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Checking and actioning a Job Capacity Assessment (JCA) report 008-06070010

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This page outlines what a Service Officer does once the Assessor submits a Job Capacity Assessment (JCA) report.

Manually accessing the report and checking referral reason

Table 1

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Step

Action

1

Manually accessing the report and checking referral reason

Check the referral reason on the JCA report.

Where the referral was for:

2

DSP New Claim JCA

If a JCA report recommends medical eligibility, in most cases a Disability Medical Assessment (DMA) referral auto-generates.

Manual action is required:

  • if the system is unable to:
    • auto-generate a DMA referral
    • auto-accept the JCA report, or
  • where the outcome does not support medical eligibility

When allocated a JCA or upgraded Employment Services Assessment (ESAt) report, before opening the JCA report, staff must check:

  • DSP Claim Progress DOC/Notes for information related to the claim
  • Check Display on Access (DOA) DOCs for information relating to Personalised Services, and to ensure the claim is not being managed by Customer Critical Response Team (CCRT)

If the claim is being managed by CCRT:

  • do not accept the JCA Report or action the DSP Claim
  • reassign the work item to a team leader in Work Optimiser
  • annotate the DSP Claim Progress DOC and include: 'JCA Report has been allocated to Team Leader because CCRT are managing the DSP claim under HTU'
  • email CCRT to advise a JCA Report has been submitted for a DSP claim they are managing under HTU. Copy your line manager/team leader into the email
  • procedure ends here

If the DSP claim is not being managed by CCRT:

  • where a JCA report recommends manifest eligibility a work item is allocated to a Disability Processing Service Officer for manual actioning of the new claim
  • if a JCA report recommends medical eligibility (non-manifest), in most cases a DMA referral is auto-generated
  • manual action is required:
    • if the system is unable to:
      auto-generate a DMA referral
      auto-accept the JCA report, or
    • if the JCA outcome does not support medical eligibility
  • go to Step 4

3

DSP Manual Medical Review JCA

JCA Referral reason for DSP manual medical review must be either DSP Medical Review of Entitlement or DSP Medical Review of Entitlement pre 1 July 2006.

Service Officers managing a DSP manual medical review and the JCA is submitted, go to Step 4.

Note: if a JCA report for the above referral reason recommends continuing medical eligibility for DSP, a DMA is not required.

See Initiating and actioning a manual medical review for Disability Support Pension (DSP).

4

Check Report Status

Check the Referral Summary (RRSUM) screen.

If the:

Note: in limited circumstances a DSP New Claim JCA will auto-return upon submission. The JCA Outcome DOC will display the JCA outcome as: Auto Return, Failed Centrelink Validation.

For more details about JCA Referral status, see Understanding Job Capacity Assessment (JCA) reports.

If the JCA has been auto returned:

  • refer to Level 2 Policy Helpdesk
  • include in the referral: DSP New Claim JCA auto returned due to vulnerabilities, please follow-up
  • apply Hold to User
  • update claim status to On Hold for reason Awaiting Level 2 Policy advice

When the JCA has been corrected and resubmitted, go to Step 5.

5

View the Job Capacity Assessment (JCA) report

In the customer's record, select the relevant JCA report.

To view the JCA Report:

  • go to the Referral Summary (RRSUM) screen
  • select ESAt/JCA Report to enter the ESAt/JCA Acceptance workflow
  • select View Report to view the ESAt or JCA report

Go to Step 6.

6

Check if referral reason is for CIS to action

JCA referral reasons 'DSPMR' and 'DSPME' are to be checked by International Services (CIS) staff only.

Is the referral reason DSPMR or DSPME?

  • Yes, for:
    • CIS staff members, check the report as outlined in Table 2 > Step 1 in Assessment for Disability Support Pension (DSP) recipients going overseas under the no future work capacity provisions. Procedure ends here.
    • Other staff members, re-categorise the work item in Work Optimiser to a CIS new claim work item. Procedure ends here
  • No, go to Step 7

7

Privacy provisions and information sharing

Check the form of assessment.

For File Assessments

In the Assessment Details, check the response to the information sharing is No.

If the JCA was initially booked as face to face, video conference or phone, but the format has been changed to file after contact and consent from the customer, the information sharing indicator must be Yes. See Job Capacity Assessments (JCA).

For Face to Face or Phone (including video conference) Assessments

In the Assessment Details, check the response to the information sharing is Yes.

Assessors are required to do this at each JCA appointment to confirm the customer has been read the Information Sharing statement explaining how JCA information can be shared and with whom.

In the Assessment Details, has the correct Yes or No response been recorded to Client has been advised of information sharing arrangements?


Check the date of claim for the correct Impairment Tables version

Table 2

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Step

Action

1

Check date of claim for correct version of Impairment Tables

From 1 April 2023, the Impairment Tables used to assess the impact of a customer's condition(s) changed. This included a change to terminology.

Job Capacity Assessors use the Impairment Tables to assign impairment ratings, when completing assessments for DSP.

The date of claim and date of effect of the JCA Report, determines which version of the Impairment Tables and terminology is used in the JCA report.

Check the date of effect for the DSP Claim - Pension Assessment (PNA)/Start date.

Date of claim and date of effect of JCA is before 1 April 2023 (2012 Impairment Tables version)

If a customer has a medical condition impacting for more than 2 years, it is assessed as:

  • permanent, and
  • either Fully Diagnosed Treated and Stabilised (FDTS) or Not Fully Diagnosed Treated and Stabilised
  • see Table 3

Date of claim and date of effect of JCA is on or after 1 April 2023 (2023 Impairment Tables version)

If a customer has a medical condition impacting for more than 2 years, it is assessed as:

  • persist for more than 2 years, and
  • either Diagnosed, Reasonably Treated and Stabilised (DTS) or Not Diagnosed, Reasonably Treated and Stabilised
  • see Table 4

Check the date of effect of JCA for DSP manual medical review for correct version of Impairment Tables.

If a DSP medical review is initiated after 1 April 2023 and a JCA is required, the Impairment Tables used by assessors will be the 2023 Impairment Tables version. See Table 4.


Check medical conditions, impairment ratings and work capacities - 2012 Impairment Tables

Table 3

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Step

Action

1

Check details of Medical Conditions

See the Medical Conditions section of the report.

For customers with medical condition Trans Vaginal Mesh (TVM) where the JCA Report recommends medical rejection:

  • do not accept the JCA Report
  • update the DSP claim status to On Hold for reason Referred for JCA for 14 days
  • annotate the DSP Claim Progress DOC with TVM claim has been referred to CCRT
  • complete a referral to CCRT for DSP Claim finalisation and Service Offer Interview (SOI) for TVM case

For all other medical conditions and TVM cases where the JCA supports medical eligibility, continue processing as normal.

Check for manifest eligibility

When an Assessor recommends a customer is manifestly eligible for Disability Support Pension (DSP), they must record the manifest indicator in the Medical Conditions section of the JCA report.

