Implementing the outcome of a review of a participation failure decision 001-10130020

After a review of a TCF decision is completed, the outcome is implemented by:

• a PST-skilled Service Officer (WNPDD) for a non-priority review, or
• the Appeals Support Team for a priority review

The decision must be implemented within:

• 7 days of the instructions being sent for a formal review by an ARO, or
• 30 days for a review by the Administrative Review Tribunal (ART). Note: an ART decision must only be implemented when directed by the Litigation Branch. See Administrative Review Tribunal (ART)

For decisions relating to:

• a participation suspension following a mutual obligation failure or work refusal failure, go to Step 2
• a financial penalty for a first or second mutual obligation failure in a failure group within 13 weeks, go to Step 3
• a financial penalty for a first or second mutual obligation failure in a failure group outside of 13 weeks, go to step 4
• an update of the penalty sequence for failures outside of 13 weeks, go to step 5
• cancellation of payment because of a third mutual obligation failure, work refusal failure, or unemployment failure, go to Step 6
• failure to re-engage within 29 days, go to Step 7
• an unemployment preclusion period at new claim, go to Step 8
• cancelling a Services Australia started review decision transaction, go to step 9

If a decision to suspend payment for a mutual obligation failure or work refusal failure is set aside following a review of the decision:

• key BIPCW in the Super Key field, select Enter. The Participation Compliance Hub screen will show
• select the associated outstanding suspension report
• select the re-engagement link
• select the reason No re-engagement, appeal outcome (RNT)
• finalise the transaction
• run the Appeal Decision Implementation script in Customer Record which will update the Appeals (APL) system and create a DOC on the job seeker’s record
• clear out of the job seeker’s record to trigger background processing

Note: If the re-engagement requirement is already finalised, run the Appeal Decision Implementation script in Customer Record. This will update the Appeals (APL) system and create a DOC on the job seeker’s record noting that the re-engagement has been finalised.

Procedure ends here.

If the decision is to set aside:

• key BIPCW in the Super Key field, select Enter. The Participation Compliance Hub screen will show
• select Compliance workflow with compliance status Applied. The Completed Compliance Actions screen will show
• select Review Decision. The Review decision workflow will show:
• Record the date of contact in the Date Review Requested/Initiated field
• In the Status field, record the status as RVK – Revoke
• Select the appropriate Category and Revoke reason
• Record the status/decision date
• Add comments in the Please provide details to support the reason for making this decision field
• finalise the Review decision workflow
• run the Appeal Decision Implementation script in Customer Record which will update the Appeals (APL) system and create a DOC on the job seeker’s record

When the decision has been made to set aside the job seeker's financial penalties, any subsequent failures in the same failure group are adjusted automatically by the system.

When either, or both, of the first or second mutual obligation failures in the failure group is revoked and a third failure has also been applied, the third penalty automatically converts to the appropriate first or second failure.

Procedure ends here.

If the decision is to set aside:

• key BIPCW in the Super Key field, select Enter. The Participation Compliance Hub screen will show
• select Compliance Workflow with compliance status Applied. The Completed Compliance Actions screen will show
• select Review Decision. The Review Decision workflow will show:
• Record the date of contact in the Date Review Requested/Initiated field
• In the Status field, record RVK – Revoke
• Select the appropriate category and revoke reason
• Record the Status/decision date
• Select Tribunal or other instruction on the Review of decision has occurred outside of the 13 week timeframe allowed for a favourable determination. If the failure should be revoked, an override reason must be selected field (This will only display if the decision to revoke is outside of 13 weeks)
• Add comments in the Explanation and Please provide details to support the reason for making this decision field
• finalise the Review decision workflow
• run the Appeal Decision Implementation script in Customer Record which will update the Appeals (APL) system and create a DOC on the job seeker’s record
• if the expected arrears are not automatically issued, these must be manually paid through PYAJ by an APS5. See How to manually calculate arrears for more details
• Note: repeat this process for each failure that is set aside

When the decision has been made to set aside:

• any subsequent financial penalties for the job seeker in the same failure group are not adjusted automatically by the system as it is outside of 13 weeks
• and if it is a first failure decision and a second penalty exists in the same failure group, the second penalty does not automatically convert to a first penalty. Manually update the Penalty sequence and return any over-recovered amount to the job seeker
• and if it is a first or second failure decision and a third failure exists in the same failure group, the third penalty does not automatically convert to the appropriate first or second failure as it is outside of 13 weeks. Manually update the Penalty sequence and return any over-recovered amount to the job seeker

Does the Penalty sequence need to be updated?

