Social Security (Disability and Sickness Support) Amendment Act 1991

Administered by Department of Employment, Skills, Small and Family Business, Department of Social Services

Legislation au C2004A04216 Not in force Act

Legislation content

 

 

Social Security (Disability and Sickness

 Support) Amendment Act 1991

No. 141 of 1991

TABLE OF PROVISIONS

PART 1—INTRODUCTORY

Section

 

1.

Short title etc.

2.

Commencement

 

PART 2—AMENDMENTS RELATING TO INVALID PENSION

3.

General definitions

4.

Insertion of new section:

 

28a. Approval of programs of assistance

5.

Insertion of new section:

 

791a. Claimant must be under pension age

6.

Grant of pension or allowance when person is outside Australia

7.

Some pensions generally portable without time limit

8.

Insertion of new section:

 

1213a. Portability of invalid pension

 

General

 

Pensions granted on or after 1 July 1991 to persons not severely disabled

 

Pensions granted on or after 1 July 1991 to persons severely disabled

 

Departure certificates and short residence


TABLE OF PROVISIONScontinued

Section

 

 

PART 3—AMENDMENTS RELATING TO DISABILITY SUPPORT PENSION AND SICKNESS ALLOWANCE

9.

General definitions

10.

Repeal and substitution of new Part:

 

PART 2.3—DISABILITY SUPPORT PENSION

 

Division 1Qualification for and payability of disability support pension

 

Subdivision AQualification

 

94. Qualification for disability support pension—continuing inability to work

 

Meaning of continuing inability

 

Person not qualified in certain circumstances

 

95. Qualification for disability support pension—permanent blindness

 

Person not qualified in certain circumstances

 

96. Refusal to attend interview etc. may lead to disqualification

 

97. Departure certificate requirements apply

 

Subdivision BPayability

 

98. Disability support pension not payable in some circumstances

 

99. Disability support pension generally not payable before claim or end of waiting period

 

100. Provisional commencement day

 

General rule

 

Initial incorrect claim followed by a claim for disability support

 

pension

 

Early claim

 

Claim resulting from a major disaster

 

101. Provision of persons tax file number

 

102. Provision of partners tax file number

 

103. Multiple entitlement exclusion

 

104. Rehabilitation and assistance programs

 

105. Refusal to attend interview etc.

 

Division 2Claim for disability support pension

 

106. Need for a claim

 

107. Form of claim

 

108. Lodgment of claim

 

109. Claimant must be under pension age

 

110. Claimant must be Australian resident and in Australia

 

111. Secretary may require claimant to give statement of claimants tax file number

 

112. Secretary may require claimant to give statement of partners tax file number

 

Division 3Determination of claim

 

113. Secretary to determine claim

 

114. Grant of claim

 

115. Date of effect of determination

 

Notified decisionreview sought within 3 months

 

Notified decisionreview sought after 3 months

 

Decision not notified

 

Division 4Medical examination following claim

 

116. Examination by medical practitioner


TABLE OF PROVISIONScontinued

Section

Division 5Rate of disability support pension

 

117. How to work out a persons disability support pension rate

 

Division 6Payment of disability support pension

 

118. Commencement of disability support pension

 

119. Payment by instalments

 

120. Effect on instalments of backdating claim

 

121. Calculation of amount of instalment

 

122. Inmates of benevolent homes

 

123. Payment to person

 

124. Nominee payments

 

125. Payment into bank account etc.

 

126. Where pension payday would fall on public holiday etc.

 

127. Payment of pension after death

 

Division 7Protection of disability support pension

 

128. Disability support pension to be absolutely inalienable

 

Payments to Commissioner of Taxation at recipients request

 

129. Effect of garnishee or attachment order

 

Division 8Recipient obligations

 

130. Secretary may require recipient to give statement of recipients tax file number

 

131. Secretary may require recipient to give statement of partners tax file number

 

132. Secretary may require notice of the happening of an event or a change in circumstances

 

133. Secretary may require recipient to give particular information relevant to payment of disability support pension

 

134. Self incrimination

 

Division 9Continuation, variation and termination

 

Subdivision AGeneral

 

135. Continuing effect of determination

 

Entitlement determination

 

Rate determination

 

Subdivision BAutomatic termination

 

136. Automatic termination—transfer to new payment type

 

137. Automatic termination—recipient complying with section 132 notification obligations

 

138. Automatic termination—recipient not complying with section 132 notification obligations

 