This displays in the report as Customer meets manifest criteria for category followed by a specific manifest indicator code.

The codes and corresponding categories are:

  • B - Permanent Blindness (BLI)
  • T - Terminal Illness (TRM)
  • I - Intellectual Disability (INT)
  • N - Nursing home level of care (NHM)
  • H - Category 4 HIV/AIDS (HV4)
  • P - Disability Pension at special rate (TPI)

If the Assessor correctly records the manifest indicator, it pre-fills the Medical Conditions Summary (MCSS) screen when the JCA report is accepted.

If the manifest indicator is not correctly displayed, and the JCA report is accepted by the Service Officer, the customer will be incorrectly assessed. The claim may be rejected or payment may cancel.

Service Officers must check the manifest indicator displays correctly before accepting a JCA report.

If the Assessor has recommended manifest eligibility in the body of the report (such as in the Remarks or Assessment Summary sections) but the manifest indicator is not displayed in the JCA report, the report must be returned to Assessment Services for correction.

The JCA report must not be accepted until it correctly reflects the Assessor's recommendation of manifest eligibility.

To return the JCA Report, go to the Referral Summary (RRSUM) screen:

  • Select ESAt/JCA Report > View Report to open the JCA report
  • Select Return from the Action dropdown menu
  • Decision Date, defaults to today's date
  • Action Reason, select the appropriate return reason
  • Return Comments, add comments asking the Assessor to further consider their assessment. Provide enough details to explain the reasons for rejecting the report, including the text 'No Manifest Indicator coded in the report'
  • Select Save > Assess to finalise the activity

To ensure Assessment Services are notified of the JCA Return and amendment required, refer back to Assessment Services.

Note: the referral must be actioned from the DSP Claim activity. Return to the TS screen or key the customer's Customer Reference Number (CRN) in the Inbox.

  • select > https://ourblueprint.internal.dept.local/content/images/process_direct_small/more options.png| > Referral
  • Referral Type, select Assessment Services
  • Referral Reason, select from:
  • query JCA Quality
  • text will pre-fill the Additional Information field
    • add additional information, JCA report indicates manifest eligibility has been met, but manifest indicator is not present, please add manifest indicator and resubmit
  • select Finish to view successful referral notification. Select OK to return to the Transaction Summary (TS) screen
  • the claim is set to status On hold - Awaiting ASB Recommendation. An annotation is added on Notes
  • annotate the DSP Claim Progress DOC on DL/Notes with the information from the referral. Add any additional notes as needed

If Service Officers identify a claim rejection or payment cancellation has occurred because the manifest indicator has not been correctly coded and applied in the JCA report, the case must be urgently escalated to the DIS Service Delivery Support Team for investigation and resolution.

The email must be titled:

  • URGENT ACTION REQUIRED: INCORRECT CAN/REJ OF RECIPIENT MANIFESTLY ELIGIBLE FOR DSP. CRN: 999 999 999A'

Check medical conditions

Assessors do not need to assess every medical condition and reference every piece of medical evidence.

Assessors do not assess or reference medical conditions/evidence if it is not considered to be currently impacting the customer's functional capacity. For example, where a condition:

  • is resolved
  • has nil impact
  • is secondary, or a symptom of, a primary medical condition

Check all verified and impacting medical conditions have been recorded as detailed on the medical evidence and that the medical evidence supports the assessment of a condition as Temporary, Permanent but not FDTS, Permanent and FDTS, or manifest.

When an Assessor has medical evidence to support manifest eligibility for DSP, they need to mark the condition as Permanent and Verified by medical evidence. It is not mandatory to mark the condition as FDTS or enter FDTS work capacities unless the customer has secondary medical conditions assessed.

For a JCA (or an Employment Services Assessment (ESAt) upgraded to a JCA), check that all medical conditions are recorded under Conditions, including permanent conditions that are likely to be ongoing for at least 2 years, should be marked as permanent and verified. The Assessor needs to determine whether any permanent condition is fully diagnosed, fully treated and fully stabilised

Check to identify any significant inconsistency (outside the range of possibility) between medical condition details and the work capacity details.

Check the assessment of the customer's ability to use public transport without substantial help is consistent with report comments about the customer's mobility.

Note: this is only a prompt to consider inviting a claim for Mobility Allowance (MOB) and is not a recommendation of eligibility for MOB.

2

Impairment

Impairment ratings can only be applied to permanent conditions that are fully diagnosed, treated and stabilised.

The Service Officer is not required to check whether the Assessor's qualifications are the most appropriate for the customer's medical conditions.

The Continuing Inability to Work (CITW)/Blind residence information is included in this section of JCA reports. When a report is accepted, it pre-fills the Pension Disability Information (PDI) screen.

3

Barrier and Support Requirements

Make sure the barriers included in the report are consistent with the support requirements, interventions and referrals recommended.

If the Support Requirements section is completed, check there are medical conditions indicated in the medical condition section. The Assessor indicates what assistance the customer is best suited for and the referrals made.

Note: where a JCA (or upgraded ESAt) is completed, and the customer is assessed as:

  • Medically qualified for DSP, with:
    • 20 pts or more under a single Impairment Table, or
    • 20 pts or more across multiple Impairment Tables and Program of Support is met, or
    • Manifestly medically eligible, and
  • Future work capacity (FDTS) is 0-7 hrs p/w, and
  • No Employment Services Referral is indicated ('The client would not benefit from participation in any programme')

The Assessor may not complete the following sections in the report if the customer has no medical conditions or disability is recorded in the medical condition section:

  • Barriers
  • Interventions
  • Support Requirements
  • Employment History (except where supporting work capacity recommendations)

For:

4

DSP Portability

For Centrelink International Services (CIS) staff.

The DSP Portability Specific Questions are only available in the DSPMR and DSPME JCA referrals. These questions are opened and mandatory, as is the 'rationale' when the recipient is assessed as 'severely impaired' with a 0-7 hours per week work capacity.

Check the responses to the 2 portability specific questions are sound and meet the guidelines. Where appropriate, and with the Assessor's agreement, return the report to provide additional information regarding the DSP Portability assessment.

5

Work Capacity

If the customer is assigned at least 20 impairment points but does not have a severe impairment (20 points under a single table), they must have completed a Program of Support (POS). If the assessment indicates the customer has not actively participated in a Program of Support (POS), the Fully Diagnosed, Treated and Stabilised Work Capacity (FDTS) fields are blank.

