Carer Allowance (CA) (child) Health Care Card (HCC) only reviews 009-08040020

Has the carer requested a Carers Child to Adult Transfer (CTAT) after being informed their CA (child) HCC only will be stopping when the care receiver turns 16?

• Yes, see Carer Payment (CP) and/or Carer Allowance (CA) Child to Adult Transfer (CTAT). Procedure ends here
• No, go to Step 2

The system automatically sends a notification letter to the carer with the forms:

• Review of Carer Allowance Medical Report including Functional Assessment (for a child under 16 years) (SA403)
• Review of Carer Allowance Care Needs Assessment (for a child under 16 years) (SA420)

The reminder stage of the review will be registered on the Future Activity List (FAL) at this time. A reminder will be issued in 28 days.

If the carer has not returned the forms after 56 days, auto-cancellation will occur, unless the review has been deferred.

Is it necessary to re-issue the forms?

• Yes, reprint the form via the History Summary (HS) screen or see Resources page for forms
• No, go to Step 4

Check that all parts of the review have been lodged.

If the carer has only returned one part of the review:

• do not register the documents in the system
• check the form is complete and has been signed by the carer and/or the Treating Health Professional (THP)
• ask the carer when they will return the form and note this in the DOC for the Processing Team
• procedure ends here

When both parts of the review have been returned, register the return of the Child Medical review:

• register the documents in the system to prevent the next auto action (such as reminder, suspension, cancellation)

If the carer is lodging forms at a service centre:

• scan the review forms
• check the review has been removed from the FAL screen on either the care receiver's and/or carer's records to prevent possible suspension/cancellation. If not, mature the review on the FAL screen manually. To remove the medical review activity from the  FAL  screen:
• navigate to Customer Record
• select the review
• key the source code and receipt date
• navigate to the Activity List (AL) screen where this activity will appear as ‘STA’rted
• procedure ends here

If a carer calls as a result of receiving a medical review reminder and the medical review can be found scanned onto the carer's record, telephony staff can mature the review from the FAL screen if it has not been removed from the FAL screen already. Procedure ends here.

For Processing Service staff, go to Step 5.

The Resources page contains links to these forms.

Reminder at 21 days

If the review is not returned within 21 days, a reminder letter will be automatically issued.

Suspension at 42 days

If the review forms are not returned within 42 days of issue, the system will automatically suspend the payments Fail to Reply to Correspondence (FRC).

A suspension letter will be issued to the carer.

If the carer contacts within 13 weeks of the cancellation, conduct a review of the decision to cancel and conduct the review.

If the carer receives CA there are 3 possible actions:

• CA (manual) will be cancelled CAN/MRN
• if there are other CA care receivers, the carer remains current
• if there are no other CA care receivers, the carer is cancelled CAN/NDE

If only one part of the review has been returned and 21 days has elapsed from the date of issue, do not remove the activity from FAL.

Allow the system to automatically issue the reminder letter at 28 days. The system will automatically suspend the record at 56 days, with a Failed to Reply to Correspondence (FRC) suspension letter issued to the customer. If the carer does not respond, payment will cancel after 13 weeks from issue of review and a cancellation letter will be sent automatically.

If the carer contacts:

• within 13 weeks of the cancellation and both parts of the review have been returned, conduct a review of the decision to cancel
• after 13 weeks of cancellation, the carer must make a new claim for CA

Carer reviews are processed manually.

There are 2 levels of CA child. One is a payment and a health care card and the other is a health care card only and no payment.

Because of this, any review of CA must check whether the carer is entitled to CA payment, and if not entitled to payment level CA, whether they are entitled to a HCC only.

When assessing a CA HCC only review, examine the review forms as though they relate to a carer getting a full CA payment review.

Calculate the Disability Care Load Assessment Determination (DCLAD) score.

Due to the full CA review, is the carer entitled to receive a CA payment?

• Yes, reassess the carer's CA payment from CA (child) Health Care Card (HCC) only. Go to Step 3
• No, go to Step 4

Is the Medical Condition the same medical condition from when the CA (child) HCC only was granted?

• Yes, the carer is eligible for payment of CA payment. Go to Step 4
• No, the Service Officer will need to contact the Treating Health Professional (THP) and confirm when the medical condition commenced. Go to Step 4

Does the THP's diagnosis indicate the child has a physical, intellectual or psychiatric disability?

• Yes, go to Step 5
• No, go to Step 8

Does the THP state that the child's condition is temporary?

• Yes, go to Step 6
• No, go to Step 7

Does the THP state that the temporary condition is expected to be present for at least 12 months?

• Yes, go to Step 7
• No, go to Step 8

Does the THP state that the condition requires extra care and attention for 14 hours or more per week?

• Yes, go to Step 9
• No, go to Step 8

The process of coding the review activity will cancel the care receiver and reassess the carer.

'S'elect the CDA/AAC activity from the Activity List (AL) screen.

Action the review in the care receiver's record, unless the care receiver does not have a record of their own (that is, the care receiver is not a customer in their own right, as is the case with many child care receivers).

Coding assistance is available by selecting each of the following links. Field help ('?') can also be used on each screen for coding assistance.

On the Carer Allowance Review (CDRV) screen, do not code the Complete Review? field:

• when the CDRV screen is accessed, the screens selected depend on the details provided on the review form requiring update:
• if care details have changed, select the Go To Care Details field by coding 'Y'
• if medical details have changed, select the Disability Assessment Tool field by coding a 'Y'
• it is possible to select both the Care Details and the Disability Assessment Tool fields at the same time
• complete the following screens:
• Care Details (CDCR) screen
• Child Medical Details (CDMD) screen - code the 14 or more hrs extra care weekly? field as 'N'. Note: mandatory field
• Child Disability Assessment Tool Summary (CDAS) screen
• Care Receiver Benefit Action (CJBA) screen
• Treating Health Professional Assessment (CDTT) screen
• Carer Assessment (CDTC) screen
• record the details on a DOC
• finalise the activity via the Assessment Results (AR) screen
• the Date of Effect for cancellation for not attaining a qualifying score is the date of determination of the review under Section 118 (13) of the Social Security (Administration) Act 1999. See Legislation on the References page for a link to the Act
• an automatic advice will be sent to the carer notifying them of the review result

Procedure ends here

'S'elect the CDA/AAC activity from the AL screen.

The review should be actioned in the care receiver's record, unless the care receiver does not have a record of their own (the care receiver is not a customer in their own right, as is the case with many child care receivers).

• the Carer Allowance Review (CDRV) screen is presented. Code the Complete Review? field 'Y' and press [Enter]
• record the details on a DOC
• finalise the activity via the AR screen
• an automatic advice will be sent to the carer notifying them of the review result