Special circumstances provisions for customers receiving compensation payments 117-04020010

Applying the normal compensation provisions to a particular customer's situation may:

• have an unintended effect
• lead to extreme hardship, or
• create an inequitable or unjust situation

Staff should apply these provisions in situations that are unusual, unforeseen, or exceptional. A combination of factors usually apply to a customer. Consider each customer’s situation as a whole. Judge each case on its merits.

Where special circumstances exist, Section 1184k of the Social Security Act 1991 allows the Compensation Recovery Team (CRT) to treat all or part of a compensation payment as:

• not having been made, or
• not liable to be paid

Only APS5 or above have the delegation to apply special circumstances under s1184K.

When staff apply special circumstance provisions to lump sum compensation payments, the decision will reduce part, or all of a preclusion period. This may also reduce or negate any associated compensation debt.

The Compensation Recovery Team (CRT) must decide whether:

• special circumstances apply if a customer:
• provides new information or has a change in circumstances, and
• requests consideration to treat all or part of a compensation payment as not having been made, or reduce a compensation preclusion period
• they can reduce any corresponding compensation debt based on the special circumstances decision

Do not apply special circumstance provisions if the customer:

• has sufficient liquid assets to support themselves for the duration of the preclusion period
• has purchased assets and there is no reason those assets cannot be realised
• does not agree with the legislation

Staff cannot use the special circumstance provisions under section 1184K to waive a compensation debt. They can only apply these provisions to disregard a compensation payment in part or full, which may reduce or negate any associated debt. For waiver of debt due to special circumstances, see Special circumstances debt waivers.

A decision to subject a customer to a compensation preclusion period has no operative effect until they make a claim for a compensation affected payment (CAP). A customer cannot request a SME explanation or apply for a formal review of a decision that has not been made or that has no effect.

Customers must make a claim for a CAP before asking for a reduced compensation preclusion period because of special circumstances.

Customers’ do not need to lodge a further claim if their CAP was cancelled or rejected within 13 weeks of requesting an explanation of decision or formal review because of the preclusion period.

If a customer does not understand or does not agree with a compensation or special circumstances decision, they can request an explanation or apply for a formal review of the decision. See First contact about a decision and the internal review process.

There are language and Interpreter Services available for customers who may need an:

• Immediate telephone interpreter
• Indigenous language interpreter