Rejecting a claim for Age Pension 065-03030030
For Age Pension Processing Services staff only
This document outlines the process to follow when a claim for Age Pension including Age Pension (Blind) is to be rejected. A customer who has lodged a claim for Age Pension may not be entitled to payment. This is because they do not meet the basic qualification, payability, or recipient obligation provisions for payment.
On this page:
Crisis or needing special help
Crisis or needing special help
Table 1
Step |
Action |
1 |
Crisis or needing special help + Read more ... Where a customer has been identified as being in a crisis situation, or requiring special assistance, care needs to be taken to make sure the customer's circumstances are considered before making a decision to reject a claim. For online claims determine if the customer has self-identified as being in crisis or needing special help, by checking for keywords applied with the claim. See Table 8 in Circumstance Change Monitor (CCM). Evidence that the customer is in crisis or needing special help may be available on the customer's record. See Identifying customer vulnerability and risk issues. Is there evidence that the customer may be in a crisis situation or requiring special assistance?
|
2 |
Claim submission exception + Read more ... An online claim submitted under an exception category cannot be rejected until 22 days is reached. Was the claim submitted less than 22 days ago under a claim submission exception, and are there outstanding required tasks?
|
3 |
Prior extension + Read more ... Check:
Have these criteria been met?
|
4 |
Customer contact for special circumstances + Read more ... Two attempts to contact must be made to determine if the customer requires an extension of time if:
The 2 contact attempts can be made at different times on the same day, where applicable. A pre-call SMS should be attempted prior to contacting customer. See Table 1 in Calling a customer or returning a customer's call. Is contact with the customer successful?
|
5 |
Special circumstances extension + Read more ... Determine how much time is required to provide the required documentation. Document the decision for the extension of time and place claim on hold for the required timeframe. Procedure ends here until the allowed time has passed. |
Reject Age Pension claim
Table 2
Step |
Action |
1 |
Claims lodged too early + Read more ...
From 1 July 2023, Age Pension age for all customers is 67 years. See: Has the customer reached, or will reach Age Pension age within the next 13 weeks (or 3 weeks for a detained person)?
|
2 |
Residence information + Read more ... Reject claims for Age Pension lodged more than 13 weeks (or 3 weeks for a detained person) before the customer is residentially qualified. Service Officers must issue a manual Q134 REJ CLE template letter. The Resources page contains the template. The customer’s Australian residence is automatically assessed based on the information recorded on the Residence and Portability screens. See Residence assessment for customers claiming Age Pension. Residence information must be recorded, even if the rejection is not due to residency. If residence details are not recorded, the system will reject the claim for an incorrect reason. Generally, a customer lodging a claim for Age Pension must be in Australia at the time the claim is lodged. However, there are some exceptions to this rule. Check the customer's travel movements (if available) using screens:
Was the customer in Australia on the date of lodgement, or do they meet an exception to this rule?
|
3 |
10 years qualifying Australian residence + Read more ... Customers claiming Age Pension are generally required to have 10 years qualifying Australian residence. However, a person may be exempt from this requirement in some circumstances. See Residence assessment for customers claiming Age Pension. Check if the customer has reached, or will reach with 13 weeks (or 3 weeks for a detained person) of claim lodgement:
If the answer is:
|
4 |
Assessment under an International Agreement + Read more ... The customer may be qualified under an international agreement if:
Centrelink International Services (CIS) assess all claims under an agreement. Claims identified as needing assessment under an international agreement must have all residence and identity information coded before being sent to CIS. If the customer has lived or is in an Agreement country or an E510RS message 'Assessment under agreement country required before rejecting (XXX)' displays:
Note: no separate referral is necessary. Procedure ends here. |
5 |
Rejection reason FSD + Read more ... Claims can be rejected Failure to Supply Documents (FSD) if:
Note: this only applies where the claim process states a request for information must not be sent. Is the claim to be rejected Failure to Supply Documents (FSD)?
|
6 |
Rejection reason FRC + Read more ... Check the correspondence provided by the customer before rejecting the claim. See Viewing Centrelink customer's digital images. Where a claim is already rejected (reason FRC or FSD) and the customer has not provided all requested or outstanding information, do not reopen or reassess the claim. See Table 1 > Step 7 of Request to reassess a rejected claim. Is the claim to be rejected Failure to Reply to Correspondence (FRC) as the customer has been sent a request for information and failed to provide all the documents (including supporting documents requested in a form) within the time allowed to respond? Note: this includes where the request for information was for documents required to confirm identity or to provide tax file number(s).
