Terminal illness reviews for Carer Allowance (CA) adult 009-08060070

When a review is due for the carer of a terminally ill person, details of the CDA/AAC activity appear on the Activity List (AL) screen.

The notes line will read 'Adult Terminal illness review (TIR) for XXXXXX. Contact carer to confirm circumstances'.

If the carer is also paid Carer Payment (CP) for the same care receiver, this activity will also review CP entitlement. See Reviews of Terminal Illness for Carer payment (CP) (adult).

Check the records of the carer and care receiver to see if contact has recently been made to advise of any change of circumstances (such as, the care receiver may have entered a hospice or died).

• Yes, the review can be finalised without contacting the carer. See Step 1 in the Finalising a review of terminal illness for CA (adult) table
• No, go to Step 3

It is best practice to phone the carer to confirm whether or not the care receiver remains in the terminal phase of a terminal illness. As the care receiver is an adult, they would have previously been exempted from completing the Adult Disability Assessment Tool (ADAT) because of the terminal illness. This review is to confirm the carer still qualifies under this criteria.

If the carer cannot be contacted by phone after a reasonable number of attempts, it may be appropriate to issue the 'Request customer to complete form or questionnaire (Q004) letter.

The Q004 letter should contain the following:

• 'To make sure that you are receiving the correct payment, we need some information from you.'
• Use Free Text paragraph option:
• '{You were granted Carer Allowance because 'Care receiver's name' was diagnosed with a terminal illness. We are reviewing your payment to confirm whether or not 'Care receiver's name' remains in the terminal phase of an illness and if not, whether you remain qualified for Carer Allowance. Please call me on {USER.PHONE.NUMBER} to discuss this review. I enclose 2 forms for you to fill in if you are unable to contact me}.
  Please fill in the enclosed original forms in pen. Sign, date and return them to me with 28 days from the day you receive this letter.
  Please answer all questions. Strokes, ticks or dashes cannot be accepted as answers except where specified.
  Section 192 of the Social Security (Administration) Act 1999 allows the Secretary or a delegate to require any person to give information relevant to Centrelink customers receiving their correct entitlement. This is a notice requesting information under Division 1 of Part 5 of the Social Security (Administration) Act 1999 and given to you under section 196 of that Act.
  Please call me on {User.Phone.Number} if you have difficulty filling in the forms.
  If you do not reply or contact us within 28 days after the day on which you receive this letter your payment may be stopped.'
• Enclose the following forms:
• SA332a - Carer Payment and/or Carer Allowance Medical Report - For a person - 16 years or over
• SA010 - Review of care provided - Carer Payment and/or Carer Allowance - Caring for a person 16 years or over

Note: the free text paragraph variable holds nine lines of a maximum of 75 characters, including spaces and punctuation. Ensure there is at least one space left at the end of each line.

The activity will not automatically complete as the MFU activity will remain on the Activity List (AL) screen until the review is completed, so it is not necessary to defer the review if delays are expected.

There is no co-residency requirement for qualification under section 954A of the SSAct, so the private home can be the home of either the residence of the carer or care receiver but not both. The required care and attention must still be provided to the care receiver in a private home but it may be the residence of either the carer or the care receiver.

If the carer and care receiver were co-residing and at time of review are no longer co-residents, issue a SA381 - 'Carer not living with the person being cared for.'

• Yes, go to Step 9
• No, go to Step 5

• Yes, the death and bereavement processing must be completed, see Death of an adult care receiver and the effect on Carer Allowance (CA). There are no bereavement payments in respect of CA with an adult care receiver. See Step 1 in the Finalising a review of terminal illness for CA (adult) table
• Note: if the carer is getting CP (XWP), and the care receiver who died was their partner, or their only or last CA care receiver, the carer is eligible for bereavement assistance. See Death of a adult or child care receiver and the effect on Carer Payment.
• No, go to Step 6

• respite
• hospitalisation
• overseas absence
• carer undertakes training, education, unpaid voluntary work, self employment or paid employment?
• Yes, ensure this absence is coded as part of the CDA/AAC activity, and go to Step 7
• No, the carer is not qualified for CA. The payment should be cancelled as a part of the CDA/AAC activity. See Step 1 in the Finalising a review of terminal illness for CA (adult) table

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

• Yes, this is an exception to the temporary absence rule. This terminally ill review procedure will follow-up on these cases. Go to Step 9
• No, unless a Temporary Cessation of Care (TCC) extension applies the carer is not qualified for CA. See Absences exceeding 63 days. The payment should be cancelled as a part of the CDA/AAC activity. See Step 1 in the Finalising a review of terminal illness for CA (adult) table

This information may have already been provided by the carer during the conversation about care details. If not, sensitively ask a question to determine the required information.

