Coding a paper claim for Carer Payment (CP) where the care receiver is 16 years of age or over 009-04050060

A carer remains qualified for CP (child) for care provided to a child with a severe disability or severe medical condition who has been given a qualifying rating under the Disability Care Load Assessment (child) Determination (DCLAD) until the earlier of:

• the care receiver turns 16 years and 3 months (or until 18 years if terminal), or
• a determination is made on a claim for another income support payment including CP (adult)

See Carer Payment (CP) and/or Carer Allowance (CA) Child to Adult Transfer (CTAT) for more details.

When a claim is ready to be recorded, all supporting documentation should have been provided. This procedure assumes the carer and care receiver have met the qualifications for this payment, and the fully completed and signed claim for CP has been lodged.

Note: if the carer is caring for an adult and 1 or 2 children whose combined level of care is equivalent to 1 qualifying child, consider multiple care options.

If the care receiver is aged 15 years and 9 months or older, a Carer Payment and/or Carer Allowance - Medical Report (for a person 16 years or over) (SA332a) may be required and can be completed by a Treating Health Professional (THP).

If the carer or the THP has ticked more than 1 answer, accept the answer that gives the highest Adult Disability Assessment Tool (ADAT) score. Where no answer has been provided, contact the carer or THP to find out why and give them the opportunity to answer unanswered questions in their respective questionnaires.

Note: if the ADAT produces a qualifying score and there are unanswered questions that have no bearing on the carer's qualification for CP or CA, do not contact the carer or THP but document this on the carer's record.

The signature of the care receiver (or correspondence nominee) on the SA332(a) is authorisation for the release of medical details by the THP. The care receiver's signature is not required for processing of the THP form.

Request a replacement medical report by another THP there are concerns that the care receiver's condition has improved (which would mean the care receiver may no longer have a qualifying ADAT score). The Service Officer would need to support this decision.

If a carer lodges 1 paper claim for CP but has listed more than 1 care receiver, it must be determined who the carer is claiming for, for example they have lodged 1 Claim for Carer Payment and/or Carer Allowance (SA404) and 2 Carer Payment and/or Carer Allowance - Caring for a person 16 years or over (SA406) forms. The carer must be contacted to discuss the following:

• CP can be paid for only 1 care receiver
• the circumstances of the carer and care receivers
• the implications of the decision on bereavement provisions

The carer must be the person to decide who they claim CP for when there is more than 1 qualifying care receiver.

Clearly document the contact with the carer on the carer's record. If the carer cannot be contacted, send a letter to the carer requesting contact before the claim is finalised.

A carer may lodge multiple claims for CP for 2 or more care receivers. See Table 2 in Processing claim for Carer Payment and/or Carer Allowance.

If there is a dispute between 2 carers over the care being provided, see Change of care for Carer Payment (CP) and Carer Allowance (CA) customers.

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 identify these customers if the claim is correctly coded, including DVA Disability payment details.

If the care receiver dies before the claim is finalised, see Death of care receiver before claim for Carer Payment (CP) and/or Carer Allowance (CA) is finalised.

Under some circumstances claims lodged after the death of a carer would also be assessed. See Processing a claim after the death of a customer.