Identifying and making suitable referrals to the Complex Assessment Officer (CAO) 101-05070010

For CAO assessments, Service Officers must:

• assess customer’s circumstances, and
• tell the customer about any relevant modules and information needed, see Completing modules and forms
• update the relationship status of the customer before the referral
• for example, link or unlink as needed
  Note: if the referral is part of a new claim, do this outside of the claim activity
• make sure Private Trust (MOD PT) and/or Private Company (MOD PC), provided in person or as part of an online claim include the required documents listed with these modules
• support customers in uploading documents
• scan relevant documents when provided in person

If AUSTRAC reports were obtained as part of the initial review:

• refer to the AUSTRAC Access and Disclosure document, (see the Resources page for a link), to make sure that they were not used as evidence, and
• have not been forwarded to the CAO as part of the referral

When Service Officers identify the need for a CAO assessment, they must create a referral or follow the appropriate escalation process.

• If it is clear the claim is to be rejected, for example basic qualification reasons are not met, do not refer the case to the CAO
• If it is not clear the claim will be rejected, make a referral to the CAO
• If the customer indicates they have been involved in a private trust or private company in the last 5 years, a CAO referral is required
• If the customer indicates they have not been involved in a private trust or company in the last 5 years, but their record is linked to a private trust or company record, a CAO referral is required to update the information

When identifying a CAO assessment as part of a claim, an open new claim activity must exist and no action is to be taken to finalise the claim or restore payments until the CAO has finalised their report and notified the Service Officer accordingly.

See Table 1, Step 8 on the Process page for appropriate cases to refer to a CAO.

If the claim is being processed using Process Direct, create the CAO Referral from More Options within the claim.

If not using Process Direct, run the CAO Referral guided procedure and select the Assessment Type New Claim for:

• claims processed outside of Process Direct
• Low Income Health Care Card (LIC) renewals requiring a CAO assessment
• current customers with new trust/ company involvement

For all other customers, run the CAO Referral guided procedure and select the Assessment Type 'Reassessment'.

An escalation to request CAO action may be needed to speed up the outcome of a CAO assessment or to request CAO intervention. CAO escalations are made via a Fast Note for:

• immediate new claim and non-new claim priority processing. For example, at risk, customers experiencing vulnerability, experiencing family and domestic violence
• assets hardship initial contact and/or change of circumstance
• processing specific tasks where CAO intervention is needed

Note: before sending an escalation to a CAO using a Fast Note, make sure a CAO referral has been made (when needed).