  • Check the non-medical personal factors have not been used as a basis to determine work capacity
  • Check the Temporary Reduced Work Capacity is for an appropriate period and supported by available evidence
  • Work capacity with intervention should generally be greater or equal to Baseline capacity. If future capacity is shown to decline, identify whether this is explained by a deteriorating condition. Note: FDTS work capacities are not available if the POS indicator is No
  • If Baseline or with intervention work capacity is less than 30 hours, there must be a permanent condition to support this. Make sure the work capacity for permanent medical conditions is recorded correctly
  • Work capacity with mainstream intervention is to be completed for grandfathered customers. To check, go to the GFS screen in Process Direct and check the status of the 2006 Welfare to Work activity. If the status is:
    • GRF or TRA, the customer is grandfathered
    • TRR or New, the customer is not grandfathered
  • Work capacities must be consistent with the impairment. For example, an impairment rating of 10 points would not usually have a DTS 'with intervention' work capacity of 8-14 hours per week. In these cases, the report must clearly justify the reason
  • For a JCA, or an ESAt which has been upgraded to a JCA, there should also be FDTS work capacities if the customer's conditions attract a rating of 20 points or more, and they have:
  • Where the customer is currently:
    • working 15 hours or more per week, in open employment, or
    • undertaking study or training 15 hours or more per week
  • check the customer's employment circumstances have been considered, including the sustainability of the employment/study, in the assessment of the customer's work capacity

Do not accept the report if recommendations are not consistent with available evidence, see Table 6 > Step 1.

For more information about work capacity, see Assessing Continuing Inability to Work (CITW).

6

Active participation in a Program of Support

For DSP new claim JCAs, when an assessment of active participation in a Program of Support (POS) is required, assessment of POS and rationale behind the assessment must be clearly outlined within the JCA report.

If the JCA report indicates POS has or has not been met, evidence must be available to support the assessment. As part of checking JCA reports, the Service Officer must make sure the recommendation is consistent with the evidence on hand, (that is, referral screens, Medical Details Section of the claim, information within the report, days of active participation).

Do not accept the JCA report if unclear, see Table 6 > Step 1.

7

Interventions

Make sure interventions are consistent with barriers and referrals.


Check medical conditions, impairment ratings and work capacities - 1 April 2023 Impairment Tables

Table 4

Expand table

Step

Action

1

Check details of Medical Conditions

See the Medical Conditions section of the report.

For customers with medical condition Trans Vaginal Mesh (TVM) where the JCA Report recommends medical rejection:

  • do not accept the JCA Report. Update the DSP claim status to On Hold for reason Referred for JCA for 14 days
  • annotate the DSP Claim Progress DOC with
  • complete a referral to CCRT for DSP Claim finalisation and Service Offer Interview (SOI) for TVM case

For all other medical conditions and TVM cases where the JCA supports medical eligibility, continue processing as normal.

Check for manifest eligibility

When an Assessor recommends a customer is manifestly eligible for Disability Support Pension (DSP), they must record the manifest indicator in the Medical Conditions section of the JCA report. This displays in the report as Customer meets manifest criteria for category followed by a specific manifest indicator code.

The codes and corresponding categories are:

  • B - Permanent Blindness (BLI)
  • T - Terminal Illness (TRM)
  • I - Intellectual Disability (INT)
  • N - Nursing home level of care (NHM)
  • H - Category 4 HIV/AIDS (HV4)
  • P - Disability Pension at special rate (TPI)

If the Assessor correctly records the manifest indicator, it pre-fills the Medical Conditions Summary (MCSS) screen when the JCA report is accepted.

If the manifest indicator is not correctly displayed, and the JCA report is accepted by the Service Officer, the customer will be incorrectly assessed. The claim may be rejected or payment may cancel.

Service Officers must make sure the manifest indicator displays correctly before accepting a JCA report.

If the Assessor has recommended manifest eligibility in the body of the report (such as in the Remarks or Assessment Summary sections) but the manifest indicator is not displayed in the JCA report, the report must be returned to Assessment Services for correction.

The JCA report must not be accepted until it correctly reflects the Assessor's recommendation of manifest eligibility.

To return the JCA Report, go to the Referral Summary (RRSUM) screen:

  • Select ESAt/JCA Report > View Report to open the JCA report
  • Select Return from the Action dropdown menu
  • Decision Date, defaults to today's date
  • Action Reason, select the appropriate return reason
  • Return Comments, add comments asking the Assessor to further consider their assessment. Provide enough details to explain the reasons for rejecting the report, including the text 'No Manifest Indicator coded in the report'
  • Select Save > Assess to finalise the activity

To make sure Assessment Services are notified of the JCA Return and amendment required, refer back to Assessment Services.

Note: the referral must be actioned from the DSP Claim activity. Return to the TS screen or key the customer's Customer Reference Number (CRN) in the Inbox.

  • select > https://ourblueprint.internal.dept.local/content/images/process_direct_small/more options.png| > Referral
  • Referral Type, select Assessment Services
  • Referral Reason, select from:
    • query JCA Quality
    • text will pre-fill the Additional Information field
    • add additional information, JCA report indicates manifest eligibility has been met, but manifest indicator is not present, please add manifest indicator and resubmit
  • select Finish to view successful referral notification. Select OK to return to the Transaction Summary (TS) screen
  • the claim is set to status On hold - Awaiting ASB Recommendation. An annotation is added on Notes
  • annotate DSP Claim Progress DOC on DL/Notes with the information from the referral. Add any additional notes as needed

If Service Officers identify a claim rejection or payment cancellation has occurred because the manifest indicator has not been correctly coded and applied in the JCA report, the case must be urgently escalated to the DIS Service Delivery Support Team for investigation and resolution.

The email must be titled:

  • URGENT ACTION REQUIRED: INCORRECT CAN/REJ OF RECIPIENT MANIFESTLY ELIGIBLE FOR DSP. CRN: 999 999 999A

If the JCA referral is for a DSP manual medical review and the report will result in a cancellation because the manifest indicator has not been correctly coded and applied in the JCA report, the Service Officer managing the medical review must return the report and email Assessment Services to alert them.

Check medical conditions

Assessors do not need to assess every medical condition and reference every piece of medical evidence.

Assessors do not assess or reference medical conditions/evidence if it is not considered to be currently impacting the customer's functional capacity. For example, where a condition:

  • is resolved
  • has nil impact
  • is secondary, or a symptom of, a primary medical condition

Check all verified and impacting medical conditions have been recorded as detailed on the medical evidence and the medical evidence supports the assessment of a condition as:

  • persist for less than 2 years
  • persist for more than 2 years but not DTS
  • persist for more than 2 years and DTS
  • manifest

When an Assessor has medical evidence to support manifest eligibility for DSP they need to mark the condition as 'persist for more than 2 years' and Verified by medical evidence. It is not mandatory to mark the condition as DTS or enter DTS work capacities unless the customer has secondary medical conditions assessed.

For a JCA (or an Employment Services Assessment (ESAt) upgraded to a JCA), check all medical conditions are recorded under Conditions, including the Assessor needs to determine whether any condition which is likely to persist for more than 2 years is diagnosed, reasonably treated and stabilised.

Check to identify any significant inconsistency (outside the range of possibility) between medical condition details and the work capacity details.

Check the assessment of the customer's ability to use public transport without substantial help is consistent with report comments about the customer's mobility.

Note: this is only a prompt to consider inviting a claim for Mobility Allowance (MOB) and is not a recommendation of eligibility for MOB.

