Recording reasons for decisions 111-15040020

For the decision making process to proceed it is important to identify the issues at hand. Some questions that may help in identifying the issues include:

• What does the customer want/need?
• What can I potentially do for the customer?

To make a correct decision it is important to understand which rules apply to the situation. These rules, and advice on how to apply them, are usually found in the relevant legislation guidelines.

Decisions must be based on relevant facts and evidence. The decision making process can be made more difficult if there is insufficient investigation or evidence obtained. The following points may help with this stage of the decision making process:

• Facts are actual circumstances capable of verification, for example, a customer commences employment on a particular date
• Evidence is information (oral or written) used to support a statement or claim, or establish the likelihood of a statement or claim being correct
• When reviewing evidence, some important questions to ask include:
• How compelling is it?
• Is it from an objective, reliable, qualified or credible source?
• Is the evidence from a firsthand source or a third party?
• Does the person providing evidence have a vested interest in the issue or is there any malicious intent evident?
• Does this piece of evidence support or conflict with other evidence?

Findings of fact are the conclusions a decision maker draws from the available facts and evidence. To make a decision the decision maker will need to:

• detail facts/findings of fact
• identify the relevant legislation and
• apply the facts/findings of fact to the legislation in a logical, balanced fashion

It is important to document the decision made so that the decision can be readily explained to the customer or if the decision is queried or challenged. The decision should be recorded on a DOC and should include:

• the decision itself
• the Act/Guide reference upon which it is based and
• the reason for making the decision

This information must be included when the Service Officer completes an activity where decisions about eligibility or entitlement are made.

Note: the DOC must meet the Online Document Recording Standards when a significant decision is made.

Most straight forward decisions will only require the Service Officer to DOC the conversation with the customer or reason for making the change (for example, mail).

It is important to explain the reasons for your decision in terms that allow the customer to fully understand why the decision was made.

Two questions that may help with this include:

• Will the information give the customer a full understanding of why the decision was made?
• Will the information convince the customer that the correct decision has been made?

Discussing the reasons for an adverse decision with a customer before sending the written advice can also improve customer service and reduce the likelihood of the customer seeking a review of a decision.

In some situations the decision to grant a payment or service is automatically determined by the system. The entitlement is assessed and paid using information already recorded on the customer's record and no manual action is required by a Service Officer. In these cases, sufficient information exists on the system and there is no requirement for a significant decision DOC to be created.

Examples of such payments or services include:

• Telephone Allowance
• Clean energy Advance (CEA), and
• Relocation Scholarship

The decision to issue the payment is made automatically and is approved by the Secretary.

When a Service Officer makes a significant decision, the details must be recorded on the customer's record in accordance to the Getting it Right (GIR) Standard - Management of customer records/interactions. Details include:

• the decision itself
• the Act/Guide reference upon which the decision is based, and
• the reason for making the decision (the discretionary aspects of the decision)

It is essential that all reasons for the significant decision are recorded.

A significant decision is defined as:

• determining qualification for a payment or service such as grant, restoration, re-grant or rejection
• manually initiating a cancellation or suspension of a payment or a service
• manually rejecting an application for a payment or a service
• raising a debt, or
• overriding qualification or payability established by the system

When quality checking the work, has a significant decision been made?

• Yes, go to Step 2
• No go to Step 3

Additional information required includes:

• the significant decision and payment type
• the Act/Guide reference upon which it is based
• if applicable, the information and reasons for making the decision if not recorded/evident on the customer's record

Note: if the reason for the decision is not obvious from elsewhere in the record, this will need to be documented in more detail.

• Yes, continue with quality check, standards regarding recording information has been met
• No,
• If activity is being checked using Quality On Line (QOL) go to Step 4
• If activity is being checked using Quality Management Application (QMA) go to Step 5

To determine what is adequate refer to ODR Standards and the specific Operational Blueprint file relating to the decision.

• Yes, continue with quality check, standards regarding recording information have been met. Procedure ends here
• No, if the activity is being checked using:
• Quality On Line (QOL) go to Step 4
• Quality Management Application (QMA), go to Step 5

When to release with feedback

When the outcome of the activity can be determined as correct, but the significant decision information is not fully documented. Select GIR DOC Minimum Standard option in QOL Check tool and provide feedback.

When to return

When a QOL Checker cannot determine if the result of the activity meets the Four Pillars of Payment Correctness (Right Person, Right Program, Right Rate and Right Date) due to missing or no information recorded in the record.

Select GIR Doc Minimum Standard options as well as the corresponding critical error relating to the Four Pillars as applicable in QOL check tool.

Returning the activity using QOL will refer the activity back to the Service Officer for correction and resubmission.

Provide written feedback using the QOL feedback.

Procedure ends here.

Record an error with feedback

Where the outcome of the checked work item can be determined as correct, but the significant decision information is not fully documented, the catch all error Q00015 - Getting it Right - Doc Minimum Standards within QMA must be recorded as a minimum.

When a Quality Management Officer (QMO) cannot determine if the result of the activity is correct due to missing or no information recorded in the record, the catch all error Q00015 - Getting it Right - Doc Minimum Standards within QMA must be recorded along with other appropriate errors related to the missing information.

The DOC or Note must be updated and the activity finalised by the QMO. Feedback must be provided to the Service Officer.