Assessing payment rates and independence for Disability Support Pension customers under 21 years 008-03140000

DSP claims

The responses from a customer (aged under 21 years) to the questions in the DSP online claim, Assisted Customer Claim or the following forms will help determine the correct rate of payment and dependence or independence criteria:

• Claim for Disability Support Pension (SA466)
• Claim for a Disability Support Pension for a Terminal Illness (SA494)
• Disability Support Pension Claim at age 16 (SA439)

DSP current customers

For DSP current customers aged under 21 years who are advising of a change in circumstances, an assessment of the customer's overall circumstances may be required to determine the correct rate of payment including independence criteria.

More evidence may be required depending on the criteria applicable to the customer's circumstances.

Go to Step 2.

A DSP claimant or current customer only requires assessment of independence if they are aged under 21 years.

Is the customer aged 21 years or older?

• Yes:
• the customer does not need to be assessed for independence for DSP
• the system automatically assesses the customer for the adult pension rate of payment.
  If the customer is paying for accommodation, including while living in the parental home with their parent/s, see Qualification for payment of Rent Assistance (RA)
• procedure ends here
• No, go to Step 3

Service Officers must not use the PCW (Partial Capacity to Work) independence code for a DSP customer. PCW independence is only legislated for YA and SpB job seekers only. Therefore, if a YAL/CUR-JSK customer has IND/PCW coded on the NIH screen, PCW cannot be coded on the PDI screen of a DSP customer - the customer must meet a DSP independence criteria.

Customers aged under 21 years who are claiming DSP and current on an Income Support Payment may have already been assessed under independence criteria for:

• Youth Allowance (YA), or
• ABSTUDY

If the previously assessed independence category is reviewable, consider all available details to determine if the independence category applies to the customer's current circumstances.

The Resources page contains more details about reviewable categories.

To determine if independence has previously been assessed, go to the Independent/Homeless/Away from Home Details (NIH) screen (in the NSS system for YAL or SVABY/ISS for ABSTUDY).

Check for any of the following codes:

• PCH - previously had a dependent child
• PDF - are or have been in a de facto relationship for a minimum of 12 months
• PDS - has been a member of a de facto relationship for at least 6 months and special circumstances exist
• PBM - is or has been married or in a registered relationship
• PSS - has worked an average of 30 hours per week for at least 18 months during any 2 year period

Are any of the above codes current on the customer's record?

• Yes, as the relevant independence category is not reviewable, the customer can be assessed as independent for their DSP claim under the same category. See Table 2 > Step 3
• No, go to Step 4

Customers under 21 years will be paid a DSP rate based on their individual circumstances, such as if they live in the parental home, or have (or have had) a dependent child. These circumstances will determine whether they are paid at the:

• dependent rate, or
• independent rate, or
• the 'over 21 years' adult pension rate (also known as 'common pension rate ')

Does the customer currently have, or has previously had a natural, legally adopted or relationship child in their care? See Wholly or substantially dependent on the customer or the customer's partner.

• Yes, for customers who:
• currently have a dependent child in care, go to Step 5
• have previously had a dependent child in care, go to Step 6
• No, go to Step 6

If the customer currently has a dependent child in their care, the '21 years and over' adult pension rate should be paid when the dependent child details are recorded.

• in Process Direct > open the Relations menu to view/access linked records to check for a dependent child. Select to view if there is a child record
• in Customer First > key CHS (Child Selection) in the Next: field, and press [Enter]

Is there a child showing?

• Yes, go to the below 'Check to make sure the child is Dependent for DSP' section
• No, go to Table 1 > Step 3 of Assessing independence when a customer has, or has had, a dependent child

• in Process Direct - key PNKDS (Pensions child detail summary screen) in the Super Key field, or
• in Customer First - key PNKDS (Pensions Child Summary) in the Next: field, and press [Enter]

Is the child showing and a Dependent indicator Y is present?