2

Impairment

Impairment ratings can only be applied to conditions that persist for more than 2 years, and are diagnosed, reasonably treated and stabilised.

The Service Officer is not required to check whether the Assessor's qualifications are the most appropriate for the customer's medical conditions.

The Continuing Inability to Work (CITW)/Blind residence information is included in this section of JCA reports. When a report is accepted, it pre-fills the Pension Disability Information (PDI) screen.

3

Barrier and Support Requirements

Make sure the barriers included in the report are consistent with the support requirements, interventions and referrals recommended.

If the Support Requirements section is completed, check there are medical conditions indicated in the medical condition section. The Assessor indicates what assistance the customer is best suited for and the referrals made. For:

Note: where a JCA (or upgraded ESAt) is completed, and the customer is assessed as:

  • Medically qualified for DSP with:
    • 20 pts or more under a single Impairment Table, or
    • 20 pts or more across multiple Impairment Tables and Program of Support is met, or
    • Manifestly medically eligible, and
  • Future work capacity (DTS) is 0-7 hrs p/w, and
  • No Employment Services Referral is indicated ('The client would not benefit from participation in any programme')

The Assessor may not complete the following sections in the report if the customer has no medical conditions or disability is recorded in the medical condition section:

  • Barriers
  • Interventions
  • Support Requirements
  • Employment History (except where supporting work capacity recommendations)

4

DSP Portability

For Centrelink International Services (CIS) staff.

The DSP Portability Specific Questions are only available in the DSPMR and DSPME JCA referrals. These questions are opened and mandatory, as is the 'rationale' when the recipient is assessed as 'severely impaired' with a 0-7 hours per week work capacity.

Check the responses to the 2 portability specific questions are sound and meet the guidelines. Where appropriate, and with the Assessor's agreement, return the report to provide additional information regarding the DSP Portability assessment.

5

Work Capacity

If the customer is assigned at least 20 impairment points but does not have a severe impairment (20 points under a single table), they must have completed a Program of Support (POS). If the assessment indicates the customer has not actively participated in a Program of Support (POS), the Diagnosed, Reasonably Treated and Stabilised Work Capacity (DTS) fields are blank.

  • Check the non-medical personal factors have not been used as a basis to determine work capacity
  • Check the Temporary Reduced Work Capacity is for an appropriate period and supported by available evidence
  • Work capacity with intervention should generally be greater or equal to Baseline capacity. If future capacity is shown to decline, identify whether this is explained by a deteriorating condition. Note: DTS work capacities are not available if the POS indicator is No
  • If Baseline or with intervention work capacity is less than 30 hours, there must be a condition that persists for more than 2 years, to support this. Make sure the work capacity for conditions that persist for more than 2 years, is recorded correctly
  • Work capacity with 'mainstream intervention' should only be completed for grandfathered customers. To check if the customer is receiving Disability Support Pension (DSP) under the Grandfather provisions, go to the GFS screen in Process Direct and check the status of the 2006 Welfare to Work activity. If the status is:
    • GRF or TRA, the customer is grandfathered
    • TRR or New, the customer is not grandfathered
  • Work capacities must be consistent with the impairment. For example, an impairment rating of 10 points would not usually have a DTS 'with intervention' work capacity of 8-14 hours per week. In these cases, the report must clearly justify the reason
  • For a JCA, or an ESAt which has been upgraded to a JCA, there should also be DTS work capacities if the customer's conditions attract a rating of 20 points or more, and they have:
  • Where the customer is currently:
    • working 15 hours or more per week in open employment, or
    • undertaking study or training 15 hours or more per week
  • check the customer's employment circumstances have been considered, including the sustainability of the employment/study in the assessment of the customer's work capacity

If JCA is for a DSP manual medical review, POS is not considered in the assessment and the report can be accepted.

Take care when accepting the report:

  • if the JCA indicates a customer meets all other criteria for DSP other than CITW, and
  • the reason they do not meet CITW is because they are currently working unsupported for at least 15 hours and less than 30 hours per week

Additional coding is required to the Work Capacity (WC) screen to prevent customer’s payment from cancelling. See Initiating and actioning a manual medical review for Disability Support Pension (DSP).

Do not accept the report if recommendations are not consistent with available evidence, see Table 6 > Step 1.

For more details about work capacity, see Assessing Continuing Inability to Work (CITW).

6

Active participation in a Program of Support

For DSP new claim JCAs, when an assessment of active participation in a Program of Support (POS) is required, assessment of POS and rationale behind the assessment must be clearly outlined within the JCA report.

If the JCA report indicates POS has or has not been met, evidence must be available to support the assessment. As part of checking JCA reports, the Service Officer must make sure the recommendation is consistent with the evidence on hand, (that is, referral screens, Medical Details Section of the claim, information within the report).

Do not accept the JCA report if unclear, see Table 6 > Step 1.

7

Interventions

Make sure interventions are consistent with barriers and referrals.

See Table 5.


Check Assessment Summary and Referrals

Table 5

Expand table

Step

Action

1

Additional Summary section

This section captures information not recorded elsewhere. Check the following is recorded in this section:

  • the first paragraph confirms whether the assessment was completed successfully or was not able to be completed. If the assessment was not completed, the Assessor's attempts to engage the customer
  • other information could include:
    • any unverified, self-reported medical conditions or observed symptoms associated with a medical condition. This may include a statement that effective assessment including referrals to specialist services such as Inclusive Employment Australia (IEA) depends on whether the customer can provide further relevant medical evidence to support the self-reported medical condition(s)
    • any new customer details such as change of address
    • any concerns with the medical information available
    • details of any referrals made that are not recorded in the Referrals section of the report
    • if recommended referral is to be deferred because of the customer's temporary reduced work capacity, dates and time frames for future referral

If a file assessment was conducted, the Assessor must indicate the need for the Service Officer to action the recommended referral.

Note: return the report to Assessment Services for correction if the Assessor has recommended manifest eligibility in the body of the report but the manifest indicator is not displayed. The JCA report must not be accepted until it correctly reflects the Assessor's recommendation of manifest eligibility. For action required for:

  • claims with a start date before 1 April 2023, see Table 3
  • claims with a DSP start date on or after 1 April 2023, see Table 4

2

Continue checking Assessment Summary

Check the following is recorded:

  • whether the report contains (or does not contain) information which, if released to the customer, might be prejudicial to their health, including a free text field for an explanation if the answer is Yes
  • whether it is considered the customer's personal factors have an impact (no impact, low, moderate or high) on their ability to work, obtain work, or look for work, and a rationale for this determination

3

Referrals

Referral recommendations

The Assessor records recommended referrals to employment services providers and other services (for example, community mental health service) in this section of the report.

There are only limited circumstances in which a referral recommendation may not be stated in the report. This is generally only because the customer has a future work capacity (with intervention) of less than 8 hours per week and is unable to benefit from referral to any program.

Return the report if a referral recommendation is not clearly stated in this section of the report and there is no clear reason.

The customer's participation in a current program or activity, or a voluntary participation decision not to accept the offer of a referral are not valid reasons for the absence of a referral recommendation.

