Coding a paper claim for Carer Allowance (CA) where the care receiver is 16 years or over 009-03040060

CA is a payment recognising the impact of a care receiver's disability on the family. The greater the level of disability, the greater the impact. CA provides financial assistance to the carer in respect of a care receiver aged 16 years or over with a severe level of disability.

Providing care to someone is often a 24 hour a day job undertaken with little assistance from anyone else. CA acknowledges the impact of significant levels of disability, on the family in social, occupational, emotional, and financial terms.

CA is not taxable, or assets evaluated. There is an income test. To be eligible for CA, the carer’s, and their partner's combined Adjusted Taxable Income (ATI) must be under $250,000 a year. This includes deemed amounts from account-based income streams if the account holder is 60 years of age or older. The same income limit applies if the carer does not have a partner.

CA (16 years or over) is assessed under the Adult Disability Assessment Tool (ADAT). The ADAT measures the functional ability and care needs of the care receiver.

The ADAT allows the care receiver to be assessed and have their level of disability objectively determined. Re-use of a previous ADAT may be possible under specific provisions.

For CA for an adult care receiver to be assessed, they need to submit an online claim or lodge a paper claim.

From 20 September 2018, a $250,000 a year Adjusted Taxable Income (ATI) test applies to CA at payment level and Carer Allowance Health Care Card only (CA HCC only). Carer Allowance does not have an asset test. Carers who lodge a paper claim on or after this date will need to include the Carer Allowance adjusted taxable income details (SA489) form as part of their required documents. The Resources page contains a link to this form.

Carers are not subject to the income test while they are exempt from providing their income details for the CA income test.

The CA income test is based on the Adjusted Taxable Income (ATI) of the carer (and their current partner if they have one) for the applicable budget year. It includes deemed income from account-based income streams if the account holder is 60 years of age or older.

ATI is the sum of:

• Taxable income - even if the person is not required to lodge a tax return
• Target foreign income - foreign income on which Australian income tax is not paid
• Total net investment losses - the sum of net financial investment losses and net rental property losses
• Employer provided fringe benefits more than $1000
• Reportable superannuation contributions - these include salary sacrifice amounts plus personal superannuation contributions for which a person has claimed a deduction in their tax return
• Tax-free pensions or benefits
• Less child support paid - also known as 'deductible child maintenance expenditure'

Deemed income from an account-based income stream is added to the carer's or their partner's ATI only if the account holder is 60 years of age or older.

The carer does not have to complete a Carer Payment and/or Carer Allowance - Medical Report (for a person 16 years or over) (SA332A) if they already receive Carer Payment (CP) for the same care receiver and the care receiver has a qualifying ADAT score for CA.

If the carer or the Treating Health Professional (THP) has ticked more than one answer, the answer that gives the highest ADAT score should be accepted. Where no answer has been provided, the carer or THP should be contacted to find out why and should be given the opportunity to answer unanswered questions. Note: if the ADAT produces a qualifying score and there are unanswered questions which have no bearing on the carer's qualification for CP or CA, staff are not required to contact the carer or THP but should document this on the carer's record.

If the care receiver is aged 15 years and 9 months or more, an SA332A medical report may be required and can be completed by a THP.

A medical report (SA332A) would be required if:

• Service Officers have concerned the care receiver's condition has improved (which would mean the care receiver may no longer have a qualifying ADAT score.) The Service Officer would have to be able to justify this decision
• The carer is claiming CA under Section 954A and the Service Officer is unable to verify that the carer provides at least 20 hours of personal care and attention per week on a daily basis that can be matched to the care required by the care receiver. A Carer Payment and/or Carer Allowance - Medical Report (for a person 16 years or over) (SA332A) form would be required before the claim could be rejected

The signature of the care receiver (or correspondence nominee) on the SA332A is authorisation for the release of medical details by the THP. The care receiver's signature is not required for processing of the THP form.

The date Services Australia issues the Claim for CA following a CP Review (SA341) form is not taken as the start date of claim.

Additionally, the date the review was started or completed is not the date of claim.

The correct start date of the claim is the date of receipt of the SA341 (the date the carer lodges the SA341). See Calculating the start day general rule.

Note: Intent to claim provisions were amended on 1 July 2018 and apply only to carers in vulnerable circumstances. See Intent to claim and vulnerable customers.

If a carer or care receiver passes away prior to finalisation of the claim, the claim should be finalised before the death action on the record is completed.

Advise the carer that a care receiver aged 16 years or over may be eligible for an income support payment.

If the care receiver wants to make a claim, an online claim must be offered first. Explain the benefits of claiming online:

• Help to apply for the right payment through streaming questions and early warnings if they may not be eligible
• Less information for them to provide, as information from their Centrelink record will be pre-populated into the online claim
• They can monitor the progress of their claim through their Centrelink online account or the Express Plus Centrelink mobile app

If the care receiver declines the online claim, ACC must be run with the care receiver. Once ACC is completed, advise the care receiver of any outstanding documents they must provide or action they must take to submit their claim, including verbal declaration. A signed Customer Declaration Form (CDF) must be sent to the carer for their signature in the even they are unable or decline to make a verbal declaration.

First Contact Service Offer (FCSO) workflow can only be used in limited circumstances when it has been determined this is the only method available to suit the carer receivers needs and must be run separately.

If the carer makes an application for CA for a care receiver, the care receiver cannot also qualify for CA for another disabled adult. Prior to granting, rejecting, or cancelling any CA payments additional information will be required from the carer and the care receiver to clarify the circumstances and whether the care receiver has ceased providing care.

When determining the start date for CA in this situation, the decision is independent of whether the care receiver has been paid CA, the date CA was cancelled or whether the care receiver is entitled to CA. The start date determination should follow the normal start date procedures that apply for new claims.

The Process page contains information on what to do when a care receiver claims CA for another care receiver.

If there is a dispute between 2 carers over the care being provided see Change of care for Carer Payment (CP) and Carer Allowance (CA) customers.