Processing claims for Age Pension and Pension Bonus 065-03030050

Customers can make a claim for Age Pension and Pension Bonus payment by submitting an online claim, with help from a Service Officer running ACC, or by lodging a paper claim form.

A correspondence nominee (individual and organisation) can submit a claim for Age Pension on behalf of their principal. Nominees cannot submit an Age Pension combined online claim.

An online claim or ACC for Age Pension cannot be submitted until all required tasks have been completed (exceptions apply in specific circumstances).

If ACC is used to submit a verbal claim on behalf of a customer and a verbal declaration is completed, 'Staff assisted verbal declaration accepted - Yes' will display in:

• Process Direct Notes
• Customer First Super Case
• Customer Claim Summary

Verifying partner details before finalising an online claim or ACC

If a customer advises they are partnered within an online claim or via ACC, the relationship status must be verified by both parties before the customer's and partner's records are linked.

Verification can be provided by the partner either:

• through the 'Partner Confirmation Logon' service on the Services Australia website, using the Temporary Access Code (TAC) provided at the end of the customer's claim,
• verbally if the partner is present, or
• by completing a Partner details (Mod P) form

This is not required if the customer has lodged an Age Pension paper claim (SA002 or SA412) which has been signed by the customer and their partner.

See Confirming a partnered relationship.

When an online or ACC is submitted as a single person or Age Pension combined partner online claim, an Age Pension claim work item is created in Process Direct containing the claim information. The claim is reviewed in Process Direct.

A SOA shell claim (with no claim information) is created automatically when an Age Pension paper claim (SA002 or SA412) is scanned onto the customer's record.

Hold to User is a function that holds a work item in a user's worklist until it can be completed.

Claims can be held to user for many reasons, for example, if the customer needs to provide more information, is vulnerable, in hardship or has complex circumstances. For a full list of reasons a claim can be held to user see Hold to User new claim criteria.

To hold the claim to user see Work Optimiser for staff.

To identify if the claim is an Age Pension combined partner online claim (customer and partner), check the Claim ID numbers are the same. Alternatively, check if keyword DUALCLM appears in the keywords options.

If the customer and partner have lodged a joint paper claim, the SOA shell is created on the customer's record only.

Age Pension with a Pension Bonus claims need to be processed outside Process Direct. Where an Age Pension with a Pension Bonus claim has been lodged:

• before assessing the claim, contact the customer and recommend they contact a Financial Information Service (FIS) Officer if they have not yet done so. If not trained in Pension Bonus assessments, reallocate both claims as per the Reallocating Pension Bonus claims table on the Process page
• after finalising the Age Pension claim process the Pension Bonus claim in Customer Record using the Pension Bonus Claim Assessment script. See Qualification and assessment of Pension Bonus Payment (PBP)

If the customer has also submitted a separate claim for the Home Equity Access Scheme (the Scheme), process the Age Pension and (if applicable) Pension Bonus claim first. The Scheme claim is processed by the Home Equity Access Scheme National team upon completion of the Age Pension and Pension Bonus claim.

Customers currently receiving Age Pension as a loan-only payment under the Home Equity Access Scheme (identified by a benefit status of AGE/CZR-PLS) may submit a claim for Age Pension if their income and assets are under the limit.

A full assessment of their income and assets must be undertaken to determine if eligible to receive a payable rate of Age Pension. Claims must then be referred to the Home Equity Access Scheme National team to review the customer's circumstances and determine the appropriate course of action prior to claim finalisation.

If a rejected claim needs to be opened and reassessed, re-index the original claim or create a SOA shell. See Indexing, re-indexing and cancelling claim activities.

Claimants who are qualified and payable for Age Pension are generally granted from the date they submit a claim with all relevant supporting documentation. From 7 December 2020, employment income is assessed in the entitlement period in which it is paid by the employer.

Where the income is too high for the customer to be payable from the Age Pension qualification date, but the customer will become payable within 13 weeks of the date they lodged the claim, the start date should be moved to the earliest Entitlement Period Start Date from which the customer is payable.

Note: this may not apply to claims with Pension Bonus entitlement. See Qualification and assessment of Pension Bonus Payment (PBP).

Customers may be presented with pre-filled Single Touch Payroll (STP) data during their online claim. Employer details, name and ABN, will be presented to the customer if STP data has been provided to the Australian Taxation Office (ATO) within the 8 weeks prior to claim.

Customers will have the option to confirm the employer within the claim. If a customer confirms the employer, once on payment, STP pre-filled income will be presented to the customer when they report. If the customer does not confirm the employer, once on payment, we may present the STP employer again when the customer reports.

A customer will automatically be placed on reporting if STP data is presented to the customer within the claim, regardless of the employer status.

Customer who have reporting requirements from their first entitlement period will not receive a Pensioner Concession Card until they complete their report.

If the customer is also claiming the Pension Bonus, the bonus will not be paid until they report and Age Pension is assessed as payable. When they report, an activity will be produced to prompt assessment of the Pension Bonus claim.

For more information on reporting, see Reporting overview.