• Yes, check the Payment Summary (PS) screen to make sure the customer's rate of payment is the Adult Pension rate. No more updates are required, customer is receiving the correct rate of payment. Procedure ends here
• No,
• complete a child refresh. The refresh must be done separately to other activities outside of the DSP new claim. See Child refresh action
• re-check the PNKDS to make sure the child is now showing and the dependent status a showing as Y
• check the Payment Summary (PS) screen to make sure the customer's rate of payment is the Adult Pension rate. No more updates are required, procedure ends here

If the customer is aged:

• 16 or 17 years, go to Step 7
• 18 to 20 years (inclusive), go to Step 8

Notes:

• For DSP claims, if the customer is aged 17 years at the time of claim, but turns 18 years before the claim is finalised, independence may need to be considered under 2 separate criteria
  Example: customer is 17 years old and their DSP claim is being assessed from 1 July 2024. Customer lives away from the parental home in disability accommodation and turned 18 years on 1 September 2024. Medical qualification for DSP has been established and the DSP claim was assessed and finalised on 1 October 2024. Independent Living Code field on the PDI screen can be coded with MED from 01/07/2024 and LAH from 01/09/2024. Both of the updates to the Independent Living Code can be made within the DSP claim activity
• If the customer is not independent at 17 years, assess their eligibility for independence as an 18 year old. If applicable, code the Independent Living Code field on the PDI screen from their eighteenth birthday or the event date independence was met if after 18 years
  Example: customer is 17 years old and their DSP claim is being assessed from 1 July 2024. Customer lives away from the parental home and does not meet UTLAH criteria as determined by a Social Worker. Customer turned 18 years on 1 September 2024. Medical qualification for DSP has been established and the DSP claim is being assessed and finalised on 1 October 2024. The Independent Living Code: field on the PDI screen can be coded with UTN from 01/07/2024 and LAH from 01/09/2024

If the customer has indicated it is unreasonable to live at home (UTLAH), the assessment of independence under the UTLAH criteria for customers aged 16 or 17 years is made by an agency Social Worker.

When the customer indicates it is UTLAH, see Unreasonable to live at home (UTLAH) initial contact for Youth Allowance (YA), Disability Support Pension (DSP), Special Benefit (SpB) or Tertiary Access Payment (TAP) to determine if Social Worker is required.

When the customer indicates they are in State care, see Assessing independence when a customer is in State care.

Procedure ends here until the Social Worker has completed the UTLAH assessment.

Is the customer living away from the parental home because of their disability or a medical condition (this includes living in disability accommodation or alternate accommodation that allows them to be closer to treatment or support services)?

Note: this does not apply to short stays in hospital.

• Yes, the customer is eligible for the medical condition (MED) independent rate of payment for DSP and the decision relates to a customer who is:
• current on DSP, see Table 2 > Step 1
• claiming DSP (includes reassessments/re-indexed/re-opened claims, appeal implementations), see Table 2 > Step 3
• No, go to Step 9

Is the customer living away from the parental home?

• Yes, the customer is eligible for the living away from home (LAH) independent rate of payment for DSP and the decision relates to a customer who is:
• current on DSP, see Table 2 > Step 1
• claiming DSP (includes reassessments/re-indexed/re-opened claims, appeal implementations), see Table 2 > Step 3
• No, go to Step 9

A customer may be considered independent for DSP if they have supported themselves through paid work:

• consisting of full-time employment averaging at least 30 hours per week, in one or more jobs, for at least 18 months during any period of 2 years, or
• of at least 15 hours every week over consecutive weeks for a continuous 2-year period since the person last left secondary school, or
• within an 18-month period with cumulative earnings totalling at least 75% of the Wage Level A of the National Training Wage schedule included in a modern award since the customer last left school

Has the customer indicated they may meet any of the above criteria?

• Yes, go to Step 10
• No, go to Step 15

To be considered as meeting the full-time employment criteria, the customer must have been in paid work:

• consisting of full-time employment averaging at least 30 hours per week, and
• in one or more jobs, and
• for at least 18 months during any period of 2 years

Does the customer meet all of the above?

• Yes, go to Step 14
• No, go to Step 11

To be considered as meeting the 15 hours work over consecutive weeks for a continuous 2 year period criteria, the customer must have been in paid work:

• the customer has worked 15 hours every week over consecutive weeks, and
• weeks are continuous for a 2 year period, and
• the 2 year period commenced any time after the customer last left secondary school

Does the customer meet all of the above?

