Reviews of Carer Payment (CP) and/or Carer Allowance (CA) 009-08060000

The purpose of carer reviews for CP and/or CA is to establish that the care receiver’s care needs continue to qualify the carer for payment, and that the carer continues to provide care and attention on a daily basis to the person they provide care for. Carers selected for review can be through Service Profiling, Age Milestones and by the Host system. Depending upon a carer’s circumstances, carers may be required to complete a medical, non-medical, CA taxable income or manual review. Manual Reviews may be necessary to ensure carers continue to meet qualifications for CP and/or CA.

CA adjustable taxable income reviews may be required to check that the carer's and their partner's combined adjusted taxable income is under the CA income limit.

If a carer, care receiver or nominee advises they are affected by family and domestic violence (FDV), or staff suspect they are, follow the FDV Support Model to determine an appropriate referral and further agency support.

Carer reviews include the following.

Adult Medical Reviews apply to carers at risk of being paid CP and/or CA when the adult care receiver's medical condition may have improved. These reviews are risk based and are generated for High, Medium, Low risk customer groups. See Medical reviews for Carer Payment (CP) and Carer Allowance (CA) (adult).

Where a care receiver does not qualify for an income support payment, a non-customer Care Receiver Income and Assets (CRIA) review may be applied to determine a carer’s entitlement to CP. The review process will only be applied to adult and child care receivers when the recorded income is within $5,000 of the applicable income threshold and/or assets are recorded in the medium or high assets value range on the CRIA screen. The review activity matures on 1 November each year. See Reviews of the Care Receiver Income and Assets (CRIA) test.

For the purposes of CA and CP (adult) a terminal condition is where a person aged 16 years or over is in the final phase of a terminal illness and is not expected to live more than 3 months. Adult Terminal Illness reviews are generated 24 months after the grant and every 12 months thereafter for the date of event recorded on the Care Receiver’s Medical Details (ADMD) screen. See Terminal Illness Reviews for Carer Payment (CP) (adult).

For the purposes of CP (child), a terminal condition is where a child under 16 years has a terminal condition and is not expected to live more than 24 months. Child care receivers with a terminal illness will have a review generated 24 months after grant, and every 12 months thereafter. A Social Worker assesses initial reviews generated 24 months after grant. The Carer Processing Team conducts all reviews thereafter. See Terminal illness reviews for Carer Payment (CP) child.

Child Medical Reviews apply to carers in receipt of CA child only. The review process coincides with patterns of childhood development and detects changes in care arrangements. Carers are exempt from the medical review if CA was granted less than 12 months before the scheduled review date, or if they have been medically reviewed in the last 12 months. A Child Medical Review CA only will automatically commence when the child reaches the following development milestones:

• 4 years and 8 months
• 10 years, and
• 13 years

If the carer is also paid CP (child) for the care receiver, separate reviews for both payments will be undertaken through Care Load Reviews. See Child Medical Reviews for Carer Allowance (CA) (child).

Child care receivers under 6 months of age with recognised disability of Severe Multiple Disabilities – Seizures require a care load review when the child reaches 6 months of age. The review is required as some conditions are considered to be a recognised disability for certain periods of time, as the condition can be of a temporary nature. See Recognised disability medical reviews for Carer Allowance (CA) child.

Carers paid CP for a child care receiver under 14 years and 9 months may be selected for a Care Load review. Carers are selected through Service Profiling and if they meet certain conditions and predictors they are profiled into either Medium or High Risk. If the care is also paid CA for the child, this will be reviewed at the same time. See Care Load reviews for Carer Payment (CP) (child) .

Development milestones are the ages at which a child should display the functional abilities listed for the age range (in addition to all of the functional abilities in lower age ranges). Similar to the CA only Child Medical Reviews, the review process coincides with patterns of childhood development and detects changes in care arrangements. To be selected for the Age Milestone Mandatory Review, carers must be paid CP for a child care receiver under 14 years and 9 months of age. The review commences automatically once the child reaches the age of

• 4 years and 8 months or
• 13 years

If the carer is also paid CA for the child, this will be reviewed at the same time. See Age Milestone Mandatory reviews for Carer Payment (CP) (child) and Carer Allowance (CA) (child).

