when she had 2 children in her care. Each time Miss U could not attend an appointment her JSP payment was suspended.

The agency’s administrative procedures for assessing FTB claims require a Service Officer to contact a customer where a potential entitlement to another Centrelink payment is identified (e.g., based on a customer’s level of income). This did not occur in Miss U’s circumstances. When Miss U’s FTB claim was processed it was not identified that she may have been entitled to an income support payment other than JSP.

The compensation investigation determined there was a failure to follow existing administrative procedures that would normally have applied to Miss U’s circumstances when her FTB claim was assessed. Miss U was offered compensation under the CDDA Scheme for the difference between PPS and the JSP she was paid from the date her FTB claim was assessed.

Case studies - General (Portability and RA)

Table 4

Circumstance/ payment

Scenario

Portability

Mr L was receiving Disability Support Pension (DSP) when he contacted to advise of his upcoming overseas travel. The Service Officer ran the portability script and advised Mr L his DSP was payable for the duration of his travel. For this reason, no assessment was made of his future work capacity to confirm portability for more than 28 Days. The agency became aware later that the portability tool was not working correctly.

While in Papua New Guinea, Mr L was unable to access his online account and could not contact the agency when his DSP was suspended and his payments ceased. He had to borrow money as he had no funds while overseas.

The compensation investigation determined defective administration occurred when the error occurred with the portability script and the information it was providing was incorrect, as it was failing to conduct a future work capacity assessment. The agency accepted the defective administration caused the cancellation of DSP. Mr L was offered compensation for the period he was not paid DSP, as he only travelled after being advised his payments would not be affected.

Rent Assistance (RA)

Mr and Mrs M started receiving RA. After 18 months of receiving RA, Mr and Mrs M updated their residential address and weekly rent amount.

Several years later, Mrs M contacted the agency to advise of a change in circumstances and in the phone contact mentioned she was receiving RA and her rent had increased.

Mrs M was incorrectly advised she was receiving the maximum rate of RA and verification would be required. Mrs M considered that there was no reason to provide verification to the agency if she was already receiving maximum rate.

Over 12 months later, Mrs M advised the agency of her new rent amount and her rate of RA increased. The agency identified Mr and Mrs M had not been paid RA correctly for the previous period.

The compensation investigation identified defective administration occurred when updated rent details were provided but not recorded on Mr and Mrs M’s customer records. Their details should have been updated and rent verification requested. This meant the RA amount was incorrectly paid on a lower rent amount. The agency accepted the defective administration caused the underpayment of RA for past periods and compensation was offered under the Compensation for Detriment Caused by Defective Administration (CDDA) Scheme.

Case studies - Medicare

Table 5

Program

Scenario

Medicare

Mrs X was admitted to hospital. Mrs X’s son contacted Medicare to confirm coverage of the associated costs and advised she had been granted a Visa subclass 010 from June 2022.

The Service Officer asked if Mrs X had now been granted Visa subclass 864, as she would then be eligible for Medicare. Her son confirmed she had. Based on this information, the Service Officer advised that she was covered for medical treatment under Medicare. Mrs X was given a full care plan as being a Medicare entitled patient.

Medicare subsequently contacted Mrs X to advise she was not eligible to have her medical treatments covered by Medicare. Mrs X in turn advised the hospital and was discharged.

Mrs X was enrolled in Medicare on 5 October 2022 incorrectly and was sent a Medicare card. It appears this occurred because of the incorrect advice Mrs X’s son had provided the agency.

Mrs X’s son lodged a claim for compensation on Mrs X’s behalf for the medical costs associated with her stay in hospital.

The compensation investigation determined defective administration occurred when Mrs X was incorrectly enrolled in Medicare. However, there was no evidence of financial loss suffered by Mrs X because of the defective administration as she was not eligible to receive Medicare benefits. No compensation was offered under the Compensation for Detriment Caused by Defective Administration (CDDA) Scheme.

Case studies - Participation (CrP, JSP, PPP, SA and SpB)

Table 6

Circumstance/ payment

Scenario

Crisis Payment (CrP)

Ms O contacted the agency and spoke to a social worker requesting a CrP due to domestic violence. No claim was lodged because Ms O was not receiving a qualifying payment at the time and so was not eligible for the payment.

Ms O’s record shows that she was advised by the social worker that a claim for CrP could not be claimed until she is receiving a qualifying payment. Ms O advised she was in the process of claiming JobSeeker Payment (JSP) through her online account.

Ms O advised she was homeless and provided a Police Report Number. A phone appointment was booked for Ms O to follow up on the progress of her JSP claim so that she could claim for a CrP.

