Eligibility for Carer Payment (CP) when a care receiver is aged 16 years or over 009-04030020

To be eligible for CP a carer must personally provide constant care, for either:

• An adult with an Adult Disability Assessment (ADAT) score of 25 with a minimum Treating Health Professional (THP) score of 10, or
• An adult with a lower ADAT score of 20 with a minimum THP score of 8 where the care receiver provides care for a dependent child. The care receiver's dependent child must be under 6 years of age, or 6-16 years attracting CA. See Eligibility for Carer Payment (CP) under the Lower Adult Disability Assessment Tool (ADAT) provisions

The carer will also need to meet all the following:

• satisfy the residence requirements
• provide care in the home of the care receiver (the carer is not required to live with the care receiver)
• have income and assets below the maximum allowed under the pensions income and assets tests

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

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.

If a care receiver is in respite care (not hospital) at the time a carer lodges a claim, see Complications to Grants of Carer Payment and/or Carer Allowance.

Carers of workforce age receiving CP are eligible for Working Credit. If a carer has unused working credits or a Student Income Bank (SIB), they may be able to restore them within 12 months.

To qualify a carer for CP (16 years or over) a care receiver must:

• be either:
• an Australian resident, or
• a higher ADAT score adult who is receiving a social security pension and CP may be granted to another person for the adult under a scheduled international social security agreement
• meet income and assets test requirements:
• be receiving a social security pension or benefit, or a Service Pension, or Income Support Supplement (ISS), or Veteran Payment, or would receive one of these payments if they have been an Australian resident long enough, or
• satisfy the Components of the Care Receiver Income and Assets (CRIA) test (noting that some assets are disregarded)
• require care permanently or for a minimum period of 6 months (unless the care receiver is in the final phase of a terminal illness and is not expected to live more than 3 months)

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 income and asset tests continue to apply. Temporary Cessation of Care (respite and hospitalisation) rules do not apply to CP (XWP) however, 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).

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 mandatory referral to a social worker.

It is necessary to make sure 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 help in this regard.

A check for basic qualification (for example, residence, income and assets) is to be completed before the referral to a Social Worker to make sure unnecessary referrals are not made. Once basic qualification can be established, all carers under 18 or over 80 years of age must be referred to a Centrelink social worker before the claim is finalised. The referral is to make sure that the carer has the physical and emotional capacity to provide the level of care required and to provide information and assistance in accessing support services.

A social worker will assess and document the care situation and, where possible, visit the carer and provide an assessment to make sure that:

• the carer has the physical and emotional capacity to provide the level of care needed
• a very young or elderly carer can access support services and resources

For carers under the minimum school leaving age in the state or territory in which they live, the social worker should check that the appropriate education authority has given permission for the young person to leave school.

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

If the care receiver has passed away before the claim is finalised, the referral to the social worker is not required. A decision should be made on the evidence available and if in doubt advice sought from the Carer Helpdesk.

A social worker can provide information to help a Service Officer make a decision about qualification for CP including:

• whether the carer can and does provide the care receiver with the constant care needed
• 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

Details 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 THP to discuss conflicting information.

The Service Officer should update the carer's record to include the outcome/ recommendation of the social worker assessment.

There is no legislative restriction on a carer receiving CP for a care receiver who in turn receives CP for caring for another care receiver. However, in this situation, a social worker can help to determine whether both carers are personally providing constant care and therefore qualify for CP.

Although social workers may provide a variety of information that contributes to decisions about qualification, the final decision regarding qualification is not made by them. See Social worker assessment of care situations for Carer Payment (CP) and Carer Allowance (CA) claims for more information.

When granting CP in this situation the error message 'Cannot link carer to carer' may prevent the claim from being finalised:

• The Service Officer must refer to Tier 1 Local Peer Support who will refer on to the relevant Level 1 Senior Service Officer who can escalate, if appropriate after checking the details of the case, to the Level 2 Policy Helpdesk
• The Level 2 Policy Helpdesk will make sure that the social worker has been involved in assessing the care situation and establishing that constant care is being provided. The Helpdesk will then liaise with the relevant ICT Service Desk for a system workaround in order to grant CP in these situations.

For CA, an adult care receiver may also qualify for CA for dependent children with disabilities in their care but cannot qualify for CA for another adult with a disability.

Department of Veterans’ Affairs (DVA) care receivers: if a carer claims CP for a DVA income support recipient, it may be necessary to contact the DVA Clearance Team (SCS) to make sure the DVA care receiver is currently receiving a Service Pension, Income Support Supplement (ISS), Veteran Payment or Social Security Age Pension (paid by DVA). If CP is granted, notify DVA of any changes in the service pensioner's circumstances.

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 equates to a normal working day.

The assessing Service Officer has the delegation to determine if constant care provisions are satisfied, based on the medical report and the ADAT Claimant Questionnaire provided with the CP (adult) claim. The constant care requirements are usually satisfied if the THP report and ADAT Claimant 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.

The Service Officer needs to consider the care receiver's medical condition(s), the THP score, the carers score, the THP 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 carer scores but the THP report states significant care was not required, clarify with the THP why they believe personal care is not required for a significant period on a daily basis. They may not have considered the need for supervision/monitoring. Even if they do not change their view on the need for significant care, the delegation rests with the Service Officer.

Note: 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.

If a carer is claiming CA and has lodged a Carer Allowance Questionnaire (SA381) should not be used on its own to determine if constant care is being provided. For example, if the SA381 states that for CA the carer is not providing care and attention on a daily basis, it should not be assumed that constant care is not being provided for CP. The SA381 can only be used to determine whether personal care and attention provided by a non-co-resident carer addresses special care needs and whether the amount of time taken undertaking that caring for CA is reasonable. If the SA381 indicates constant care is not being provided, the situation needs to be clarified prior to a decision being made and the carer should be contacted.