CA HCC only reviews are to determine a carer’s ongoing entitlement to CA HCC only or whether a carer has become eligible for CA at payment level. Carers who are CA HCC only will be reviewed in line with the age milestones for Child Medical Reviews CA only. The Adjustable Income Test for CA will also apply to CA HCC only, see Carer Allowance Income Review.

See Child Medical Reviews for Carer Allowance (CA) (child)

Carers may have access to an unlimited number of hospital admission days for a child care receiver and remain qualified for CP (child) under the hospitalisation provision for CP (child). Carers paid CA for a child who is hospitalised are reviewed every 12 weeks (84 days) of continuous hospitalisation. After 24 months of continuous hospitalisation a Care Load review is undertaken. The Care Load review is then repeated for each subsequent 12 months of continuous hospitalisation (for example, the child has been in hospital continuously for 36 months). See Hospitalisation reviews for Carer Payment (CP) and Carer Allowance (CA) for a child under 16 years.

A carer's eligibility to continue to receive payments is reassessed when they, or the care receiver update their address and advise they no longer live with the carer/care receiver.

See Change of address for Carer Payment and Carer Allowance.

From 20 September 2018, a $250,000 a year adjusted taxable income test applies to CA and CA Health Care Card Only recipients.

Carers are not subject to a CA income review while they are exempt from providing their income details for the CA income test. An exception applies if the carer is only exempt because they or their partner receive Family Tax Benefit - in this case they may be required to complete a CA income review triggered from the data matching process with the Australian Taxation Office (ATO).

Following the initial mailout, subsequent CA income reviews may be triggered. These will generally be triggered automatically but may also be manually triggered, see Manual reviews. Carers should complete their income review online.

Automatic CA income reviews may be triggered in the following situations:

• ATO data matching will automatically trigger a review where the Adjusted Taxable Income (ATI) for the carer (and their partner if they have one) is $250,000 or more for the previous financial year. The rules to trigger a review take into account deemed income and expected ATI if one partner has not been matched with the ATO
• The carer was not exempt from proving their income details for the CA income test as at 20 September 2018 (initial mailout)
• The CA new claim was lodged before 20 September 2018 and the carer was not exempt from providing their income details when the claim was processed after that date
• Changes of circumstances will trigger a CA income review in the following situations if the carer is not exempt from providing their income details for the CA income test and ATI details for the carer and their current partner were not provided in the same financial year:
• the carer is linked to a new partner
• the carer is no longer exempt from providing their income details for the CA income test
• a new account-based income stream has been added for the carer or their partner and the account holder is aged 60 or older
• the CA new claim was submitted before 20 September 2018 and processed after this date
• The Service Officer initiates a CA income review manually because the carer notifies one of the following and is not exempt from providing their income details for the CA income test:
• their and their partner’s combined adjusted taxable income for the previous financial year was over the limit and they are not already assessed on a current year estimate
• they or their partner receive an account based income stream and current Adjusted Taxable Income (ATI) information is not held

A manual review may be required when information is received that indicates entitlement to CP and/or CA has been lost. There are no time restrictions on when a manual review may be conducted, a manual review can be started whenever it is deemed appropriate. A Manual Review would be initiated for the following:

• Services Australia receives notification a care receiver has returned to full time work
• a carer or care receiver advises the agency the care receiver's medical condition has improved significantly
• the agency has been advised by a third party the carer is no longer providing care for the care receiver

The above scenarios are only examples. Commence a review in any situation when entitlement to CP and or CA may be cancelled. See Cancellation and suspension of Carer Payment (CP) and/or Carer Allowance (CA).

A review activity may be created when the care receiver enters a residential care facility. When a care receiver permanently enters an institution, they permanently leave the care of their carer. Carers in receipt of CP continue to receive payment for 14 weeks from the first date the carer did not provide constant care. In most cases, it will be the day after the person enters the institution.

There is no equivalent provision for CA. When a permanent cessation of care occurs, cancel CA from the first date the carer did not provide care and attention. See Care receiver permanently enters or temporarily/permanently leaves an institution.