• Yes, go to Step 13
• No, go to Step 12

To be considered as meeting the 18 month period, the customer must have been in paid work:

• has cumulative earnings totalling at least 75% of the rate that applied when the period/s of employment began under the:
• Wage Level A of the National Training Wage schedule included in a modern award (NTWS), or
• the rate as varied or replaced by Fair Work Australia, and
• a period of 18 months must have elapsed since the customer last left school, and
• the employment period must have occurred since the person last left school, and
• the customer does not need to be in employment for the whole 18 month period

Does the customer meet all of the above?

• Yes, go to Step 13
• No, customer does not meet any self-supporting through paid employment/workforce participation independence criteria, go to Step 15 to assess if the customer meets any other independence criteria

To meet the criteria for the following relevant to when the customer left school, the evidence must show the date the customer last:

• left Secondary School for 15 hours work over 2 year period, or
• left school for 18-month period with cumulative earnings

Go to Step 14.

The customer must provide evidence to support an assessment of eligibility under a self-supporting through paid employment/workforce participation independence category where there is no evidence on their record.

Evidence may include:

• a statement from an employer certifying periods of full-time employment
• letter(s) from employers which outline periods of employment and hours worked
• payslips, payroll reports or payment summaries (group certificates) from their employer showing the weekly hours worked and periods of employment
• Employment Separation Certificate

Advise the customer of the above and send a request for the documentation, see Requesting information (CLK). When evidence is provided, workforce participation independence category can be assessed.

Self-supporting through paid employment workforce participation independence categories:

• PSS - full time employment averaging at least 30 hours per week for at least 18 months during any period of 2 years
• PSP - paid work of at least 15 hours per week for at least 2 years since the person last left secondary school
• PSE - paid work within an 18-month period with cumulative earnings totalling at least 75% of the Wage Level A of the National Training Wage schedule included in a modern award

Has sufficient evidence been provided for assessment?

• Yes, and the customer:
• meets an independence category detailed above and the decision relates to a customer who is current on DSP, see Table 2 > Step 1. Or is claiming DSP (includes reassessments/re-indexed/re-opened claims, appeal implementations), see Table 2 > Step 3
• does not meet any of the independence categories detailed above, go to Step 15 to assess if the customer meets any other independence criteria
• No, and the customer is not eligible for the higher rate of DSP under a self-supporting through paid employment/workforce participation independence category until evidence is provided for assessment. Go to Step 15 to assess if the customer meets any other independence criteria

Note: Service Officers must not use the PCW (Partial Capacity to Work) independence code for a DSP customer.

DSP customers aged under 21 years can be paid the independent rate if they meet at least one of the following criteria. If the customer:

• can prove their independence through a relationship status:
• has been married, or
• is in a registered relationship, or
• has been living as a member of a couple for at least one year, or 6 months in exceptional circumstances
• can prove their independence through previously having a dependent child. See Table 1 > Step 3 in Assessing independence when a customer has, or has had, a dependent child
• is an orphan
• is a refugee without parents in Australia and not dependent on anyone else
• has parents who cannot exercise their responsibilities for example in prison, mentally incapacitated, living in a nursing home or missing
• is in State care or only stopped being in state care due to their age

Are there sufficient details to determine the customer meets any of the above criteria?

• Yes, the customer meets the independence criteria detailed above (including reference to the linked assessment file) and the decision relates to a customer who is:
• current on DSP, see Table 2 > Step 1
• claiming DSP (includes reassessments/re-indexed/re-opened claims, appeal implementations), see Table 2 > Step 3
• No, and the decision relates to a customer who is:
• current on DSP, see Table 2 > Step 2
• claiming DSP (includes reassessments/re-indexed/re-opened claims, appeal implementations), see Table 2 > Step 4

When updating independence for a current DSP customer, an update must be applied to the Independent Living Code field on the PDI screen in Customer First or Process Direct.

It is important the correct code is used so the customer is paid the correct rate of DSP. This code also determines if the independence is reviewable. See the Resources page for more details.

Note: Service Officers must not use the PCW (Partial Capacity to Work) independence code for a DSP customer.