Immediate referrals made by the Assessor

The Assessor's actions to make the referral must be clear in the report. This includes:

  • if an immediate referral was appropriate, details of the referral, including the service provider and appointment details
  • whether a customer with future work capacity or temporary reduced work capacity of less than 15 hours per week declined the offer of a referral
  • if the Assessor intended the referral to be deferred because of the customer's temporary reduced work capacity - supported by other information in the report

Check an appointment was made by the Assessor for referrals completed in the Department of Employment and Workplace Relations (DEWR) system:

  • enter customer record through Customer Summary
  • select https://ourblueprint.internal.dept.local/content/images/process_direct_small/more options.png| > Participation Summary > Online Diary
  • to return to claim assessment:
  • return to Inbox
  • search using CRN
  • select DSP claim activity. If needed, re-enter the JCA Report to resume consideration of JCA

Referral recommendations from a file assessment are not actioned by the Assessor. It must be indicated in the Assessment Summary the Service Officer needs to action the recommended referral.

Return the report if an immediate referral is required but the Assessor's referral actions are not evident in the submitted report, see Table 6 > Step 1.

Are there referrals recommended but the customer could not be referred immediately by the Assessor?

4

Employment services provider referral not actioned

When the Assessor recommends a referral to an employment services provider, check the Participation Summary to see if the customer has been referred.

If the customer has not been referred, the Service Officer finalising the DSP claim must action the referral if there is an opportunity to do so (e.g. during the Service Offer Interview (SOI)).

Inclusive Employment Australia (IEA)

Customers who had a JCA completed prior to 1 November 2025 and have a referral recommendation to the former Disability Employment Services (DES) program can be referred to an IEA provider.

See Referring a customer to Inclusive Employment Australia (IEA) if the Assessor has recommended a referral to an IEA provider or the former DES program.

Other employment services providers

If the Assessor has recommended a referral to another employment services provider, see:

When a referral cannot be actioned by the Assessor or Disability Processing, a work item is created for the customer to be contacted and referred at another time.

Deferred referrals

If referrals are recommended to an employment services provider for a job seeker with mutual obligation requirements, but the referral cannot be immediately actioned by the Assessor:

  • the Assessor must record the recommended future referral including the reason for the deferred referral, the date and timeframe
  • when the deferred referral period ends, a work item is created for the referral to be actioned

See Deferred referral to employment services providers.

Before accepting a report where making a deferred referral may be required, check the report for any factors that may affect the ability to action an IEA referral in the future. See Eligibility criteria for participation with Inclusive Employment Australia (IEA).

5

Final overview

Read the report to check it has been completed with enough information to determine income support eligibility and/or appropriate assistance. Check it is internally consistent.

See Table 6.


Accept or escalate the report

Table 6

Expand table

Step

Action

1

Determine if further escalation is required

If a JCA report indicates potential medical eligibility (excluding manifest), the report cannot be accepted. The claim must be placed on hold while a Disability Medical Assessment (DMA) is undertaken. The report cannot be accepted and will be locked.

If DSP is already CUR and the submitted JCA does not support medical eligibility, do not accept the JCA report. Hold the JCA report work item for 14 days and refer to Level 2 Policy Helpdesk.

Where a quality issue is identified after the JCA report has been accepted:

  • For issues related to residence/CITW, go to Step 2
  • For all other issues, refer to a Service Support Officer (SSO), go to Step 7

Where a quality issue is identified prior to a JCA report being accepted, Service Officers should escalate the report. Where:

  • incorrect version of the Impairment Tables has been used based on date of claim
  • incorrect terminologies have been used in the JCA report based on the relevant impairment table version. For examples, see The Impairment Tables Resources page, Frequently asked questions (FAQs)
  • the report is not internally consistent
  • incorrect or inconsistent gender information is contained within the body of the report.
    Note: the Client Details section on page 1 of JCA reports is system generated. This section will display the customer's legal name and gender and cannot be amended. Where a customer's preferred name and pronouns differ from their legal details, Assessors should use the customer's preferred details throughout the report and note the reason for the discrepancy in the Assessment Summary. Reports must be accepted where the preferred details are used throughout the report and the discrepancy between the legal and preferred details is documented
  • customer's current open employment has not been considered in assessed work capacity
  • customer's current study/training has not been considered in assessed work capacity
  • insufficient information for income support decision
  • medical evidence not referenced adequately in the report
  • Program of Support (POS) has not been assessed
  • POS has been assessed as met with 0 days of active participation
  • an incorrect, or no, determination has been made of where the customer's CITW arose, for customers who have less than 10 years residence
  • the Assessor has not documented why written medical evidence has not been used to verify condition as:
    • fully diagnosed, treated and stabilised (2012 Impairment Tables), or
    • diagnosed, reasonably treated and stabilised (2023 Impairment Tables), and
    • the reasons do not meet the specifically defined circumstances
  • insufficient information to determine appropriate assistance
  • insufficient rationale given for decisions or ratings
  • Impairment Tables or ratings used incorrectly
  • a referral recommendation has not been made, and no valid reason is stated
  • referral action has not been made, or the Assessor's referral actions are not clear
  • other errors or reasons as discussed with the Assessor
  • Assessor requests return of the report
  • inappropriate or prejudicial information is included in the report
  • information sharing indicator is incorrect or not recorded. If the Assessor has not advised the customer of information sharing arrangement, it may be a breach of privacy to accept the report
  • the report does not address all the customer's medical conditions
  • new medical evidence has been supplied since the JCA report was submitted
  • incorrect information recorded. For example, a typographical error.
    Note: reports with minor spelling or grammatical errors should be accepted unless it impacts the JCA outcome or causes a risk to the agency, if the report was released to the customer. For example, where the report references the incorrect customer's name
  • missing fields or sections in the report
  • the report was completed after 1 November 2025 and references Disability Employment Services (DES) instead of Inclusive Employment Australia

Can the report be accepted?

2

Issue relates to Residency/assessment of where Continuing Inability to Work (CITW) occurred

Identified issues in a JCA report relating to residency and CITW can include:

  • an assessment of where the customer's CITW occurred is not recorded, and this is required based on the customer's residence status
  • an assessment of where the customer's CITW occurred is recorded, and this is not required because the customer:
    • has 10 years qualifying residence, or
    • has a Qualifying Residence Exemption (QRE) or
    • does not have a CITW (i.e. work capacity is greater than 15 hrs pw)
  • an incorrect statement regarding the customer's period of residence in Australia
  • a statement 'client does not have a continuing inability to work' when the customer has been assessed as having a CITW (i.e. work capacity is less than 15 hrs per week)
    Note: where the JCA contains a manifest indicator, the customer's period of residence and where their CITW occurred will not present in the report. The Assessor must include this information (if applicable), in the 'Assessment Summary' of the report

This process does not apply to upgraded ESAts. Where there is an incorrect statement regarding the customer's residency in an upgraded ESAt, the report should be accepted. Customer's residency/CITW will be considered in the MAT report/SA479 (if applicable). See the Resources page for more information about upgraded ESAts and residence.