• Yes, go to step 5
• No, Procedure ends here

Update the penalty sequence using the Review Decision workflow:

• Key BIPCW in the Super Key field, select Enter. The Participation Compliance Hub screen will show
• Select Compliance Workflow with compliance status Applied. The Completed Compliance Actions screen will show
• Select Review Decision. The Review Decision workflow will show:
• Record the date of contact in the Date Review Requested/Initiated field
• Select the appropriate sequence update In the Actions Required field
• Select the response PVR – Variation to penalty as a result of review in the field Please indicate why the penalty needs to be adjusted
• Add comments in the Please provide details to support the reason for making this decision field
• Finalise the Review Decision workflow
• If the expected arrears do not issue automatically, these must be manually paid through PYAJ by an APS5. See How to manually calculate arrears for more details

Repeat the above penalty sequence update for all relevant failures. See Resources for penalty sequence examples.

Procedure ends here.

If the decision is to set aside:

• key BIPCW in the Super Key field, select Enter. The Participation Compliance Hub screen will show
• select Compliance Workflow with compliance status Applied. The Completed Compliance Actions screen will show:
• select Review Decision. The Review Decision workflow will show:
• Record the date of contact in the Date Review Requested/Initiated field
• In the Status field, record RVK – Revoke
• Select the appropriate category and revoke reason
• Record the status/decision date
• Select Tribunal or other instruction in the Review of decision has occurred outside of the 13 week timeframe allowed for a favourable determination. If the failure should be revoked an override reason must be selected: field (Note: This only displays if the decision to revoke is outside of 13 weeks)
• Add comments in the Explanation and Please provide details to support the reason for making this decision: field
• finalise the Review Decision workflow
• run the Appeal Decision Implementation script in Customer Record which will update the Appeals (APL) system and create a DOC on the job seeker’s record
• make genuine attempts to contact the job seeker to make them aware of their responsibility to comply with compulsory requirements
• make sure the job seeker’s Job Seeker Registration (JSR) is active (ACT). For more details, see Registering a customer as a job seeker

When the decision has been made to set aside

If a decision that cancelled a participation payment is set aside, payment must be reinstated from the date of effect of the decision to cancel. This only applies when the application for review was lodged within 13 weeks of the decision being notified to the job seeker.

The non-compliance cancellation and post cancellation non-payment periods are automatically lifted after the Review workflow is finalised. To allow background processing to take effect, clear out of the job seeker’s record.

If the background processing is not successful, a manual follow up (MFU) activity with keyword TCFRES is created. For more information, see Participation Compliance Manual Follow Up Review guide.

Procedure ends here.

If a decision to cancel a payment because of a failure to re-engage within 29 days (CAN CDR) is set aside after a review:

• restore the payment, see Restoring payment after an incorrect CDR cancellation, Re-engaging job seekers – Targeted Compliance Framework > Process > Step 8 (Restoring payment after an incorrect CDR cancellation), and
• run the Appeal Decision Implementation script in Customer Record which will update the Appeals (APL) system and create a DOC on the job seeker’s record

Procedure ends here.

