Compensation lump sum preclusion periods (CLK) 117-02020000

Check no periodic compensation payments have been recorded on the following screens:

• Claim Details or
• Periodic Payment Details

Has the customer received periodic payments?

• Yes, go to Step 3
• No, go to Step 2

Determine the start date of the preclusion period. Either the date of:

• injury
• diagnosis, or
• economic loss or capacity to earn commenced

If the economic loss date on the Incident Details screen is:

• the same as the injury date or date of diagnosis, the preclusion period starts on the date of injury or date of diagnosis
• different than the date of injury or date of diagnosis, the preclusion period starts on the day economic loss commenced

The Resources page contains an example.

Have prior lump sums been awarded for the same date of incident?

• Yes, go to Step 5
• No, procedure ends here

If periodic payments have been received, check the following screens:

• Claim Details
• Date Periodic Payments ceased
• Periodic Payments Details:
• If ongoing periodic compensation is coded, end date the periodic compensation
• If nothing is recorded the preclusion start date will be the date coded on the Claim Details screen

Where periodic payments have:

• ceased as a result of the lump sum settlement, the preclusion period starts from the day after periodic compensation ceased
• continued, the start date of the preclusion period cannot be calculated until the periodic payments stop

If the customer receives ongoing periodic payments and a lump sum payment which incurs a future preclusion period:

• Send a Q928 Nil Recovery notice to the compensation payer. This will allow the payer to release the lump sum and stop periodic payments
• Place the CMM/CHG activity on hold for 7 days
• If there is no CMM/CHG activity, create the Compensation Progress Doc Fast Note and place it on hold for 7 days:
• Select Auto text, use Compensation > For use by Compensation Staff only > Template: Compensation Progress Doc. Select Confirm
• Enter notes (for example, periodic payments continuing until settlement is released, preclusion period to be actioned)
• Record all action taken in a DOC

The Resources page contains examples of the determination of the start date of the lump sum preclusion period.

Procedure ends here.

If the customer’s periodic payments are reduced to allow for a lump sum redemption of part of the future periodic payments, check the following screens:

• Claim Details
• Date Periodic Payments ceased – record the day before the periodic payments are reduced
• Periodic Payment Details
• If ongoing periodic compensation is coded, end date the periodic compensation.
• If nothing is recorded, the preclusion start date will be the date coded on the Claim Details screen

Have prior lump sums been awarded for the same date of incident?

• Yes, go to Step 5
• No, procedure ends here

Where more than one lump sum payment has been awarded for the same incident:

• Add the lump sums together
• Calculate a new preclusion period by applying the relevant divisor at the time of settlement

Any lump sum paid prior to the full and final settlement are treated under the aggregation rules as per s1171 of the Social Security Act 1991. This includes:

• Impairment payments
• Advance Payments
• Redemption Lump Sums

Do not code lump sums paid solely for arrears of periodic payments as a lump sum.

Update the Lump Sum Payments screen to allow for auto aggregation prior to calculating a charge. Advance payments and Redemption Lump Sum will result in a preclusion period.

The start day of the preclusion period is:

• the date of the incident, diagnosis or economic loss if no periodic payments have been made
• the day after periodic payments ceased if periodic payments have been made