Further contact with Ms O was unsuccessful. Ms O lodged a claim for JSP which was granted. Ms O requested a CrP for the incident which occurred before she was on payment, but the claim was unfortunately not successful as she was not receiving a qualifying payment at the time.

Ms O lodged a claim for compensation under the Compensation for Detriment Caused by Defective Administration (CDDA) Scheme for missed CrP. The compensation investigation found Ms O’s CrP had been correctly rejected as she did not meet the qualifying criteria for payment. Ms O’s claim for compensation was refused, as there was no defective administration on the part of the agency in the circumstances.

JobSeeker Payment (JSP) (failed to attend the initial interview)

Mr C was advised that a job seeker registration interview was booked for him after he failed to attend the initial interview. The relevant Operational Blueprint procedure states that if a customer fails to attend the initial interview, they are required to lodge a new claim for JSP.

Mr C was not advised at the time he would need to lodge a new claim after he had missed the initial interview and so did not lodge a new JSP claim. Mr C contacted the agency 3 weeks after his interview to follow up on the progress of his JSP claim and was then advised that the claim had been rejected due to him failing to attend the interview. It was at this contact he was advised he needed to lodge a new claim

The compensation investigation determined there has been an unreasonable failure by agency officers to give Mr C proper advice that was within their power and knowledge to give. The agency accepted Mr C has suffered a loss of JSP from the date he lodged his first claim until he lodged a new JSP claim, because of defective administration. Compensation was paid under the CDDA Scheme.

JobSeeker Payment (JSP) (incorrectly coded superannuation lump sum)

Ms V claims that the agency incorrectly coded a superannuation lump sum as annual income which resulted in her receiving a reduced rate of JSP. In August 2019, the agency sent Ms V a letter indicating that $229.32 of fortnightly income was being used to calculate her JSP. In April 2021, Ms V contacted the agency to discuss the income listed on her income statement. Ms V’s record was corrected from January 2021 and arrears paid.

Ms V requested a review of decision to pay her arrears from January 2021 and the decision was affirmed. Ms V approached the Administrative Review Tribunal (ART), the agency’s decision was set aside, and the ART determined Ms V was not entitled to arrears earlier than March 2021.

The compensation investigation determined there had been an unreasonable failure by the agency to institute appropriate administrative procedures to cover Ms V’s circumstances. Operational Blueprint procedures were not followed, and care not taken to code the superannuation correctly. Letters sent to Ms V advising of the income being taken into account, did not provide enough detail that she could have identified it was incorrectly coded superannuation.

The agency accepted Ms V had suffered a financial loss. Ms V was paid compensation under the CDDA Scheme as the decision to code her lump sum superannuation as income was incorrect.

Parenting Payment Partnered (PPP)

Mrs I made several claims for PPP over a 2 year period. The claims were rejected, based on the assessment of income. On multiple occasions, Mrs I provided documents to show her and her partner’s combined income and assets.

Mr and Mrs I’s financial circumstances were complex due to several factors including self-employment, home businesses, real estate assets and large financial transactions. Ultimately the PPP claim was rejected.

Mrs I later lodged another PPP claim which was granted after multiple contacts about what would be required to establish eligibility for the payment. Mrs I considered this meant the PPP claims previously rejected had been rejected incorrectly, because they had been assessed on incorrect financial year income and she lodged a CDDA claim for missed PPP.

The compensation investigation found the previous decisions to reject Mrs I’s claims for PPP had been correct. In the absence of defective administration being identified, Mrs I’s CDDA claim was refused.

Sickness Allowance (SA)

Mr A lodged a claim for SA after suffering a workplace injury. Mr A lodged a MOD C to advise the agency about the compensation payment he was due to receive. It was noted on Mr A’s record that he was to receive Personal Accident and Sickness Insurance through his superannuation (which is not viewed as compensation, which is a $ 1 for $1 deduction, but should be coded as ordinary income and assessed under the income test).

Mr A’s SA claim was rejected because additional information associated with the MOD C was needed to assess his claim. Unfortunately, the Service Officer failed to follow guidance in the relevant Operation Blueprint, to delay the assessment of Mr A’s SA claim to allow him the opportunity to provide the required information.

Mr A was provided incorrect advice in a subsequent service centre visit that, if his income protection claim was granted, he would not qualify for SA payments. Therefore, he did not ask for a review of the SA rejection decision or lodge a new SA claim. Mr A subsequently qualified for JobSeeker Payment (JSP) (incapacitated) after his employment was terminated by his employer and his insurance claim had been paid.

The compensation investigation identified it was more likely than not Mr A’s claim would have been granted if the processing of his SA claim been delayed and the requested information was provided. In addition, had Mr A not been advised incorrectly that he would not qualify for SA if the insurance claim was paid, it is likely he would have lodged a new claim for SA and been granted.