139. Suspension may occur instead of automatic termination in some circumstances

 

140. Suspension may be taken to have occurred

 

Subdivision CAutomatic rate reduction

 

141. Automatic rate reduction—partner starting to receive pension or benefit

 

142. Automatic rate reduction—recipient not complying with section 132 notification obligations

 

143. Automatic rate reduction—failure to inform Department of payment for remunerative work where earnings credit account balance available


TABLE OF PROVISIONScontinued

Section

 

 

Subdivision DDeterminations

 

144. Rate increase determination

 

145. Rate reduction determination

 

146. Cancellation or suspension determination

 

146a. Cancellation or suspension for failure to comply with section 132, 1304 or 1305 notice

 

146b. Changes to payments by computer

 

146c. Resumption of payment after cancellation or suspension

 

Subdivision EDale of effect of determinations

 

146d. Date of effect of favourable determination

 

Notified decision—review sought within 3 months

 

Notified decision—review sought after 3 months

 

Decision not notified

 

Notified change of circumstances

 

Prescribed student child determination

 

Other determinations

 

146e. Date of effect of adverse determination

 

General

 

Contravention of Act

 

False statement or misrepresentation—suspension or cancellation.

 

False statement or misrepresentation—rate reduction

 

Division 10Bereavement payments

 

Subdivision ADeath of pensioner partner

 

146f. Qualification for payments under this Subdivision

 

146g. Continued payment of partners pension or allowance

 

146h. Lump sum payable in some circumstances

 

146j. Adjustment of persons disability support pension rate

 

146k. Effect of death of person entitled to payments under this Subdivision

 

146l. Matters affecting payment of benefits under this Subdivision

 

Subdivision BDeath of dependent child

 

146m. Bereavement payments on death of dependent child

 

146n. Continued payment of child-related amounts

 

146p. Lump sum payable in some circumstances

 

Subdivision CDeath of recipient

 

146q. Death of recipient

 

Division 11Fringe benefits

 

146r. Fringe benefits

 

146s. Qualification for fringe benefits

 

146t. 12 month extension of fringe benefits—person ceasing to be on disability support pension because of employment

 

146u. 12 month extension of fringe benefits—person failing income test because of employment income

11.

Qualification for wife pension

12.

Insertion of new sections:

 

664c. Disability support pension recipients

 

664d. Amount of section 664c payment

13.

Repeal of Parts 2.9 and 2.10

14.

Repeal and substitution of new Part:


TABLE OF PROVISIONScontinued

Section

PART 2.14—SICKNESS ALLOWANCE

 

Division 1Qualification for and payability of sickness allowance

 

Subdivision ABasic qualification

 

666. Qualification for sickness allowance

 

Work

 

Person cannot qualify for sickness allowance in respect of same medical condition within 2 years

 

Person receiving job search allowance or newstart allowance immediately before qualifying for sickness allowance

 

Person not qualified in certain circumstances

 

667. Person undertaking rehabilitation program may qualify for sickness allowance

 

Person not qualified in certain circumstances

 

668. Refusal to attend interview etc. may lead to disqualification

 

669. Time limit on qualification for sickness allowance

 

Secretary may extend maximum allowance period

 

670. Person ceases to be qualified for sickness allowance after one year

 

671. Certain extensions at end of 52nd week

 

672. Where Secretary makes determination, person ceases to be qualified after 2 years

 

673. Special case—person undertaking rehabilitation program

 

674. Temporary absence from Australia

 

675. Loss of income

 

676. Liquid assets test waiting period

 

Subdivision BSituations where allowance not payable (general)

 

677. Sickness allowance not payable in certain circumstances

 

678. Provision of tax file number

 

679. Provision of partners tax file number

 

680. Assets test—allowance not payable if assets value limit exceeded

 

681. Value of assets of members of couples

 

682. Person previously receiving job search allowance (under 18)

 

683. Person previously receiving job search allowance (18 or over)

 

684. Person previously receiving newstart allowance

 

685. Full-time students

 

686. Multiple entitlement exclusion

 

687. Provisional commencement day

 

Claim resulting from a major disaster

 

688. Commencement of sickness allowance

 

Claim within 5 weeks of incapacity and no waiting period applying

 

Claim within 5 weeks of incapacity and ordinary waiting period applying

 

Claim within 5 weeks of incapacity and unused annual leave waiting period applying

 