For DSP new claims

Does the identified issue in the JCA Report relate to the customer's residency and assessment of where the customer's CITW occurred?

  • Yes:
    • apply Hold to User until the claim is completed. See Work Optimiser for staff
    • update status of DSP claim to On Hold for reason Awaiting Level 2 policy advice
    • refer error about residency/CITW to Level 2 Policy Helpdesk (record team leader as the additional contact name)
    • annotate DSP Claim progress DOC to include: 'An error has been found in the JCA referral and CITW assessment in JCA. Requires review. Referred to Level 2 Policy Helpdesk'
    • if an error has been found in the JCA Referral, send feedback to the referring Service Officer via the Staff Feedback Tool
  • No, go to Step 3
For DSP Appeals

Does the identified issue in the JCA Report relate to the customer’s residency and assessment of where the customer’s CITW occurred?

  • Yes:
    • refer error about residency/CITW to Level 2 Policy Helpdesk via the Online Enquiry form (record team leader as the additional contact name)
    • annotate DSP appeal DOC to include: 'An error has been found in the JCA referral and CITW assessment in JCA. Requires review. Referred to Level 2 Policy Helpdesk'
    • if an error has been found in the JCA Referral, send feedback to the referring Service Officer via the Staff Feedback Tool
  • No, go to Step 3

3

Issue relates to the Incorrect Impairment Tables / terminology
  • Where there are no issues in the JCA Report relating to the Impairment Tables version and/or related terminology
  • Where the correct version of the Impairment Tables has been applied, but the Assessor has used incorrect terminology, e.g. the 2023 tables apply and the Assessor has used the term “permanent” to describe a disability or medical condition. For more information about the use of the term permanent, see the Frequently Asked Questions tables, in The Impairment Tables
  • Where the incorrect version of the Impairment Tables has been applied, review the DSP claim start date and ensure PNA is correct, based on customer circumstances
  • If the Impairment Tables in an upgraded ESAt do not align with the PNA date, do not refer to Assessment Services to be amended. The ESAt cannot be considered current and valid for the DSP Claim, refer to MAT to review the MAT report/SA479, see Streaming a new claim for Disability Support Pension (DSP)
  • If the incorrect version of Impairment Tables have been applied for DSP manual medical reviews, Service Officer managing the review can email Assessment Services directly
  • If it is clear the incorrect Impairment Tables version has been applied in a DSP New Claim JCA, and there is a DMA Referral or DMA Report Submitted for the related claim/appeal:
    • do not action the JCA or DMA Report
    • refer to Level 2 Policy Helpdesk
    • annotate the DSP Claim Progress DOC
    • hold the DSP claim under HTU for 14 days with reason 'Awaiting Level 2 Policy Advice'
    • Level 2 will liaise with Assessment Services and GCD Contract Management Team to correct the relevant report
    • procedure ends here until corrected reports are resubmitted
  • If there is no DMA Referral/Report related to the claim/appeal, refer to Service Support Officer (SSO)

4

Issue relates to Information Sharing Indicator only

Is the only error due to the Information Sharing Indicator being incorrect or not recorded?

Note: this includes upgraded ESAts, regardless of the report status (i.e. submitted/finalised)

5

All other JCA issues

Service Officers can refer some JCA issues directly to Assessment Services, without referring to an SSO.

These include:

  • new medical evidence lodged since JCA was completed
  • internal inconsistency
  • medical evidence not referenced
  • missing fields and sections in the report
  • Program of Support (POS) related enquiries

Typographical errors such as minor typing, spelling, grammatical errors which do not impact the JCA outcome or cause a risk to the agency do not need to be referred to Assessment Services. JCA report is to be accepted.

Referral to an SSO is required when:

  • there is a complex or sensitive issue and is not appropriate to record on a DOC. See Online Document Recording (ODR)
  • the Service Officer is unsure if the JCA can be accepted or not
  • a DMA Referral has occurred, or a DMA Report has been submitted related to the JCA Report

Is a referral to an SSO required?

6

Refer JCA to Assessment Services

Service Officers can refer errors to Assessment Services for review.

Note: typographical errors such as minor typing, spelling, grammatical errors which do not impact the JCA outcome or cause a risk to the agency do not need to be referred to Assessment Services. The JCA report is to be accepted.

If the JCA Report requires review, refer to Assessment Services.

For DSP new claims

Note: the referral must be actioned from the DSP Claim activity. Return to the TS screen or key the customer's CRN in the Inbox.

  • select https://ourblueprint.internal.dept.local/content/images/process_direct_small/more options.png| Referral
  • Referral Summary screen, select Referral Type
  • Referral Type, select Assessment Services
  • Referral Reason, select one of the following:
    • POS Post DMA
    • New Medical Evidence
    • Query JCA Quality
    • Query JCA Status
  • text will pre-fill the Additional Information field
  • add additional information if required
  • select Finish to view the referral notification
  • select OK to return to the Transaction Summary (TS) screen
  • the claim will be set to status On hold - Awaiting ASB Recommendation. A note is added on DL/Notes under Notes. 'A referral has been created for Assessment Services', with the reason selected
    Note: the additional text added does not display in the Notes and cannot be viewed by Assessment Services in Process Direct
  • manually hold the Job Capacity Assessment - Initial Submission transaction in Process Direct to prevent the JCA report being reallocated to another user:
    • Within the JCA work item, select place on hold
    • Use hold reason Clarifying JCA referral details
    • Select a hold expiry date of 14 days in the future
    • Add a comment to explain that the JCA has been returned to assessment services
  • manually hold the JCA report transaction for 14 days and add text: referred to Assessment Services due to quality issue with JCA, see DSP Claim Progress DOC
  • annotate the DSP Claim Progress DOC on DL/Notes with the reason the JCA report is being referred to Assessment Services. Staff must not record personal or sensitive details in the DOC. This includes medical conditions. See Online Document Recording (ODR)
  • claim does not need to be held to user while JCA is being reviewed unless the claim meets Hold To User criteria, as in Work Optimiser for staff

For DSP Appeals

  • place JCA report in Process Direct on hold:
    • Status > Edit > change Status to On Hold > use reason Referral to SSO > hold for 14 days
  • update DSP appeal DOC to explain why the JCA was not accepted. Do not record personal or sensitive details in the DOC. This includes medical conditions. See Online Document Recording (ODR)
  • Hold the DOC for 14 days
  • Apply Hold to User. See Work Optimiser for staff
  • In Customer First, run ASB Assistance Required Fast Note and add query details

Procedure ends here until referral is actioned by Assessment Services. When completed, go to Step 12.

7

Referral to a Service Support Officer (SSO)

To refer to SSO use the Direct SSO Referral webform > Benefit Type: DSP > Escalation type: Check JCA/ESAt/DMA report.

