Eligibility for Carer Payment (CP) when a care receiver is aged under 16 009-04030010

In certain situations, 2 or more carers may qualify for CP for the same care receiver aged under 16.

To be eligible for CP for a care receiver aged under 16 years, a carer must meet the following criteria:

• Be personally providing constant care for:
• a child with a severe disability or severe medical condition, or
• 2 or more children who each have a disability or a medical condition and their combined care needs are equal to that of a single child with a severe disability or severe medical condition, or
• 1 or more children and an adult who each has a disability or medical condition and their combined care needs are equal to that of a single child with a severe disability or severe medical condition, or
• Be providing constant care for 2 or more children with a severe disability or severe medical condition in an exchanged care arrangement and provide care for a significant period every day, equivalent to a normal working day
• A Treating Health Professional (THP) certifies in writing that because of a severe disability or severe medical condition the care receiver will need personal care for 6 months or more
• The care is provided in the care receiver's home and the care needs are permanent, or for an extended period of at least 6 months unless the condition is terminal
• If the condition is short term or episodic the care is required for at least 3 months but less than 6 months
• A qualifying rating of intense is required to be eligible under the Disability Care Load Assessment (child) Determination (DCLAD), this means the THP score is greater than 0 and the Care Needs Assessment (CNA) is 85 or greater

To qualify for CP for a care receiver aged under 16 years the carer must also:

• satisfy the residence requirements
• be personally providing constant care for a child with a severe disability or severe medical condition with a qualifying DCLAD score in the home of the care receiver. Note: the carer is not required to live with the care receiver
• have income and assets below the maximum allowed under the pension's income and assets test

Carers can participate in paid work or study and still qualify for CP as long as the total time they are not providing constant care, including the time taken to travel, does not exceed 25 hours per week.

Note: for Carer Payment (child) claims, the care receiver does not need to be a dependent child of the carer. This differs from Carer Allowance (child) claims where the care receiver must be a dependent child of the carer. See Eligibility for Carer Allowance (CA) (child) when a carer is claiming or receiving CA only.

Carers can be contacted to clarify the care they provide, however carers are not required to provide care schedules or care plans. Provision of the claim form is the carer's declaration that additional care is provided. Clarification should only be sought if there is a dispute about the care being provided or there are concerns as to whether the carer is providing constant or daily care.

While there are no legislative age limits applicable to carers, claims from carers under 18 years of age, or 80 years of age or older, require a referral to a social worker.

This is necessary to ensure that the carer can and does, provide the care receiver with the level of care and attention on a daily basis that is required. A very young or elderly carer may have difficulty accessing support services and resources. A social worker can provide help with this.

The provision for up to 63 days of respite for carers recognises the need for carers to have a break from their caring responsibilities while remaining qualified for payment.

There is no limit to the number of hospitalisation days for child care receivers, however all absences must still be recorded. If the carer is paid under the short term care or episodic care provisions, the respite limit will be a pro-rata amount, based on the period for which Carer Payment (child) is being granted.

A carer is said to provide constant care if they personally provide care on a daily basis for a significant period during each day. The care may be active, supervisory or monitoring. This includes circumstances where the carer or care receiver is absent from the care situation for part of the day, but the intensity of the care required and provided during the remainder of any 24 hour period is such that it roughly equates to a normal working day.

The assessing Service Officer has the delegation to determine if the constant care provisions are satisfied, based on the medical report and the Care Needs Assessment (CNA) Questionnaire provided with the CP (child) claim. The constant care requirements are usually satisfied if the Treating Health Professional (THP) report and CNA Questionnaire result in a qualifying score for CP, or an assessment of terminal illness unless there are circumstances indicating constant care is not being provided. If there are circumstances that could indicate constant care is not being provided, this can be taken into account in the determination.

The Service Officer needs to consider the care receiver's medical condition(s), the THP score, the CNA score, the THP and carer's responses to the provision of significant care and any other relevant factors. Any inconsistency needs to be considered and in some instances clarified. For example: if the condition is consistent with high THP and CNA scores but the THP report state significant care was not required, we must clarify with the THP why they believe personal care is not required for a significant period on a daily basis. It is possible they have not considered the need for supervision/monitoring. Even if they do not change their views on the need for significant care the delegation rests with the Service Officer.

In establishing constant care for a child care receiver the following should be considered:

• If the care receiver is in the final phase of a terminal illness and is not expected to live for more than 24 months, constant care is deemed to be met unless there are inconsistencies.
• Prior to determination that constant care is not being provided, clarification must be made with the carer and/or the THP to confirm as it is possible not all aspects of care have been considered
• The Treating Health Professional (THP) indicates on their report that the child care receiver requires personal care, due to a severe disability or severe medical condition, for a significant period every day for 6 months or more
• If the carer provides care for more than 1 care receiver, a response of 'No' or 'not sure' by the THP on the medical report or 'No' response by the carer is not an automatic assessment that constant care is not provided. Consider the total level of care provided to all care receivers. A carer should reasonably be expected to provide at least the equivalent of a normal working day in personal care.
• If the carer provides care for 1 care receiver and there is a response of 'No' or 'not sure' by the THP, on the medical report, consider if constant care is being provided based on the information in the medical report and the CNA Questionnaire. Depending on the circumstances of the individual, clarification may be required from the THP
• Also consider any factors indicating constant care is not being provided.

Carers who are current or suspended on 30 June 2010 and were:

• granted CP (child) under the DCLAD (2009) or CA (child) under the Child Disability Assessment Determination (CDAD) (2001) will maintain qualification and payability under their existing provisions. This remains until they are selected for review under DCLAD 2020 or lose qualification on or after 1 July 2010. This group of care receivers will not appear on the Carer Payment Grandfathered (CRGF) screen
• granted CP (child) due to caring for a Profoundly Disabled Child (PDC), or two children who require the equivalent care of a PDC, will maintain qualification and payability under PDC provisions. This remains until they are selected for review under DCLAD 2020 or lose qualification on or after 1 July 2010. Carers in this group who reclaim CP (child) for the same care receiver from 1 July 2010 to 17 August 2020 will be required to provide a DCLAD (2020) care load assessment and medical report. These groups of care receivers will appear on the  CRGF  screen

Wife Pension customers who were getting payment level Carer Allowance on 19 March 2020 qualify for Carer Payment (XWP) under grandfathering provisions as long as payment level CA continues without a break. They are not required to satisfy the normal CP requirements such as constant care, the 25 hour rule, or CP reviews including the Care Receiver Income and Assets (CRIA) test. However, pension's income and asset tests continue to apply. Temporary Cessation of Care (respite and hospitalisation) rules do not apply to CP (XWP) but all CA rules continue to apply to CA as normal.

When a CP (XWP) customer's only or last payment level CA is suspended or cancelled for any reason (including due to respite or hospitalisation) or reduced to a zero rate due to Education, Training or Treatment (ETT), CP (XWP) will automatically be cancelled. A carer will lose qualification for CP (XWP) permanently if they have a break in payment level CA entitlement after 19 March 2020. For more information, see Transfer from Wife Pension (WP) to Carer Payment (CP).