Claim more than 5 weeks after incapacity and delay due to incapacity

 

Claim more than 5 weeks after incapacity and delay not due to incapacity

 

689. Initial incorrect claim followed by claim for sickness allowance

 

Subdivision CSituations where allowance not payable (wailing periods)

 

690. Unused annual leave waiting period

 

691. Notional leave period

 

692. Duration of unused annual leave waiting period

 

693. Ordinary waiting period

 

694. Duration of ordinary waiting period

 

No unused annual leave waiting period

 

Unused annual leave waiting period


TABLE OF PROVISIONScontinued

Section

 

 

695. Education leavers waiting period

 

Persons subject to waiting period

 

No education leavers waiting period in some cases where already served

 

696. Duration of education leavers waiting period

 

General rule

 

Change of status in first 6 weeks

 

Change of status after 6 weeks

 

Notification required

 

Reduction of waiting period for periods of special benefit and employment

 

Reduction of education leavers waiting period where already partially served

 

6 month ceiling

 

Subdivision DSituations where allowance not payable (recipient non-compliance)

 

697. Rehabilitation programs

 

698. Refusal to attend interview etc.

 

Division 2Claim for sickness allowance

 

699. Need for a claim

 

700. Form of claim

 

701. Lodgment of claim

 

702. Claimant must be Australian resident and in Australia

 

703. Temporary absence from Australia

 

704. Medical certificate to accompany claim

 

705. Secretary may require claimant to give statement of partners tax file number

 

Division 3Determination of claim

 

706. Secretary to determine claim

 

707. Grant of claim

 

708. Date of effect of determination

 

Notified decision—review sought within 3 months

 

Notified decision—review sought after 3 months

 

Decision not notified

 

Division 4Rate of sickness allowance

 

709. How to work out a persons sickness allowance rate

 

710. Limitation on rate—loss of salary, wages or income

 

General rule

 

Loss of salary, wages or income includes NEIS and FAS payments

 

Payment to a substitute

 

711. Limitation on rate—loss of job search or newstart allowance qualification

 

712. Limitation on rate—transferee

 

Partner getting wife or carer pension

 

Other transferee cases

 

713. Sickness allowance recipient may ask Secretary to change appropriate tax year

 

714. Rate of persons receiving sickness allowance with rent assistance since before 1 July 1987


TABLE OF PROVISIONScontinued

Section

Division 5Payment of sickness allowance

 

715. Commencement of sickness allowance

 

716. Instalments

 

717. Instalments for period less than a fortnight

 

718. Rounding off instalment

 

719. Payment to person

 

720. Nominee payments

 

721. Payment into bank account etc.

 

722. Where allowance payday would fall on public holiday etc.

 

723. Payment of allowance after death

 

Division 6Protection of sickness allowance

 

724. Sickness allowance to be absolutely inalienable

 

Payments to Commissioner of Taxation at recipients request

 

725. Effect of garnishee or attachment order

 

Division 7Recipient obligations

 

726. Secretary may require recipient to give statement of partners tax file number

 

727. Secretary may require notice of the happening of an event or a change in circumstances

 

728. Secretary may require recipient to give particular information relevant to payment of sickness allowance

 

728a. Self incrimination

 

Division 8Continuation, variation and termination

 

Subdivision AGeneral

 

728b. Continuing effect of determination

 

Entitlement determination

 

Rate determination

 

Subdivision BAutomatic termination

 

728c. Automatic termination when maximum allowance period ends

 

728d. Automatic termination—transfer to new payment type

 

728e. Automatic termination—recipient complying with section 727 notification obligations

 

728f. Automatic termination—recipient not complying with section 727 notification obligations

 

Subdivision C—Automatic rate reduction

 

728g. Automatic rate reduction—partner starting to receive pension or benefit

 

728h. Automatic rate reduction—recipient not complying with section 727 notification obligations

 

Subdivision DDeterminations

 

728j. Rate increase determination

 

728k. Rate reduction determination

 

728l. Cancellation or suspension determination

 

728m. Cancellation or suspension for failure to comply with section 727, 1304 or 1305 notice

 

728n. Changes to payments by computer

 

728p. Resumption of payment after cancellation or suspension


TABLE OF PROVISIONScontinued

Section

Subdivision EDate of effect of determinations

 

728q. Date of effect of favourable determination

 

Notified decision—review sought within 3 months

 

Notified decision—review sought after 3 months

 

Decision not notified

 

Notified change of circumstances

 

Prescribed student child determination

 

Other determinations

 

728r. Date of effect of adverse determination

 

General

 

Contravention of Act

 

False statement or misrepresentation—suspension or cancellation

 

False statement or misrepresentation—rate reduction

 

Division 9Bereavement payments

 

Subdivision ADeath of dependent child

 

728s. Bereavement payments on death of dependent child

 

728t. Continued payment of child-related amounts

 

728u. Lump sum payable in some circumstances

 

Subdivision BDeath of recipient

 

728v. Death of recipient

15.