Do not use the word 'terminal' as it is possible the carer is not aware of the doctor's assessment of the severity of the condition.

Is the care receiver still terminally ill?

• If the care receiver is still terminally ill, or
• If the care receiver's condition has improved, See Step 2 in the Finalising a review of terminal illness for CA (adult) table

'S'elect the activity from the Activity List (AL) screen (or the FAL screen if more than 28 days since the review matured). This activity must be undertaken in the care receiver's record. The Carer Allowance Review (CDRV) screen is presented.

Ensure death action is taken in the care receiver's record. See Death of an adult care receiver and the effect on Carer Allowance (CA). Offer the carer to the social work service.

Procedure ends here.

As the care receiver is an adult and reviews are conducted 24 months after grant and 12 monthly thereafter, they must undertake a standard Adult Disability Assessment Tool (ADAT) including the re-use and reclaim provisions review before a decision can be made on eligibility.

Issue to the carer:

• A 'Request customer to complete form or Questionnaire' (Q004) letter
• Carer Payment and/or Carer Allowance Medical Report for a person 16 years or over (SA332a)
• The Review of Care provided - Carer Payment and/or Carer Allowance - caring for a person 16 years or over (SA010)
• The carer has 14 days to return the forms, the delegate has discretion to grant the carer an extension at the carer's request

Go to Step 3.

Has the carer returned the Carer Payment and/or Carer Allowance Medical Report for person 16 years and over (SA332(a)), and the Review of Care Provided - Carer Payment and/or Carer Allowance (caring for a person 16 years or over) (SA010)?

• Yes, go to Step 5
• No, go to Step 4

If the carer has not returned the Carer Payment and/or Carer Allowance Medical Report for person 16 years and over (SA332(a)), and the Review of Care Provided - Carer Payment and/or Carer Allowance (caring for a person 16 years or over) (SA010) forms payment may be cancelled at the delegate's discretion. Cancellation reason 'Failed to return Correspondence' (FRC) is to be used; and a comprehensive DOC must be updated on the carer's record.

Procedure ends here.

Assistance with coding can be accessed by selecting the screen name below. Field help ('?') can also be used on each screen for coding assistance.

• 'S'elect the CDA/AAC activity from the AL or FAL screen, which will go to the Carer Allowance Review (CDRV) screen. The activity must be processed in the care receiver's record. A series of questions are asked on this screen. The Complete Review?: field should only be selected at this point if the answer to all the questions on the CDRV are yes.
• The Complete Review?: field must not be coded with a 'Y' if any of the circumstances have changed, until the record has been updated. Updating the record may require absences being recorded on the Absence Details (ABSN) screen if all absences have not been recorded, then return to the CDRV screen to follow up on further updates or finalise the review
• If care details have changed, select the Go To: Care Details: field by coding a 'Y'
• If medical details have changed, select the Disability Assessment Tool: field by coding a 'Y'
• Note: it is possible to select both the Care Details: and the Disability Assessment Tool: fields at the same time, but the Complete Review?: field cannot be selected at this same time
• Update the ADMD screen and code the Period of Condition field as 'TMI'
• Depending on the coding above, some, or all of the following screens will be selected:
• Care Details (CDCR) screen
• Adult Medical Details (ADMD) screen
• Adult Disability Assessment Tool Summary (ADAS) screen - enables the update of the medical details. 'S'elect the Add a new assessment: field to be navigated to Adult Disability Management (ADMG) screen
• Adult Disability Behaviour (ADBH) screen
• Adult Disability Personal Activities (ADPA) screen
• Adult Disability Cognitive Functions (ADCF) screen
• Insert data as required and press [Enter] to step through the selected screens. The information entered will determine the outcome of the review. The result will be indicated on the Assessment Results (AR) screen
• An automatic advice will be sent to the carer notifying them of the outcome of the review

Note: a CP (XWP) carer may lose qualification for CP (XWP) if they no longer qualify for payment level CA after completion of a CA adult terminal illness review. For more information see Transfer from Wife Pension (WP) to Carer Payment (CP).