If the decision to apply an Unemployment Non-payment Period (UNPP) is set aside after a review of the decision:

• key BIPCW in the Super Key field, select Enter. The Participation Compliance Hub screen will show
• select Compliance Workflow with compliance status Applied. The Completed Compliance Actions screen will show
• select Review Decision. The Review Decision workflow will show:
• Record the date of contact in the Date Review Requested/Initiated field
• In the Status field, record RVK – Revoke
• Select the appropriate category and revoke reason
• Record the status/decision date
• Select Tribunal or other instructions in the Review of decision has occurred outside of the 13 week timeframe allowed for a favourable determination. If the failure should be revoked an override reason must be selected field (This only displays if the decision to revoke is outside of 13 weeks)
• Add comments in the Explanation and Please provide details to support the reason for making this decision: fields
• finalise the Review Decision workflow
• run the Appeal Decision Implementation script which will update the Appeals (APL) system and create a DOC on the job seeker’s record
• make genuine attempts to contact the job seeker, to make them aware of their responsibility to comply with compulsory requirements

Note: if the 13 week favourable determination rules are met, the unemployment preclusion period is automatically lifted after the Review workflow is finalised. This may affect the new claim start date.

Procedure ends here.

When a started review decision activity is no longer required, PST SMEs can update the status to cancelled in Process Direct as follows:

• Go into the customer’s record using Customer Summary
• Select Transaction
• Select the Review decision transaction
• Select Status
• Select Edit
• Use the dropdown to update the Status to Cancelled
• Select Save

After a review of a JSCF decision is completed, the outcome is implemented for:

A non-priority review:

• by a PST SME
• by a service centre SME with security resource Unemployment Non-Payment Period (UNPP) for decisions:
• made by service centre Service Officers
• relating to a UNPP, and
• with a start date prior to claim (including associated hardship decisions)

A priority review - by the Appeals Support Team.

The outcome must be implemented within:

• 7 days of instructions for a formal review sent by an ARO, or
• 30 days for a review by the Administrative Review Tribunal (ART). Note: only implement an ART decision when directed by the Litigation Branch. See Administrative Review Tribunal (ART)

For decisions relating to:

• payment under hardship provisions, go to Step 2
• Non-attendance Report (NAR), go to Step 3
• connection, non-attendance, reconnection or No Show, No Pay failures, including payment suspension (participation), go to Step 4
• cancelled payment because of ongoing non-compliance, go to Step 5
• UNPP or a serious failure, go to Step 6
• cancelling a Services Australia started Re-engagement or review decision activity, go to step 7

If a decision not to make payment under hardship provisions is affirmed following a review of the decision:

• run the Appeal Decision Implementation script in Customer Record which will update the Appeals (APL) system and create a DOC on the job seeker’s record, and
• make genuine attempts to contact the job seeker if they are serving a serious failure penalty:
• Explain waiver provisions if they agree to participate in a Compliance Activity
• Record the conversation with the job seeker in a DOC

If a decision not to make payment under hardship provisions is set aside following a review of the decision:

• key BIPCW in the Super Key field, select Enter. The Participation Compliance Hub screen will show
• select Compliance Workflow with compliance status Applied. The Completed Compliance Actions screen will show
• select Review Decision
• use the Review Decision workflow to record eligibility for hardship provisions from the date the job seeker meets the eligibility criteria on the Waiver Consideration screen. For more details, see:
• Unemployment due to a voluntary act or misconduct
• Serious failure hardship provisions
• finalise the Review Decision workflow
• make genuine attempts to contact the job seeker to:
• explain the need to continue to meet their mutual obligation requirements while receiving payment under hardship provisions, and
• re-engage with their Employment Services Provider.
  Record the conversation with the job seeker (including any notification provided) in a DOC
• run the Appeal Decision Implementation script in Customer Record which will update the Appeals (APL) system and create a DOC on the job seeker’s record

Procedure ends here.

If a NAR is found to be invalid:

• key BIPCW in the Super Key field, select Enter. The Participation Compliance Hub screen will show
• select Compliance Workflow with compliance status Applied. The Completed Compliance Actions screen will show
• select Re-engagement on the Completed Compliance Action screen
• select the reason No re-engagement, appeal outcome (RNT)
• complete the transaction

This will result in the following:

• When the NAR was not already finalised, the NAR and any outstanding reconnection requirement will be finalised
• When the NAR was already finalised, finalisation reason will be updated and any outstanding reconnection requirement from the NAR will be finalised
• If a non-attendance failure (NAF) has already been generated within the same sequence of events, the NAF can only be rejected
• If a non-attendance failure (NAF) has already been applied, the result will be changed to revoke
• If a reconnection failure has already been generated, it can only be applied without penalty or rejected
• If a reconnection failure has already been applied with penalty, the result will be changed to 'applied without penalty'

Procedure ends here.