Qualification for mobility allowance

16.

Rate of mobility allowance

17.

Effect on mobility allowance when person ceases to be qualified

18.

Rate of age, disability support (over 20), wife and carer pensions (people who are not blind)

19.

Rate of age and disability support (over 20) pensions (blind people)

20.

Insertion of new Parts:

 

PART 3.4aPENSION RATE CALCULATOR D

 

1066a. Rate of disabilitv support pension (people under 21 who are not blind)

 

PART 3.4bPENSION RATE CALCULATOR E

 

1066b. Rate of disability support pension (people under 21 who are blind)

21.

Insertion of new sections:

 

1198a. Adjustment of disability support pension (under 21 and child) MBRs

 

1198b. Adjustment of disability support pension (under 21 and no child) MBRs

 

1198c. Adjustment of youth disability supplement

22.

Application of income and assets test reductions and of compensation reductions for income tax purposes

23.

Schedule 1aSavings and transitional provisions

24.

Consequential amendments

25.

Insertion of Schedule of Impairment Tables

 

PART 4—AMENDMENT OF THE HEALTH INSURANCE ACT 1973

26.

Principal Act

27.

Insertion of new section:

 

4ca. Disadvantaged persons, being children attracting child disability allowance


TABLE OF PROVISIONScontinued

SCHEDULE 1

CONSEQUENTIAL AMENDMENTS

SCHEDULE 2

NEW SCHEDULE 1b TO THE SOCIAL SECURITY ACT 1991


Social Security (Disability and Sickness Support) Amendment Act 1991

No. 141 of 1991

An Act to amend the Social Security Act 1991 in relation to disability and sickness support, and for related purposes

[Assented to 9 October 1991]

The Parliament of Australia enacts:

PART 1—INTRODUCTORY

Short title etc.

1. (1) This Act may be cited as the Social Security (Disability and Sickness Support) Amendment Act 1991.

(2) In this Act, Principal Act means the Social Security Act 19911.

Commencement

2. (1) Part 1 commences on the day on which this Act receives the Royal Assent.

(2) The remaining provisions of this Act commence on 12 November 1991.

PART 2—AMENDMENTS RELATING TO INVALID PENSION

General definitions

3. Section 23 of the Principal Act is amended:

(a) by inserting in subsection (1) the following definitions:

physical impairment includes sensory impairment;

program of assistance means:

(a)     a program approved under section 28a; or

(b)     a program offered as part of the competitive employment training and placement services as defined by section 7 of the Disability Services Act 1986;;

(b) by inserting after subsection (4a) the following subsection:

(4b) For the purposes of this Act, a person is severely disabled if:

(a) a physical impairment, a psychiatric impairment, an intellectual impairment, or 2 or all of such impairments, of the person make the person, without taking into account any other factor, totally unable:

(i) to work for at least the next 2 years; and

(ii) unable to benefit within the next 2 years from participation in a program of assistance or a rehabilitation program; or

(b) the person is permanently blind..

4. After section 28 of the Principal Act the following section is inserted:

Approval of programs of assistance

28a. The Secretary of the Department of Employment, Education and Training may, by writing, approve:

(a)     a course of vocational training; or

(b)     a labour market program; or

(c)     another course or program;

(other than a rehabilitation program) as a program of assistance for the purposes of this Act..

5. After section 791 of the Principal Act, the following section is inserted in Division 2 of Part 2.16 of Chapter 2:

Claimant must be under pension age

791a. A claim by a person for special needs disability support pension is not a proper claim unless the person is under the pension age on the day on which the claim is lodged.

Note: the pension age is 65 for a man and 60 for a woman..


