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



Process 009-04030010

A system issue exists resulting in incorrect and/or incomplete claim forms being issued to customers. Staff must follow the workaround available in Network News Update (NNU) - NNU - PD - CLM - CAR - FCSO issuing incomplete system-generated forms (12719)

This page contains the qualifications for Carer Payment (CP) (child) for a person caring for a care receiver aged under 16 years.

Qualifications for CP (child) for a care receiver aged under 16 years

This table describes the qualifications for CP (child) for a person caring for a care receiver aged under 16 years.

Step

Action

1

Carer is an Australian resident + Read more ...

For residence information, see Residence assessment for customers claiming Carer Payment (CP).

  • Yes, go to Step 2
  • No, the carer does not qualify for CP. Procedure ends here

2

Consider the age of the carer + Read more ...

While there are no legislative age limits applicable to carers, it is necessary to ensure that the carer can and does provide the care receiver with the constant care required.

If the carer is under the normal school leaving age in their State or Territory where they live, it is necessary to check that the appropriate education authority has given permission for the young person to leave school.

Referral to a social worker

Claims from carers under 18 years of age, or 80 years of age or older, require careful assessment. These customers must be referred to a Centrelink social worker.

A social worker should contact the carer and provide an assessment to ensure:

  • the carer has the physical and emotional capacity to provide the level of care required
  • the carer has access to support services and resources

If there are concerns about the capacity of the carer to provide the appropriate care, regardless of their age, advice from a social worker should be sought.

Social worker assistance in determining claims

A social worker can provide information to assist in making a decision about qualification for CP, including:

  • whether the carer can and does provide the care receiver with the constant care required
  • the care receiver's personal care or supervision needs in the home
  • the level of care or supervision actually being provided by the carer
  • whether the carer has the physical and/or emotional capacity to deal with the care receiver's care needs

Information provided by a social worker can contribute to a decision about qualification for CP, but the Service Officer makes the decision about qualification.

CP should not be rejected or cancelled without contacting the carer and/or Treating Health Professional (THP) to discuss conflicting information.

Where a referral to a social worker has been made, update the carer's record to include the outcome/recommendation from the social worker assessment.

3

Eligibility for CP + Read more ...

  • To be eligible for CP, a Treating Health Professional (THP) must certify in writing that because of a severe disability or severe medical condition, the care receiver will need personal care for a period of 6 months or more
  • If the THP ticks Yes to the 'child's condition being permanent' and Yes to the 'child's condition requires extra care and attention for 14 hours or more per week', then this meets the requirement that a THP has certified in writing that, because of that disability or condition the child will need personal care for 6 months or more
  • The carer must be personally providing constant care in the home of the care receiver, however the carer is not required to live with the care receiver
  • Constant care is usually considered to be provided if both the carer and THP give positive responses to the relevant questions on the claim/review forms unless there are circumstances indicating constant care is not being provided
  • The carer must be providing constant care for:
    • a child aged under 16 years with a severe disability or severe medical condition
    • a disabled adult and 1 or 2 children with a disability or medical condition (multiple care)
    • 2 to 4 children each with a disability or medical condition (combined care)
    • a qualifying child for a one-off period of at least 3 months but less than 6 months (short term care)
    • a qualifying child for a period of at least 3 months but less than 6 months where the child's condition is of an episodic nature and likely to recur (episodic care)
    • a child aged under 16 years with a terminal illness, or
    • a care receiver under the exchanged care provisions

Are the above eligibility criteria met?

  • Yes, go to Step 4
  • No, the carer does not qualify for CP. Procedure ends here

4

The child's medical condition + Read more ...

The severity of the child's condition and the level of care provided is assessed as part of the new claim. The claim requests specific details, which when coded on the system will assess the carer's eligibility.

When doubt exists as to whether the child has a severe medical condition or severe disability, advise the customer to test their eligibility by completing the claim and supplying any requested information.

Does the child care receiver have a severe medical condition or severe disability?

  • Yes, or it is not clear, go to Step 5
  • No, the carer does not qualify for CP. Procedure ends here

5

Carer's income and assets + Read more ...

The carer's income and assets information is provided with their claim for payment.

Are the carer's income and assets below the maximum allowed under the pensions income and assets tests?

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 6
  • No, the carer does not qualify for CP. Procedure ends here

6

Care receiver income and asset limits + Read more ...

Note: if the child care receiver lives with their parent or legal guardian, the income/assets of the child's parent or legal guardian and their partner and their Family Tax Benefit (FTB) children are included. For more detail, see Components of the Care Receiver Income and Assets (CRIA) test.

Determine if the care receiver meets the care receivers assets test limit and care receiver's income threshold. For care receivers asset test limits, see Carer Payment (CP) - Carer Receiver Income and Asset Limits.

Does the care receiver meet the care receivers assets test limit and the care receivers income threshold?

  • Yes, go to Step 7
  • No, the carer does not qualify for CP. Procedure ends here

7

Does the care receiver have a terminal condition, or do they require care for a minimum period of 6 months? + Read more ...

  • Yes, go to Step 8
  • No, the carer does not qualify for CP. Procedure ends here

8

Medical assessment required to determine eligibility for CP + Read more ...

  • If the care receiver is in the final phase of a terminal illness and is not expected to live for more than 24 months, they do not need to undergo the Disability Care Load Assessment (child) Determination (DCLAD) and are granted CP automatically, provided they meet all other eligibility criteria
  • All further determination of qualification is based on the qualifying rating determined by the Disability Care Load Assessment (child) Determination, comprising:
    • the assessment of the disability, from the Carer Payment Medical Report including functional assessment (for a child under 16 years) (SA397/SA427), and
    • the assessment of the level of care required and provided, from the Carer Payment - Care Needs Assessment (SA394 v1007/SA408)
  • When the care receiver is a child with a severe disability or severe medical condition, the level of care required may mean that there is more than 1 carer
  • Entitlement is determined by processing the online or assisted customer clam, or by manually coding the claim
  • CP (child) may be claimed for:
  • When the care and medical details are recorded, the system assesses qualification for Carer Allowance (Auto)