Mr A did not ask for a review of the agency’s decision to reject his SA claim in 2018, and he did not become aware until 2021 that he would have qualified for SA in 2018. Therefore, the timeframe for Mr A to request a review was well outside 13 weeks after the decision was made and he could not be paid any arrears under social security law. For this reason, the agency determined that Mr A had suffered a loss of SA due to defective administration and compensation was offered under the CDDA Scheme for the loss of SA from the date he first became eligible, until he was qualified for and was granted JSP.

Special Benefit (SpB)

Ms O is a New Zealand citizen in Australia on a 444 Visa and therefore is not eligible for an income support payment. Her child was born in Australia and due to his health, Ms O was unable to return to work. Ms O contacted the agency and enquired about payments she would be eligible for and was advised due to her residency status she was not entitled to an income support payment.

Approximately six months later, Ms O spoke to the agency’s Families Line about payments available and at this time she was advised to test her son’s eligibility for SpB. The claim was granted, and arrears paid from the date of Ms O’s second contact.

The compensation investigation determined appropriate guidance was not available in Operational Blueprint to cover her circumstances. The agency accepted Ms O suffered a financial loss because of not been given correct advice, due to the lack of guidance available. Compensation was offered under the CDDA Scheme for arrears of SpB from the date of Ms O’s initial contact.

Case studies - Seniors/Carers (Age Pension, Aged care, CA and CP)

Table 7

Circumstance/ payment

Scenario

Age Pension

Mrs G considered the agency incorrectly assessed superannuation investments and therefore sought compensation for the additional Age Pension she would have received if not for the incorrect assessment.

Mrs G was granted Age Pension. 19 years later, changes were made to Mrs G’s assessed assets. Mrs G’s assessable assets were $516,666 and her rate of payment was assessed under the asset test. Mrs G provided verification of her assets to the agency each year.

From the date Mrs G’s assessed assets changed, the agency issued numerous letters over the next 8 years advising Mrs G of the assessable asset amount the agency had assessed for her. Mrs G contacted the agency and requested a review of her assessable assets by an Authorised Review Officer (ARO). The ARO concluded Mrs G’s assets had been incorrectly assessed and paid arrears of Age Pension for part of the period.

The compensation investigation determined there was a specific and unreasonable lapse in complying with existing administrative procedures that would normally have applied to Mrs G’s circumstances, when the Agency did not update Mrs G’s assets as per the Operational Blueprint in place at the time. This resulted in Mrs G being paid an incorrect rate of Age Pension. Compensation was offered to Mrs G from the point the agency failed to update her assets correctly to when Mrs G received Age Pension arrears from the review of decision by the ARO.

Aged care

A mistake was made in the assessment of Mr H’s aged care fees in 2015 and his Daily Accommodation Payment (DAP) fees were calculated incorrectly. The error was found and corrected only after Mr H had passed away and his estate was asked to pay a fees debt for the DAP fees for 2015 to 2017.

At the time a pre-entry fees assessment was done, Mr H’s wife planned to still be living in their home and the value of their principal property was not included in the assessable assets. Mr H was assessed as having to pay only the Basic Daily Care Fee.

Mrs H also entered aged care on the same day as Mr H. This meant the value of the home was assessable for the aged care fees. However no new means test assessment was completed.

After Mr H had passed away, the agency identified that a pre- admission aged care assessment had been completed prior to Mr H going into care, but a post admission assessment had not been done. When the information was corrected, Mr H’s estate was asked to pay past DAP fees from 9 April 2015.

The executor of the estate advised, had they been aware in 2015 that a DAP should be paid, they would have rented out Mr and Mrs H’s vacant family home and the rental income would have helped pay the fees.

The compensation investigation determined defective administration occurred when the agency failed to conduct a post admission assessment for Mr H, which caused an incorrect fees assessment. The agency’s delay in correcting the error prevented Mr H from meeting the cost of the DAP by renting out the family home. Compensation was offered for the additional DAP fees payable to the aged care facility.

Carer Allowance (CA) and Carer Payment (CP)

Mrs I interacted with the agency on several occasions over an 18 month period when she attempted to apply for payments CP/CA and Disability Support Pension (DSP) for herself and her terminally ill husband.

The compensation investigation found that, from the information on Mrs I’s customer record that was available to Service Officers managing her enquires, the agency should have been aware of Mrs I’s family and economic circumstances, including the fact she had children. This is especially the case, given Mrs I provided this information (that she had dependent children for whom she was not receiving Family Tax Benefit (FTB) for) in her CP claim form.