Grant of pension or allowance when person is outside Australia

6. (1) Section 1212 of the Principal Act is amended:

(a) by omitting subparagraph (3) (c) (ii) and substituting the following subparagraph:

(ii) if the person is severely disabled—a disability support pension; or;

(b) by inserting after subsection (3) the following subsection:

(4) If a person who has been granted a disability support pension under subsection (3) ceases to be severely disabled, the person ceases to be qualified for that pension.;

(c) by adding at the end the following Notes:

Note 4: for severely disabled see subsection 23 (4b).

Note 5: subparagraph (3) (c) (ii) and subsection (4) do not affect disability support pensions granted to a person before 12 November 1991—see subsection 9 (2) of the Social Security (Disability and Sickness Support) Amendment Act 1991..

(2) If, on 11 November 1991 a person was receiving an invalid pension granted:

(a)     while the person was outside Australia; and

(b)    on another pension or allowance being cancelled or ceasing to be payable;

section 1212 of the Principal Act as in force before the amendments made by subsection (1) continues to apply in relation to that person.

Some pensions generally portable without time limit

7.     Section 1213 of the Principal Act is amended by omitting paragraph (1) (b).

8.     After section 1213 of the Principal Act, the following section is inserted:

Portability of invalid pension

General

1213a. (1) Subject to subsections (2) and (3), a persons right to continue to be paid invalid pension is not affected by the persons leaving Australia.

Pensions granted on or after 12 November 1991 to persons not severely disabled

(2) If:

(a)     a person is receiving a disability support pension granted on or after 12 November 1991; and

(b)     the person leaves Australia on or after that day; and


(c)     the Secretary decides that the person is not severely disabled when leaving; and

(d)     the person continues to be absent from Australia for a period of 12 months;

the person ceases to be qualified for disability support pension on the day after the 12 month period ends.

Pensions granted on or after 12 November 1991 to persons severely disabled

(3) If:

(a)     a person is receiving a disability support pension granted on or after 12 November 1991; and

(b)     the person leaves Australia on or after that day; and

(c)     the person is severely disabled when leaving; and

(d)     the Secretary decides that the person has ceased to be severely disabled; and

(e)     the person continues to be absent from Australia for a period of 12 months after the decision;

the person ceases to be qualified for disability support pension on the day after the 12 month period ends.

Departure certificates and short residence

(4) Subsection (1) has effect subject to:

(a)     sections 1218 and 1219 (departure certificates); and

(b)     section 1220 (claim based on short residence).

Note: for severely disabled see subsection 23 (4b)..

PART 3—AMENDMENTS RELATING TO DISABILITY SUPPORT PENSION AND SICKNESS ALLOWANCE

General definitions

9. Section 23 of the Principal Act is amended:

(a) by inserting in subsection (1) the following definition:

Impairment Tables means the Tables in Schedule 1b;;

(b) by inserting after subsection (4b) the following subsections:

(4c) For the purposes of this Act, a person is in disability accommodation if:

(a) the person:

(i) is in accommodation for people with disabilities; or

(ii) is:

(a) in accommodation that is not the principal


home of the parents or a parent of the person; and

(b) receiving accommodation support services for people with disabilities; and

(b) the accommodation, or services, for people with disabilities are funded wholly or partly by the Commonwealth, a State or a Territory.

(4d) For the purposes of this Act, a person is living away from the persons parental home if the person is living away from:

(a)     where the persons parents have the same principal home—that home; or

(b)     where the person has only one parent—the principal home of that parent; or

(c)     where the persons parents have different principal homes—all of those homes..

10. Part 2.3 of the Principal Act is repealed and the following Part is substituted:

PART 2.3—DISABILITY SUPPORT PENSION

Division 1Qualification for and payability of disability support pension

Subdivision AQualification

Qualification for disability support pension—continuing inability to work

94. (1) A person is qualified for disability support pension if:

(a)     the person has a physical, intellectual or psychiatric impairment; and

(b)     the persons impairment is of 20% or more under the Impairment Tables; and

(c)     the person has a continuing inability to work; and

(d)     the person has turned 16; and

(e)     the person either:

(i) is an Australian resident at the time when the person first satisfies paragraphs (a), (b) and (c); or

(ii) has 10 years qualifying Australian residence; or

(iii) is born outside Australia and, at the time when the person first satisfies paragraphs (a), (b) and (c) the person:

(a) is not an Australian resident; and

(b) is a dependent child of an Australian resident;


and the person becomes an Australian resident while a dependent child of an Australian resident.

Note 1: for Australian resident and qualifying Australian residence see section 7.

