Eligibility for Carer Payment (CP) under the Lower Adult Disability Assessment (ADAT) Tool 009-04010010

• Yes, go to Step 2
• No, the carer (of the adult care receiver) cannot qualify for CP under this provision. To see if the adult care receiver can qualify under the 'full' qualification provisions, see Eligibility for Carer Payment (CP) when a care receiver is aged 16 years or over. At least 2 genuine attempts to contact must be made to contact the carer to advise of the unfavourable decision. Record details on a DOC in the carer's record. For more details, see Advising verbally of an unfavourable decision (CLK). Procedure ends here

• Yes, go to Step 3
• No, go to Step 5

• Yes, go to Step 4
• No, the carer (of the adult care receiver) cannot qualify for CP under this provision. Check Eligibility for Carer Payment (CP) when a care receiver is aged 16 years or over. At least 2 genuine attempts to contact must be made to contact the carer to advise of the unfavourable decision. Record details on a DOC in the carer's record. For more information, see Advising verbally of an unfavourable decision (CLK). Procedure ends here

To reach this step, the care receiver will have a dependent child who is either:

• aged under 6, or
• aged 6 to less than 16 and who is attracting a payment of CA (child)

Note: from this step onwards, the care receiver referred to is the adult care receiver, and the carer is the carer of the adult care receiver.

• Yes, go to Step 7
• No, go to Step 6

Is the care not being provided in the residence of the care receiver because the care receiver is absent from the home as they are hospitalised and the carer is participating in their treatment?

• Yes, go to Step 7
• No, the carer cannot qualify for CP. The CP claim should be manually rejected. At least 2 genuine attempts to contact must be made to contact the carer to advise of the unfavourable decision. Record details on a DOC in the carer's record. For more information, see Advising verbally of an unfavourable decision (CLK). Procedure ends here

Does the carer meet the pensions income and assets test? Note: if the carer is currently on another pension type and paid under the transitional rules the income test is not the same as the current pension income test.

• Yes go to Step 8
• No, the carer cannot qualify for CP. The CP claim should be manually rejected. At least 2 genuine attempts to contact must be made to contact the carer to advise of the unfavourable decision. Record details on a DOC in the carer's record. For more information, see Advising verbally of an unfavourable decision (CLK). Procedure ends here

Is the care receiver either:

• in receipt of a Social Security pension or benefit, or a Service Pension or Income Support Supplement (ISS) or Veteran Payment, or
• would be receiving such a payment if they had been an Australian resident for a long enough period?

Note: CA is not 1 of the payment types mentioned above.

• Yes, see Step 1 in the Assessment of the medical report for CP claims table
• No, go to Step 9

For more details, see Components of the Care Receiver Income and Assets (CRIA) test.

• Yes, see Step 1 in the Assessment of the medical report for CP claims table
• No, the carer cannot qualify for CP. The CP claim should be manually rejected. At least 2 genuine attempts to contact must be made to contact the carer to advise of the unfavourable decision. Record details on a DOC in both the carer's and care receiver's records. For more details, see Advising verbally of an unfavourable decision (CLK). Procedure ends here

Has the SA332(a) form been returned?

• Yes, go to Step 2
• No, processing of the new claim cannot continue until the Medical Report is returned. Inform the carer of this fact, and issue the SA332(a). When the SA332(a) is returned, go to Step 2

• Yes, calculate the ADAT score based solely on the health professional's responses. Go to Step 3
• No, then the CP claim should be manually rejected on the Benefit Action (BA) screen, using the reason code 'NMQ' (not medically qualified). At least 2 genuine attempts to contact must be made to contact the carer to advise of the unfavourable decision. Record details on a DOC in the carer's record. For more details, see Advising verbally of an unfavourable decision (CLK). Procedure ends here

• Less than 8, go to Step 4
• 8 or greater, go to Step 5

The CP claim should be manually rejected.

At least 2 genuine attempts to contact must be made to contact the carer to advise of the unfavourable decision. Record details on a DOC in the carer's record. For more details, see Advising verbally of an unfavourable decision (CLK).

Procedure ends here.

Calculate the total ADAT score, which is the total achieved when the scores from the THP and carer questionnaires are combined.

• Less than 20, go to Step 6
• 20 or greater, go to Step 7

The total ADAT score is not sufficient to attract CP for the carer. The CP claim should be manually rejected. At least 2 genuine attempts to contact must be made to contact the carer to tell of the unfavourable decision. Record details on a DOC in the carer's record. For more details, see Advising verbally of an unfavourable decision (CLK).

Procedure ends here.

Has the THP responded No or Unsure on the SA332(a) to either of the following questions:

'Does the person require help on a daily basis because of their disability and/or medical condition(s) to carry out routine personal activities OR because they may be at risk to themselves or to others?'

'Is this care required for a significant period each day (at least the equivalent of a normal working day)?'

• Yes, go to Step 8
• No, go to Step 9

• The THP's responses should not be an automatic assessment that constant care is not being provided
• The decision maker (DM) will need to make an assessment based on the total level of care provided to the care receiver, that is, a carer should reasonably be expected to provide at least the equivalent of a normal working day in personal care
• When coding the CP claim the review officer's determination if the constant care qualifications are met should be recorded on the Care Receiver Care & Institution Details (CRCI) screen

For more details, see Coding a paper claim for Carer Payment (CP) where the care receiver is 16 years of age or over.

Record details on a DOC in the carer's record.