For DSP new claims

  • place the DSP claim in Process Direct on hold:
    • select Status > Edit > change Claim Status to On Hold > use reason Referral to SSO > hold for 14 days
  • place JCA report in Process Direct on hold:
    • Status > Edit > change Status to On Hold > use reason Referral to SSO > hold for 14 days
  • annotate DSP Claim Progress DOC to advise referral to SSO has been actioned due to an issue with the JCA Report and include the specific reason e.g. incorrect version of Impairment Tables used or missing information in report. Staff must not record personal or sensitive details in the DOC. This includes medical conditions. See Online Document Recording (ODR)
  • claim does not need Hold To User while JCA is being reviewed, unless the claim meets Hold to User criteria, as in Work Optimiser for staff

For DSP Appeals

  • place JCA report in Process Direct on hold:
    • Status > Edit > change Status to On Hold > use reason Referral to SSO > hold for 14 days
  • update DSP appeal DOC to advise referral to SSO has been actioned due to an issue with JCA Report and include the specific reason. For example, incorrect version of Impairment Tables used or missing information in report. Do not record personal or sensitive details in the DOC. This includes medical conditions. See Online Document Recording (ODR)
  • Apply Hold to User criteria

Procedure ends here, until the SSO has reviewed the JCA.

Action required by SSO depends on the JCA status, and if a DMA referral has occurred or not:

8

DMA referral has occurred

SSO must review the query and JCA Report.

Where the SSO determines review of the JCA is not required, they:

  • Annotate the DSP claim Progress DOC or DSP appeal on DL/Notes with outcome
  • For DSP new claim, take the DSP claim off hold so it allocates to a Service Officer:
    • Status > Edit> set Claim activity to 'In Process'
  • For DSP appeals, remove the resubmit date from the appeal DOC so it allocates to a Service Officer
  • Finalise Direct SSO referral in TSC database with the outcome
  • Advise Service Officer to accept JCA, go to Step 13

Where the SSO determines further review of JCA is required, and the:

  • JCA report is already accepted, including JCA's with a finalised status:
    • review of a JCA report after accepted should only occur if a change to the impairment rating or work capacity may impact payment, the customer's mutual obligation or participation
    • SSO must refer to Level 2 Policy Helpdesk
    • include details of the JCA issue/error and DMA status
    • annotate the DSP claim Progress DOC on DL/Notes or DSP appeal DOC with outcome
    • hold the Direct SSO Referral in the TSC database until a response from Level 2 is received
  • JCA report has not been accepted, and the DMA status is 'Referred' or 'Scheduled':
    • SSO must escalate the matter via email to GCD Contract Management team detailing the:
    • issue/error with the JCA Report, and
    • expected outcome (for example, no change in decision or update leads to a change in outcome)
    • SSO must not take any action on the JCA Report, until they receive a response from GCD

JCA report has not been accepted, and the DMA status is not 'Referred' or 'Scheduled',' for example, Attended or Submitted, or after GCD team has responded to email (above):

  • SSO can escalate the matter to Assessment Services:
    • For sensitive complex issues which cannot be recorded on a DOC, go to Step 10
    • If the issue is not sensitive or complex. go to Step 11

9

DMA referral has not occurred

The SSO must review both the query and JCA report if there is no DMA Referral.

Where an SSO determines:

  • a JCA review is not required:
    • annotate the DSP claim Progress DOC or DSP Appeal DOC on DL/Notes with the outcome
    • for DSP new claims, select Status > Edit > set Claim activity to 'In Process' so it allocates to a Service Officer
    • for DSP appeals, remove the resubmit date from the appeal DOC so it allocates to a Service Officer
    • finalise Direct SSO referral in TSC database with the outcome
    • advise the Service Officer to accept the JCA, go to Step 13
  • a JCA review is required, and a JCA is already accepted, including finalised status:
    • review of a JCA report after acceptance should only occur if a change to the impairment rating or work capacity may impact payment the customer's mutual obligation or participation
    • SSO must refer to Level 2 Policy Helpdesk
    • include details of the JCA issue/error and DMA status
    • annotate the DSP claim Process DOC on DL/Notes with outcome
    • hold the Direct SSO Referral in TSC database until a response from Level 2 is received
  • further review by Assessment Services is required and JCA has not been accepted, if the JCA query:

10

JCA query relates to a sensitive or complex issue

Do not make a referral to Assessment Services through Referrals.

SSO is to:

  • email the query to the Assessment Services DAS
  • hold the Direct SSO Referral in TSC database until a response from Assessment Services is received

Where a DMA Referral has occurred/DMA Report submitted, and GCD CMT have not already been contacted, send an email to GCD Contract Management team to outline the JCA error / omission being reviewed.

Once response is received and if JCA is:

  • re-opened and re-submitted, it will present as a work item to Service Officer
  • not re-submitted, SSO must update DSP claim status to In Process:
    • annotate the DSP claim Progress DOC or DSP Appeal DOC on DL/Notes with outcome to advise the JCA report can be accepted
    • finalise Direct SSO Referral in TSC database

Go to Step 12.

11

JCA query does not relate to a sensitive or complex issue

If there are no sensitive or complex issues and a review by Assessment Services is required, the SSO must refer to Assessment Services.

For a DSP new claim

Note: the referral must be actioned from the DSP Claim activity. Return to the TS screen, or key the customer's CRN in the Inbox.

  • select https://ourblueprint.internal.dept.local/content/images/process_direct_small/more options.png| > Referral
  • from the Referral Summary screen, select Referral Type
  • from Referral Type dropdown, select Assessment Services
  • Referral Reason, select appropriate reason from one of the following:
    • POS Post DMA
    • New Medical Evidence
    • Query JCA Quality
    • Query JCA Status
  • text pre-populates in the Additional Information field
  • add additional information if required
  • select Finish to view a successful referral notification
  • select OK to return to the Transaction Summary (TS) screen
  • the claim is set to status 'On hold - Awaiting ASB Recommendation'. A note is added on DL/Notes under Notes. 'A referral has been created for Assessment Services, with the reason selected
    Note: the additional text added is not displayed in the Notes and cannot be viewed by Assessment Services in Process Direct
  • annotate DSP claim Progress DOC with the information from the referral, i.e. the reason the JCA Report is being referred to Assessment Services

For DSP Appeal

In Customer First, run the ASB Assistance Required Fast Note for checking by the Assessment Services Quality Team:

  • annotate the DSP Appeal DOC with details
  • SSO to finalise the Direct SSO Referral in the TSC database and advise that query has been escalated to Assessment Services for review of JCA

SSO must finalise the Direct SSO Referral in TSC database and advise the query has been escalated to Assessment Services for review of JCA.

Where a DMA referral has occurred/DMA report submitted, and GCD CMT have not been contacted, send an email to GCD Contract Management team to outline the simple error or omission being reviewed.

Procedure ends here, until Assessment Services complete the referral. Once completed, go to Step 12.

12

Assessment Services

Assessment Services reviews the query and the relevant JCA report.