Note 2: for Impairment Tables see section 7a.

Meaning of continuing inability

(2) A person has a continuing inability to work if the Secretary is satisfied that:

(a) the persons impairment is of itself sufficient to prevent the person from doing:

(i) the persons usual work; and

(ii) work for which the person is currently skilled;

for at least 2 years; and

(b) either:

(i) the persons impairment is of itself sufficient to prevent the person from undertaking educational or vocational training during the next 2 years; or

(ii) the persons impairment does not prevent the person from undertaking educational or vocational training but such training is not likely to equip the person, within the next 2 years, to do work for which the person is currently unskilled.

Note: for work see subsection (5).

(3) In deciding whether or not a person has a continuing inability to work under subsection (2), the Secretary is not to have regard to:

(a)     the availability to the person of work in the persons locally accessible labour market (unless subsection (4) applies to the person); or

(b)     the availability to the person of educational or vocational training.

(4) For the purposes of subparagraph (2) (b) (ii), if a person has turned 55, the Secretary may, in considering whether educational or vocational training is likely to equip the person to do work, have regard to the likely availability to the person of work in the persons locally accessible labour market.

(5) In this section:

educational or vocational training does not include a program designed specifically for people with physical, intellectual or psychiatric impairments;

work means work:

(a) that is for at least 30 hours per week at award wages or above; and


(b) that exists in Australia, even if not within the persons locally accessible labour market.

Person not qualified in certain circumstances

(6) A person is not qualified for a disability support pension on the basis of a continuing inability to work if the person brought about the inability with a view to obtaining a disability support pension or a sickness allowance.

Qualification for disability support pension—permanent blindness

95. (1) A person is qualified for a disability support pension if:

(a)     the person is permanently blind; and

(b)    the person has turned 16; and

(c)     the person either:

(i) is an Australian resident at the time when the person first satisfies paragraph (a); or

(ii) has 10 years qualifying Australian residence; or (iii) is born outside Australia and, at the time when the person first satisfies paragraph (a), the person:

(a) is not an Australian resident; and

(b) is a dependent child of an Australian resident;

and the person becomes an Australian resident while a dependent child of an Australian resident.

Note: for Australian resident and qualifying Australian residence see section 7.

Person not qualified in certain circumstances

(2) A person is not qualified for a disability support pension on the basis of blindness if the person brought about the blindness with a view to obtaining a disability support pension or a sickness allowance.

Refusal to attend interview etc. may lead to disqualification

96. (1) A person is not qualified for a disability support pension if:

(a)     the person has lodged a claim for disability support pension, but the claim has not yet been determined; and

(b)    the Secretary is of the opinion that the person should:

(i) contact a specified officer of the Department; or

(ii) attend an interview at a specified location; or

(iii) complete a questionnaire; or

(iv) attend a medical, psychiatric or psychological examination; and

(c) the Secretary notifies the person that the person is required to:

(i) contact that officer; or


(ii) attend that interview; or

(iii) complete that questionnaire; or

(iv) attend that examination; or

(v) if the person has undergone an examination—provide to the Secretary the medical practitioners report on that examination in the approved form; and

(d)     the Secretary is satisfied that it is reasonable for this section to apply to the person; and

(e)     the person does not take reasonable steps to comply with the Secretarys requirements within the time specified in the notice.

(2) A notice under paragraph (1) (c) must be in writing and must inform the person of the effect of this section.

Departure certificate requirements apply

97. Sections 94 and 95 have effect subject to sections 1218 and 1219 (departure certificate requirements for people leaving Australia).

Subdivision BPayability

Disability support pension not payable in some circumstances

98. (1) Even though a person is qualified for disability support pension, the pension may not be payable to the person because:

(a)     the pension has not commenced to be payable (see sections 99 and 118); or

(b)     the person has not taken reasonable steps to claim or obtain compensation (see section 1164); or

(c)     the person or the persons partner is subject to a compensation preclusion period (see Division 3 of Part 3.14); or

(d)     the person has not provided a tax file number for the person (see section 101) or the persons partner (see section 102); or

(e)     the person is in gaol (see Part 3.13); or

(f)      the person is receiving another pension or benefit (see section 103); or

(g)     the person fails to comply with a requirement that the person:

(i) contact an officer; or

(ii) attend an interview; or

(iii) complete a questionnaire; or

(iv) attend a medical, psychiatric or psychological examination;

as required by section 105; or

(h) the person has not nominated a bank, credit union or building society account for payment of the pension (see section 125).