|
7 |
Rejection reason payability + Read more ... Check outcome of claim on the Entitlements (ELD) Assessment Results (AR) screens. Make sure the provisional data matches the expected results. Check income and asset details from the Date of Events (DOV) on the following screens:
Do not reject the claim if a change of circumstances with the customers income and/or assets has occurred within 13 weeks of the date the customer will become payable. See Processing claims for Age Pension and Pension Bonus. |
8 |
Rejection reason CLE qualification or payability + Read more ... Age Pension claims automatically reject due to CLE, qualification or payability. Claims rejected due to qualification do not need income and asset coding, if neither the customer or their partner (if they have a partner) are currently on a means tested income support payment. This includes if the customer/partner are exempt from the means test due to permanent blindness. Where the customer is not qualified or payable for Age Pension, action the following:
Before finalising the activity, go to Step 14. |
9 |
Reject FSD or FRC + Read more ... If the claim is a combined claim, the Benefit Action (BA) screen may need coding for both customer and partner claims. Combined claims may have a different eligibility outcome, as one may be granted and the other rejected. For claim rejections processed in Process Direct:
|
10 |
Streamline rejection in Process Direct + Read more ... Streamline rejection allows rejection of a claim in Process Direct, without coding all of the information provided in the claim. This function will only display if the claim will not be rejected for residency reasons. For combined claims, both the customer and partner must meet residency requirements in order for the streamline reject function to be available. Note: if the claim is a combined claim, the BA screen may need to be coded for both customer and partner claims. Combined claims may have a different eligibility outcome, as one may be granted and the other rejected). If streamline rejection does not display, go to Step 12. Claims subject to Circumstance Change Monitor (CCM) Where the customer has not provided the required documents at the time they submitted their claim, it can be rejected Fail to Supply Documents (FSD) using the streamline rejection function. Where the customer has intentionally provided inappropriate documentation to allow their claim to be submitted under Circumstance Change Monitor (CCM). For example, non-claim related documents or images, reject the claim FSD with no request for information or documentation requests to be issued. To streamline reject the new claim:
To undo a streamlined rejection in the claim, regenerate the claim from the TS screen. If customer and/or partner are receiving a means tested Income Support Payment and they have had a change of circumstances, see:
|
11 |
Manual rejection in Process Direct + Read more ... A claim is manually rejected as follows:
Note: for a manual rejection, all customer verified personal details must be coded to make sure the notice of rejection is issued to the correct address. If the customer and their partner (where they have a partner) are not currently on an income support payment, income and asset coding is not required if rejecting FSD or FRC. If customer and/or partner is current ISP and they have had a change of circumstances, see:
|
12 |
Handover function + Read more ... Sometimes a claim activity may need to be processed in Customer First/Customer Record and the Handover to CF/CR function may be required. This is to apply an approved workaround for a known issue/error or gaps in Process Direct. Prior to utilising the Handover function, staff must refer to the Using Digital Assistance Roxy in Process Direct and the Handover function table for required actions. Is a handover to Customer First or Customer Record required?
|
13 |
Manual rejections in Customer First/Customer Record + Read more ... A claim is manually rejected as follows:
For a manual rejection, all customer verified personal details must be coded to make sure the notice of rejection is issued to the correct address. If the customer and their partner (if they have a partner) are not currently on an income support payment, income and asset coding is not required if rejecting FSD or FRC. If customer and/or partner is current ISP and they have had a change of circumstances, see:
|
14 |
Rejection DOC and follow-up action + Read more ... For claims rejected in Process Direct:
For claims processed in Customer First/Customer Record:
Follow-up actions in Process Direct for claims finalised in Customer Record and Customer First:
If the rejection reason is FSD/FRC:
Home Equity Access Scheme (the Scheme) applications:
Service Officers must issue a manual rejection letter for the following rejected claims:
Is a manual letter required?
|
15 |
Send a manual letter + Read more ... An auto-reject letter is not generated if the:
Service Officers must issue a manual Q134 REJ CLE template letter. The Resources page contains the template. If the customer is deceased, a manual letter (Q999) must be issued. The grant or rejection letter must be issued to the:
The Resources page contains an example of suitable text for these letters. For other cases where no auto-reject letter is generated, send manual letter Q134 (select the 'undetermined' option) to the customer:
See Creating a manual letter or Online Advice (OLA) Record the details of decision on a DOC. |