For DSP new claims

If the JCA is:

  • reopened and resubmitted, and JCA recommends:
    • medical ineligibility, or
    • manifest medical eligibility, then
    • the JCA report will be a work item for a Service Officer to action
  • reopened and resubmitted, and JCA recommends:
    • medical eligibility, this will automatically refer to DMA
    • Note: if DMA has already been submitted, the Assessor must update the DSP claim status to 'In Process' for a Service Officer to action
  • not resubmitted, Assessment Services:
    • updates the DSP claim status to In Process, so it allocates to a Service Officer to action, and
    • annotates the DSP Claim Progress DOC or DSP appeal DOC with the outcome of the quality check

For DSP Appeals

Close the ASB Assistance Required Fast Note.

  • annotate the DSP appeal DOC with outcome
  • remove the resubmit date from the appeal DOC so it allocates to a Service Officer.

If Service Officers have any concerns with an outcome or response, make a Direct Referral to SSO for review.

For queries raised by SSO via email, Assessment Services respond to the SSO with the outcome:

  • SSO to update the DSP claim status to In Process and annotate the DSP claim Progress DOC on DL/Notes with outcome
  • SSO to finalise SSO Referral in TSC database

If required, SSO can email the Assessment Services DAS for further advice.

If agreement cannot be reached, the SSO can consider referral to the Health Professional Advisory Unit (HPAU). See Inconsistencies in a Job Capacity Assessment (JCA) report.

13

Accept the JCA Report

Where the JCA report has been checked as part of the Disability Medical Assessment (DMA) report checking process, manual JCA acceptance is not required. When the DMA report is accepted, the system will attempt to automatically accept the JCA. See Assessing Disability Support Pension (DSP) after a Disability Medical Assessment (DMA)

Prior to accepting a DSP new claim JCA:

  • locate the DSP claim
  • update the claim status to OPEN
  • apply Hold to User
  • place the claim on hold for one day using the reason JCA

After reviewing the JCA and the report is ready to finalise, from the Referral Summary RRSUM screen:

  • select ESAt/JCA Report > View Report to open the JCA report
  • select Accept from the Action dropdown menu
  • confirm the date the report is being accepted has populated correctly
  • Save > Finalise the activity via the Entitlements (ELD) screen

If JCA activity is creating a negative adjustment (debt) and an update to Assessment Consequences (ASC) is required, complete updates to ASC as part of the same activity. See Explaining and actioning negative adjustments on a customer’s record

JCA Report is selected for quality checking

When a JCA Report is accepted in Process Direct, it may be selected for quality checking. If a JCA is selected for checking, the work item will be sent to Quality Management Application (QMA) and quality checked by a Quality Management Officer (QMO).

If quality checking is required:

  • annotate relevant DSP DOC as follows: JCA Report selected for quality checking
  • For DSP new claims, locate the related DSP Claim, if not on hold, update status to On Hold for reason Referred to JCA for one day

QMOs actioning QMA of the JCA report, see Table 7.

The JCA outcome does not appear on the customer's Medical Conditions Details (MC) screen, until QMA is complete.

Once QMA is complete, continue with action below.

Once a JCA report has been accepted by the Service Officer, it auto-attaches to the customer's eMIFE. The MC screen and the WC screen display with information updated from the report.

Note: the MC date of event may need to be amended as part of DSP new claim and appeal process.

Partial Capacity to Work (PCW)

Where an error relating to Independence PCW appears when accepting the report:

The JCA report status remains submitted for 28 days. It then becomes finalised from day 29. If required, staff can request early finalisation of the JCA report. This stops delays to DSP new claims if a new referral needs to be made immediately after the previous report is submitted. Once the report is selected for finalisation, it finalises overnight.

When the JCA report is accepted, it auto-generates a DOC which includes details when:

  • an IEA/DES referral was recommended and:
    • actioned
    • not actioned/requires action
    • deferred as the customer has a temporary reduced work capacity
  • the date a temporary reduced work capacity is expected to end
  • information in the report suggests medical eligibility for DSP

Further actions

For DSP new claims, the Service Officer is to continue assessing the claim, see Assessing a new claim for DSP after JCA. Before assessing the DSP claim, staff must locate the claim in Work Optimiser and select Assign to me.

If the customer meets medical and other eligibility requirements for DSP and currently does not have a claim for DSP, contact them to invite a claim. See Claiming Disability Support Pension (DSP).

For DSP appeals, DSP Processing SME, see:

For SWS, see Supported Wage System (SWS) medical eligibility assessment process.

For DSP manual medical reviews, see Initiating and actioning a manual medical review for Disability Support Pension (DSP).

14

DOC for ESAt/JCA Outcomes

When a ESAt/JCA report is accepted the system creates a DOC with the ESAt/JCA Outcome.

The ESAt/JCA assessment is current for 2 years, except where:

  • a customer has a subsequent ESAt/JCA in the 2 year period, or
  • duplicate DOC is created for the same ESAt/JCA report

When accepting the ESAt/JCA report or finalising a claim, staff must check new DOA DOCs are not created and expire any old ESAt/JCA Outcome DOA DOCs. See Creating, reviewing and deleting documents (including Fast Notes and DOA DOCs) for more details.


Completing Quality Management Assessment (QMA) of a JCA

Table 7

Expand table

Step

Action

1

Quality checking a JCA acceptance

Where a Quality Management Officer (QMO) is quality checking a JCA acceptance activity in QMA, QMO's must check the record for any provisional updates.

QMO's must not select Save on the Referral Summary (RRSUM) screen until all checks have been completed and the QMO has determined what the correct JCA report action outcome (Accept or Return) will be.

Selecting Save will cause the system to regenerate the transaction and all provisional data will delete.

Initial QMA checks

Before selecting Process in the QMA transaction, check:

  • the Document List (DL)/Notes screen for DOCs that may indicate the customer has had a change of circumstance
  • Screens listed in the Task Selector on the Errors (SWE) screen and go to screens flag with provisional updates
  • Scanned documents

Make a note of the details:

  • where provisional updates have been made within the ESAt acceptance transaction, or
  • if information available on the record indicates the customer has had a change of circumstances
  • Note: change of circumstances updates should be made outside of the JCA acceptance transaction. For example, a change of address that requires an update to the Accommodation Details (AC) screen.

2

QMO determines correct report action

Go to the Transaction Summary (TS) screen and select Process.

From the RRSUM screen, view the JCA report and determine if the JCA can be accepted.

Is the JCA acceptance action correct, and can the JCA report be accepted?

  • Yes, select Next and continue to process the QMA activity. Procedure ends here.
  • No, go to Step 3

3

JCA acceptance action is incorrect

If the QMO determines the JCA acceptance is incorrect and the report needs to be returned:

  • any provisional change of circumstance updates within the transaction will be removed when the report status is changed to Return. Details must be updated outside of the JCA transaction
  • go to the RRSUM screen:
    • in the Report Action field, select Return
    • select Save and finalise the transaction
  • if required, update any change of circumstances in a new transaction