Service Officers must:

• check if the customer is under income management (INM on the Benefit Status line). If INM is present, and if the update below will result in eligibility to arrears:
• contact the Income Management Contact Officers (IMCO) to allow income management to be turned on for the arrears payment. Do not make any changes to the record before contacting the IMCOs
• update all fields when using Add (in Process Direct) to Create Pension Disability Information
• not change any existing fields other than Event Date and Independent Living Code
• consider if the customer may be eligible for Rent Assistance (RA) based on the update. See Table 2 > Step 4 in Qualification for payment of Rent Assistance (RA) for additional RA eligibility criteria which apply to specific customer groups

Note: if a customer received a Crisis Payment in the period the change is applied, a manual reassessment of Crisis Payment may be required. For more details, see Reviewing and reassessing Crisis Payment (CrP).

• Go to the Pension Disability Information table by keying PDI in Super Key field
• Event Date: use calendar to select today's date
• Blind Indicator: select existing code
• Independent Living Code: select XXX (the Resources page has the Independent rate categories for appropriate independence code)
• Blind - Income & Assets Exempt: select existing code
• Severely disabled Code: select existing code
• Select Save
• Receipt Date: use calendar to key today's date
• Channel: select Phone or Personal from the dropdown menu
• Service Reason: select DSP
• Select Save
• When the Transaction ID is created for Activity Type: REA, select Assess
• On the SWE screen:
• if there are no errors, select Assess
• if the transaction presents with an error, see Using Digital Assistant Roxy in Process Direct
• Select Finish
• Select Finalise
• Access the Payment Summary screen by keying PS in the Super Key field
• Select Execute
• Tell the customer:

We confirm your next entitlement period payment delivery date is DD/MM/YYYY and subject to any change in circumstances, your gross amount of payment will be $XXX.XX.

• If the customer is currently studying or an Australian Apprentice:

You may be eligible for additional payments such as Pensioner Education Supplement or Mobility Allowance. You can find more details on these payments by going to our website.

• Service Officer must record a DOC. Use Fast Note -select Auto text, use Disabilities > Update/s > Template - DSP IND assessment
• Procedure ends here

If checks have determined the customer cannot be considered as independent based on their circumstances under any independence criteria, Service Officers must make sure the customer's record correctly reflects the assessment.

Existing independent coding on the Independent Living Code field on PDI:

• Where the customer no longer meets the independence criteria related to the existing coding on the PDI screen, the independent coding must be ceased
• The Independent Living Code field must be updated to make sure the customer is notified of their correct DSP rate entitlement
• NLE (no longer eligible) must be coded - see coding instructions below

No coding on the Independent Living Code field on PDI:

• When there is no existing coding in the Independent Living Code field, the customer may be currently receiving:
• the dependent rate of DSP, or
• the adult pension rate as they have a dependent child
• If the customer is being paid:
• the dependent rate of DSP - NID (Not Independent) must be coded - see pre-coding instructions below
• the adult pension rate - no more coding action is required. Service Officers must record a DOC. Use Fast Note -select Auto text, use Disabilities > Update/s > Template - DSP IND assessment
• if the customer is currently studying or an Australian Apprentice, tell the customer:

You may be eligible for additional payments such as Pensioner Education Supplement or Mobility Allowance. You can find more details on these payments by going to our website.

• procedure ends here

Service Officers must:

• update all fields when using Add to Create Pension Disability Information (in Process Direct)
• not change any existing fields other than Event Date and Independent Living Code (in Process Direct and Customer First)

Note: if a customer received a Crisis Payment in the period the change is applied, a manual reassessment of Crisis Payment may be required. For more details, see Reviewing and reassessing Crisis Payment (CrP)

• Go to the Pension Disability Information table by keying PDI in Super Key field
• Event Date: use calendar to select date the customer advised the change occurred
• Blind Indicator: select existing code
• Independent Living Code: select NLE or NID (refer to Coding check in this Step)
• Blind - Income & Assets Exempt: select existing code
• Severely disabled Code: select existing code
• Select Save
• Receipt Date: use calendar to key today's date
• Channel: select Phone or Personal from the dropdown menu
• Service Reason: select DSP
• Select Save
• When the Transaction ID is created for Activity Type: REA, select Assess
• On the SWE screen:
• if there are no errors, select Assess
• if the Transaction presents with an error, see Using Digital Assistant Roxy in Process Direct
• Select Finish
• Select Finalise
• Access the Payment Summary screen by keying PS in the Super Key field
• Select Execute
• Tell the customer:

We confirm your next entitlement period payment delivery date is DD/MM/YYYY and subject to any change in circumstances, your gross amount of payment will be $XXX.XX.