The agency considered there has been an unreasonable failure by agency officers to give Mrs I proper advice that was within their power and knowledge to give (such as inviting a claim for FTB) during the multiple interactions during the relevant period. The agency accepted Mrs I has suffered a loss of FTB because of defective administration and compensation was paid under the Compensation for Detriment Caused by Defective Administration (CDDA) Scheme.

Carer Payment (CP)

Mr and Mrs M were preparing to lodge claims for CP and Age Pension. Mrs M had recently resigned from her employment and the agency advised they could not apply for payment until her termination payout for unused leave payments had been exhausted. Based on this advice, Mr and Mrs M decided not to lodge the claim forms until the leave entitlements had ended.

Mr and Mrs M later moved interstate, attended another service centre and lodged the claims for CP and Age Pension. At this contact they were advised that they could have claimed previously, as the termination payments did not impact CP or Age Pension. Their claims were granted.

Mr and Mrs M claimed compensation for the pension they did not receive from the date they would have first lodged their CP and Age Pension claims to the date the claims were lodged and granted.

The compensation investigation determined there was an unreasonable failure by agency officers to give Mr and Mrs M advice that was within their power to give, noting the information the agency held in relation to their circumstances. It was accepted that Mr and Mrs M had suffered a financial loss of income support payments because of defective administration. Compensation was offered under the CDDA Scheme for loss of payments from the date their applications were originally going to be lodged.

Case studies - Sundry expenses (due to identity document damage and loss of concession entitlement)

Table 8

Circumstance

Scenario

Sundry expense – identity document damage

Mr Y attended his local service centre to lodge proof of identification. Mr Y’s birth certificate was taken for scanning and destroyed while going through the scanner. Mr Y claimed compensation for the cost of a replacement birth certificate and provided verification of his expenses.

The agency considered there has been an unreasonable failure by the agency and reimbursed Mr Y the cost of a new birth certificate. The agency accepted this was a negligent act by an agency officer and it was likely a court would find the agency had a legal liability for the damage caused to Mr Y in the circumstances. For this reason, Mr Y was reimbursed the cost of obtaining a new birth certificate under the Legal Services Directions rather than the Compensation for Detriment Caused by Defective Administration (CDDA) Scheme.

Sundry expense – loss of concession entitlement

Mr Z had previously made a claim for compensation in relation to the cancellation of his Age Pension earlier than 1 January 2017. Had Mr Z remained on Age Pension his entitlement would have ended on 1 January 2017, when the application of the new Assets Test meant he was no longer eligible for the payment. However, had Mr Z remained current on Age Pension until 1 January 2017, he would then have retained his eligibility to a Pensioner Concession Card (PCC).

Mr Z lodged a second compensation claim in relation to the loss of his PCC and provided verification of the concessions he was unable to claim due to not having a PCC, as proof of his financial loss.

The compensation investigations determined Mr Z had lost his eligibility to Age Pension because of defective administration (first compensation claim), which in turn caused him the loss of his PCC and associated financial losses. Compensation was offered under the CDDA Scheme for the evidenced loss of concessions.

Case studies - Youth and Students (AIC and YA)

Table 9

Payment

Scenario

Assistance for Isolated Children (AIC) Scheme

Ms V contacted the agency about the AIC Scheme for her two children. Ms V explained she would be claiming for two calendar years for two children. Ms V was advised of her potential entitlement and the Service Officer checked the details of both the children.

Ms V’s AIC claim was processed and granted. Ms V was not aware that the amount of AIC she was paid was only for one child. When Ms V became aware she had not been paid AIC for two children she lodged a separate claim for her second child for the relevant calendar year. This claim was rejected as it was outside the allowable time for claiming the payment.

The compensation investigation determined the agency failed to provide Ms V proper advice (such as advising her to lodge a claim for each child) during the interaction with the agency. The agency accepted Ms V suffered a loss of AIC because of defective administration and compensation was paid under the Compensation for Detriment Caused by Defective Administration (CDDA) Scheme.

Youth Allowance (YA)

Miss U attended a service centre to lodge a claim for YA. The Service Officer lodged an ABSTUDY claim for Miss U instead, and Miss U did not review the claim prior to it being lodged. The ABSTUDY claim was approved.

Subsequently Miss U was found not to have been eligible for ABSTUDY and a debt was raised. She was able to qualify for YA.

There was insufficient evidence available for the compensation investigation to verify the events specific to the lodgement of Miss U’s ABSTUDY claim.

However, the compensation investigation determined defective administration occurred because Miss U’s ABSTUDY claim should not have been granted and this caused the loss of YA payments for this period. Compensation was offered under the CDDA Scheme for the loss of YA resulting from the agency’s defective administration.

Legal Services Division

Contact details

Commonwealth Ombudsman