Assessing claims for Carer Allowance (CA) for 2 disabled children 009-05010030

Has a Carer Allowance Medical Report for a child under 16 years (SA333TDR/SA426) form been provided for each care receiver?

• Yes, go to Step 2
• No, processing cannot continue until all the forms are provided. Procedure ends here

Does either child have a recognised disability?

• Yes, go to Step 3
• No, go to Step 4

If a child has a recognised disability, that child is medically qualified to attract full CA for their carer. CA (auto) is automatically available to all carers of Carer Payment (CP) child.

The carer may still qualify for a second payment of CA for the second child (if required). See:

• Processing carers online and assisted customer claims
• Coding a paper claim for Carer Allowance (CA) where the care receiver is under 16
• Health Care Card (HCC) only Carer Allowance (CA) (child)

Procedure ends here.

Further information is required from the carer before the claim can proceed:

• issue the customer 2 Care Needs Assessment forms (SA408 or SA394 v1007) by coding 'Y' in the Issue a Carer Assment? field on the Treating Health Professional Screen (CDTT) screen for each care receiver. If this field is not displayed, issue the forms via the Mail Forms workflow
• tell the carer they have 21 days to return the completed forms. An activity will be created on the Future Activity List (FAL) screen for return of the forms

When the forms are returned, see Step 1 in Table 2.

Select the activity from the Activity List (AL) screen (if the review has become due) or the Future Activity List (FAL) screen if it has not yet become due:

• in the Carer Allowance Task Selector (CATS) screen, select the Care Receiver Summary (CRS) screen and press [Enter]
• select the relevant care receiver to view the Care Receiver Task Selector (CETS) screen. Select the Disability Assessment Tool to view the Child Disability Assessment Tool Summary (CDAS) screen
• select the current Event Date to display the Child Medical Details Screen (CDMD). This screen has already been completed before starting this procedure
• press [Enter] to view the Treating Health Professional Assessment (CDTT) screen
• Press [Enter] to view the Carer Assessment (CDTC) screen. Press [Enter]

Code the relevant fields:

• Care Rcvr, CRN, Birth Date. If the care receiver is:
• not a customer in their own right, the CDTC screen will display these fields from within the carer's record
• is a customer in their own right, these details will be displayed in the CDTC screen header only
• Age Milestone is a protected field calculated by comparing the child's date of birth with the date signed
• Adjusted in some circumstances, the DCLAD (2020) score is adjusted to the next milestone age. If this 'cusp adjustment' occurs, the screen will display Adjusted
• Score is protected and represents the system calculated Child Disability Assessment score associated with the assessment provided by the THP
• Initial DOR is protected and displays the date of receipt of the first activity used to enter details of the DCLAD (2020) assessment and is defaulted from the Initial DOR field on the CDMD screen
• Effect Date is protected and shows the date from which the medical information takes effect. Itis defaulted from the CDMD screen. If carer assessment details are keyed first, the date in the Initial DOR field will default to the Effect Date field
• Date signed is to record the date the carer signed the assessment or if it was not dated, the date of receipt
• Date Returned the date the carer returned the carer assessment
• Questions 1 - 10 are used to input the responses received from the carer. Use field help ('?') for relevant entries. Questions 1-8 are mandatory. For Questions 9 and 10, the carer can mark as many statements as they want to describe the child's behaviour. If none of the statements are relevant to this child, Questions 9 and 10 do not need to be answered
• Source, DOR and Action in the footer. The Action field is optional and will accept 'I' for Insert or 'C' for Correct on this screen

Press [Enter]. The CDTC screen will redisplay with the score for each individual question and the total carer score.

If the screen displays as:

• Care Load Validation (CLVL), go to Step 4
• Child Disability Assessment Tool Summary (CDAS), go to Step 5

If the CLVL error SR004 displays on SWE, a process called validation will be required.

Is validation required?

• Yes,
• see Care Load Validation (CLVL) screen
• then go to Step 5
• No, go to Step 5

The CDAS screen summarises the information input, including the THP score and the total score.

Repeat the procedure for the second child.

If the THP score is greater than zero and the total CNA score for either child is 85 or greater:

• for 1 child, go to Step 7
• for both children, go to Step 8

If the CNA is less than 85 for both children, go to Step 9.

If 1 child has a THP score greater than zero and a CNA score of 85 or greater, that child is medically qualified to attract full CA for their carer.

However, the carer may still qualify for Health Care Card (HCC) only level of CA for the second child.

If both children have a THP score greater than zero and a CNA score of 85 or greater, they are medically qualified to attract full CA for their carer. Full payment may be granted in respect of each care receiver.

See Coding a claim for Carer Allowance (CA) where the care receiver is under 16.

If both children have a THP score of greater than zero and a CNA score of less than 85, combine the 2 children's scores.

See Assessing a claim for Carer Allowance (CA) using the combined assessment scores of two children

Is the total combined score 85 or greater?

• Yes, payment may be granted under this provision
• No, the carer cannot be granted under this provision. However they may still qualify for Health Care Card only CA (child)