When a decision is affirmed for a connection failure for non-attendance at a third party provider appointment, or failure to enter into a Job Plan following a review of the decision:

• check to see if the job seeker has already been re-engaged. If not:
• schedule the appropriate reconnection requirement on the Re-engagement screen, and
• notify the job seeker of the requirement to comply, including consequences of non-compliance
• run the Appeal Decision Implementation script in Customer Record which will update the Appeals (APL) system and create a DOC on the job seeker’s record

When a decision to apply a connection failure, non-attendance failure, or reconnection failure is set aside following a review of the decision:

• use the Review Decision workflow to:
• record the date of contact in the Date Review Requested/Initiated: field
• in the Status field, record RVK – Revoke
• select the appropriate category and revoke reason
• record the status/decision date
• select Tribunal or other instruction in the Review of decision has occurred outside of the 13 week timeframe allowed for a favourable determination. If the failure should be revoked an override reason must be selected: field (Note: This only displays if the decision to revoke is outside of 13 weeks)
• add comments in the Explanation and Please provide details to support the reason for making this decision: field
• finalise the Review Decision workflow
• if re-engagement has not already occurred, make genuine attempts to contact the job seeker to re-engage them with the Employment Services Provider through the Re-engagement screen
• run the Appeal Decision Implementation script in Customer Record which will update the Appeals (APL) system and create a DOC on the job seeker’s record

When a decision to apply a connection failure or suspension failure is set aside:

• return any reconnection failure penalty amounts already recovered to the job seeker when:
• the failure was revoked for being '‘invalid'’, and
• this was the only valid failure in the failure sequences before a reconnection failure was '‘applied with penalty'’.
  The reconnection failure is not revoked, but instead becomes a connection failure
• return any non-attendance failure penalty amounts already recovered to the job seeker

The Review Decision workflow will help to identify when adjustments to penalties are required. In some cases, an MFU will also be created if manual calculation of a penalty amount or arrears is needed.

Manually calculate the job seeker's net entitlement for the affected periods. If necessary, correct the arrears or debt amount displayed. For more details, see How to manually calculate arrears.

If the decision is varied, and the reconnection failure should be applied without penalty, the reconnection failure status should automatically change to 'applied without penalty'. This applies if the previous failures in the failure sequence were assessed as invalid.

A failure is invalid if it was rejected or revoked using one of the following rejection codes:

• Returned for update - insufficient evidence/documentation (IVA)
• Returned for update - incorrect incident date (IVH)
• Withdrawn by provider - PR invalid (WRA)
• Undertaking other requirements included in Job Plan - unable to comply (ERD)
• Notification was not given or recorded (NOA)
• Job seeker not notified properly (NOB)
• Requirement not supported by Activity Agreement (URA)
• Inappropriate activity or program referral (URB)
• Unreasonable commuting distance (URC)
• Unreasonable requirement - not supported by policy (URD)
• Job seeker exempt from requirement at time of failure (URF)
• Failure incorrectly reported (IRA)
• Other pending connect/reconnect failure for this provider (IRE)
• Other applied NSNP failure for this date (IRF)
• Nil entitlement for failure period (IRG)
• Failure occurred during Recon failure period (IRH)
• Connection failure revoked (IRI)

Updating the status of previous failures

If the rejection reason for a failure needs to be changed to show it is invalid:

• go to the Incident Summary (BIIS) screen in Customer First
• select the failure, and
• change the Status Reason on the Breach Investigation (BIDE) screen

To change the revoke reason recorded for a failure, use the Review Decision workflow.