• If the customer is currently studying or an Australian Apprentice:

You may be eligible for additional payments such as Pensioner Education Supplement or Mobility Allowance. You can find more details on these payments by going to our website.

• Service Officers must record a DOC. Use Fast Note -select Auto text, use Disabilities > Update/s > Template - DSP IND assessment
• Procedure ends here

• key PDI in the Next: field, press [Enter]
• code 'I' next to the Event Date field
• key the Event Date field: key DDMMYY as the date the customer advised the change occurred
• Blind Ind field: do not alter existing coding
• Blind - Income & Assets Exempt field: do not alter existing coding
• Severely disabled Code field: do not alter existing coding
• Independent Living Code field: select NLE or NID (refer to Coding check in this Step)
• Source field: key PHO (if customer is contacting via telephone) or LIA (if customer is contacting face to face)
• DOR field: key DDMMYY (today's date)
• select Continue, press [Enter]
• key AR in the Next field: to check the activity assessment outcome

Are there any errors and all adjustments are correct?

• Yes, refer to the Technical Support Model. When resolved, continue these steps
• No, select Finalise > Continue

Check customer's payment:

• Access the Payment Summary screen by keying PS in the Next field > press [Enter]
• Make sure the PEN system is showing and check the customer's future payments

Advise customer/nominee

Tell the customer:

We confirm your next entitlement period payment delivery date is DD/MM/YYYY and subject to any change in circumstances, your gross amount of payment will be $XXX.XX.

• If the customer is currently studying or an Australian Apprentice:

You may be eligible for additional payments such as Pensioner Education Supplement or Mobility Allowance. You can find more details on these payments by going to our website.

Service Officer must record a DOC. Use Fast Note -select Auto text, use Disabilities > Update/s > Template - DSP IND assessment

Procedure ends here.

Once the customer has been determined to be medically eligible for DSP, see the coding PDI table details for a DSP claim in:

• Assessing Disability Support Pension (DSP) after a Disability Medical Assessment (DMA), or
• Disability Support Pension (DSP) manifest eligibility

Service Officers must use the correct independence code to make sure the customer is paid the correct rate of DSP. The code also determines if the independence category is reviewable. See the Resources page for more details.

Note: see Table 1 > Step 6 if the customer has had a birthday between when the DSP claim was submitted and the date the claim is being assessed.

Service Officers must check if the customer is under income management (INM on the Benefit Status line). If INM is present, and if the update below will result in eligibility to arrears:

• contact the Income Management Contact Officers (IMCO) to allow income management to be turned on for the arrears payment
• do not make any changes to the record before contacting the IMCOs

Note: if a customer received a Crisis Payment in the period the change is applied, a manual reassessment of Crisis Payment may be required. For more details, see Reviewing and reassessing Crisis Payment (CrP).

• Process Direct: on the PDI screen, under the Pension Disability Information section key XXX (see the Resources page Independent rate categories for appropriate independence code) in the Independent Living Code field
• Customer First: on the PDI screen, key XXX (see the Resources page Independent rate categories for appropriate independence code) in the Independent Living code field
• Return to relevant claim processing file to finalise DSP claim assessment
• Once the claim is finalised, Service Officers must annotate the DSP Grant DOC with the outcome of the independence assessment

Procedure ends here - return to DSP claim assessment.

Once the customer has been determined to be medically eligible for DSP, see the coding PDI table details for a DSP claim in:

• Assessing Disability Support Pension (DSP) after a Disability Medical Assessment (DMA), or
• Disability Support Pension (DSP) manifest eligibility

Where there are sufficient details to determine the customer cannot be considered independent, the customer's record must be updated within the DSP new claim:

• From the PDI screen, key NID in the Independent Living code column
• Return to relevant claim processing file to finalise DSP claim assessment
• Once the claim is finalised, Service Officers must annotate the DSP Grant DOC with the outcome of the independence assessment

Procedure ends here - return to DSP claim assessment.