Coding a paper claim for Carer Payment (CP) for one care receiver or combined care receivers under 16 009-04050030

The coding in this procedure covers paper claims for CP for one care receiver or CP (combined) for 2 to 4 care receivers and CP where there has been a change in care receiver.

If the carer has claimed both CP (child) and CA (child), determine the claim for CA (child) before CP (child).

If the carer is not eligible for CA (child), they may be eligible for CA (auto) if CP (child) is granted. Coding a CP claim may automatically assess eligibility for CA (auto).

If CA HCC only was granted and during the CP claim the DCLA score has increased (such as via the Care Load Validation process), a manual assessment of eligibility for CA auto or CA manual may be required.

If a carer lodges one claim for Carer Payment (CP) but has listed more than one care receiver, determine who the carer is claiming for. For example, if one SA404 and 2 SA407’s are lodged. The carer must be contacted to discuss the following:

• CP can be paid for:
• one care receiver, or
• combined care receivers
• discuss the circumstances of the carer and care receivers
• discuss the implications of the decision such as bereavement provisions
• the carer must be the person to decide who they claim CP for when there is more than one qualifying care receiver

The contact with the carer must be clearly documented on the carer's record. If the carer cannot be contacted, a letter must be sent to the carer requesting contact before the claim is finalised.

If a carer lodges multiple paper claims for CP for 2 or more care receivers, determine who the carer is claiming for. For example, if 2 x SA404’s and 2 x SA407’s are lodged. The carer must be contacted to discuss the following:

• CP can be paid for:
• one care receiver, or
• combined care receivers
• discuss the circumstances of the carer and care receivers
• discuss the implications of the decision such as bereavement provisions
• the carer must be the person to decide who they claim CP for when there is more than one qualifying care receiver

The contact with the carer must be clearly documented on the carer's record. If the care cannot be contacted, a letter must be sent to the carer requesting contact before the claim is finalised.

Note: if multiple CP claims are received, all claims must be finalised such as rejection for one care receiver and grant for second care receiver.

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 2 children who require the equivalent care of a PDC, will maintain qualification and payability under PDC provisions 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

If the carer is receiving a disability payment from the Department of Veterans' Affairs (DVA), do not reject their claim based on income before checking whether they may be entitled to receive Defence Force Income Support Allowance (DFISA).

The system will be able to identify these customers if the claim is correctly coded including DVA Disability payment details.

The Care Receiver Income and Assets (CRIA) test for CP (child) is administered in addition to the pension income and assets test. Claims require the CRIA screen to be coded for each care receiver.

Some assets must be disregarded when applying the care receiver income and assets test, including:

• the family home
• funds received from the National Disability Insurance Agency (NDIA) that are deposited into an account used to manage the care receiver's National Disability Insurance Scheme (NDIS) plan, and
• assets obtained to specifically assist the care receiver in respect of their disability

See Components of the Care Receiver Income and Assets (CRIA) test.

If the income is over the limit for the appropriate year, or the assets are over the limit and the requirements for exemption from the care receiver asset test are not met, the claim will automatically be rejected and an automatic letter issued.

For when to issue a Carer Payment Income and assets details - child or children being cared for - under 16 years (SA304(C)), and who should complete this form, see Components of the Care Receiver Income and Assets (CRIA) test.

When information recorded in the New Claim activity needs to be finalised on the customer's record before the New Claim activity can be, the Selective Application of Data (SAD) can transfer certain tasks into another activity to allow approval.

Under some circumstances, claims lodged after the death of a customer would also be assessed.