Note: when the rejection reason is updated on the BIDE screen to show a failure is now invalid, the system may not automatically change the subsequent reconnection failure status from 'Applied' to 'Applied without penalty'. If this occurs, manually update the reconnection failure status in the Review Decision workflow. Only take this action when all the previous failures in the same failure sequence are invalid.

For further information, see Non-compliance with compulsory requirements - review and appeals.

Implementing outcomes of a decision relating to a payment suspension (participation).

If the outcome of a review/appeal is to restore payment, it must be restored back to the date of suspension. This applies when:

• a payment suspension (participation) exists, and
• the application for review was lodged within 13 weeks of the decision being notified to the job seeker

Procedure ends here.

Decision to cancel a payment because of ongoing non-compliance is set aside:

• For details of the workaround for restoration, see Cancellation of payment after a compliance related suspension
• Run the Appeal Decision Implementation script in Customer Record which will update the Appeals (APL) system and create a DOC on the job seeker’s record
• Procedure ends here.

If the penalty period was subject to Payment Pending Review (PPR), it generally recommences from the start date of the entitlement period following the one in which the decision was recorded (when it is within 13 weeks of the new decision).

The job seeker will only need to serve the remaining balance of the non-payment period if they have already 'self-served' part of the UNPP:

• before claiming, or
• before the start date of their participation payment

In all other cases that were subject to PPR, the job seeker will be required to serve the full UNPP.

Staff must:

• make genuine attempts to contact the job seeker:
• Advise them when the penalty period will start
• For serious failures, explain they can attend a waiver re-engagement appointment in lieu of serving the serious failure penalty
• Consider their eligibility for payment under UNPP hardship provisions or serious failure hardship provisions
• key BIPCW in the Super Key field, select Enter. The Participation Compliance Hub screen will show
• select Compliance Workflow with compliance status Payment Pending Review. The Completed Compliance Actions screen will show
• select Review Decision. The Review Decision workflow will show:
• Record the date of contact in the Date Review Requested/Initiated field
• Update the status to Reapplied following Review (RAP)
• Record the Status/decision date
• Add the most appropriate selection in the Actions required: field
• Add comments in the Please provide details to support the reason for making this decision: field
• finalise the Review Decision workflow
• run the Appeal Decision Implementation script in Customer Record which will update the Appeals (APL) system and create a DOC on the job seeker’s record

Staff must:

• make genuine attempts to contact the job seeker to:
• remind them that meeting their mutual obligation requirements is a condition of their payment
• tell them if re-engagement with a provider is required
• key BIPCW in the Super Key field, select Enter. The Participation Compliance Hub screen will show
• select Compliance Workflow with compliance status Applied. The Completed Compliance Actions screen will show
• select Review Decision. The Review Decision workflow will show:
• Record the date of contact in the Date Review Requested/Initiated field
• In the Status field, record RVK – Revoke
• Select the appropriate category and revoke reason
• Record the status/decision date
• Select Tribunal or other instruction in the Review of decision has occurred outside of the 13 week timeframe allowed for a favourable determination. If the failure should be revoked an override reason must be selected: field. (This only displays if the decision to revoke is outside of 13 weeks)
• Add comments in the Explanation and Please provide details to support the reason for making this decision: field
• finalise the Review Decision workflow
• run the Appeal Decision Implementation script in Customer Record which will update the Appeals (APL) system and create a DOC on the job seeker’s record

Note: the job seeker's net entitlement may need to be manually calculated for the affected periods. Correct the arrears or debt amount on the Daily Rate Component (RAC) screen if required.

The provider will be advised electronically that the failure (including serious failures for persistent non-compliance) has been re-applied or revoked. A letter will be issued to the job seeker telling them the outcome.

Procedure ends here.

When a started re-engagement or review decision transaction is no longer required, update the status to cancelled in Process Direct.

Note: this only applies to Centrelink generated re-engagement transactions and review decisions.

PST SMEs can update the transaction status as follows:

• In Process Direct, go into the customer’s record using Customer Summary
• Select Transaction
• Select the Re-engagement/Review decision transaction
• Select Status
• Select Edit
• Use the dropdown to update the Status to Cancelled
• Select Save