(2) A disability support pension is not payable to a person if the persons disability support pension rate would be nil.

Disability support pension generally not payable before claim or end of waiting period

99. Disability support pension is not payable to a person who is qualified for the pension before:

(a)     the persons provisional commencement day (identified under section 100), unless paragraph (b) applies to the person; or

(b)     if the person is subject to a DSP non-compliance waiting period—the first day after the end of that waiting period.

Note: a person may be subject to a DSP non-compliance waiting period under section 105.

Provisional commencement day

General rule

100. (1) Subject to subsections (2), (3) and (4), a persons provisional commencement day is the day on which the person claims the disability support pension.

Initial incorrect claim followed by a claim for disability support pension

(2) If:

(a) a person makes a claim (in this subsection called the initial claim) for:

(i) a social security or service pension or a social security benefit; or

(ii) a pension, allowance, benefit or other payment under another Act, or under a program administered by the Commonwealth, that is similar in character to a disability support pension; and

(b)     on the day on which the person makes the initial claim, the person is qualified for a disability support pension; and

(c)     the person subsequently makes a claim for a disability support pension; and

(d)     the Secretary is satisfied that it is reasonable for this subsection to apply to the person;

the persons provisional commencement day is the day on which the person made the initial claim.

Early claim

(3) If:

(a)     a person lodges a claim for a disability support pension; and

(b)     the person is not, on the day on which the claim is lodged, qualified for a disability support pension; and

(c)     the person becomes qualified for a disability support pension


sometime during the period of 3 months that starts immediately after the day on which the claim is lodged;

the persons provisional commencement day is the first day on which the person is qualified for the pension and is an Australian resident and in Australia.

Claim resulting from a major disaster

(4) If a person:

(a)     claims a disaster relief payment; and

(b)     is qualified for the payment; and

(c)     as a result of the major disaster to which the payment relates, claims disability support pension within 14 days of claiming the disaster relief payment;

the persons provisional commencement day is the day on which he or she was affected by the disaster.

Provision of persons tax file number

101. (1) A disability support pension is not payable to a person if:

(a)     the person is required under section 111 or 130 to give the Secretary a written statement of the persons tax file number; and

(b)     at the end of the period of 28 days after the requirement is made, the person has neither:

(i) given the Secretary a written statement of the persons tax file number; nor

(ii) given the Secretary a declaration by the person in a form approved by the Secretary and satisfied either subsection (2) or (3).

(2) The person satisfies this subsection if:

(a) the persons declaration states that the person:

(i) has a tax file number but does not know what it is; and

(ii) has asked the Commissioner of Taxation to inform the person of the persons tax file number; and

(b) the person has given the Secretary a document by the person that authorises the Commissioner of Taxation to tell the Secretary:

(i) whether the person has a tax file number; and

(ii) if the person has a tax file number—the tax file number; and

(c) the Commissioner of Taxation has not told the Secretary that the person has no tax file number.

(3) The person satisfies this subsection if:


(a)     the persons declaration states that an application by the person for a tax file number is pending; and

(b)     the person has given the Secretary a document by the person that authorises the Commissioner of Taxation to tell the Secretary:

(i) if a tax file number is issued to the person—the tax file number; or

(ii) if the application is refused—that the application has been refused; or

(iii) if the application is withdrawn—that the application has been withdrawn; and

(c)     the Commissioner of Taxation has not told the Secretary that an application by the person for a tax file number has been refused; and

(d)     the application for a tax file number has not been withdrawn.

Provision of partners tax file number

102. (1) Subject to subsection (4), a disability support pension is not payable to a person if:

(a)     the person is a member of a couple; and

(b)     the person is required under section 112 or 131 to give the Secretary a written statement of the tax file number of the persons partner; and

(c)     at the end of the period of 28 days after the requirement is made the person has neither:

(i) given the Secretary a written statement of the partners tax file number; nor

(ii) given the Secretary a declaration by the partner in a form approved by the Secretary and satisfied either subsection (2) or (3).

(2) The person satisfies this subsection if:

(a) the partners declaration states that the partner:

(i) has a tax file number but does not know what it is; and (ii) has asked the Commissioner of Taxation to inform the partner of the partners tax file number; and

(b) the person has given the Secretary a document by the partner that authorises the Commissioner of Taxation to tell the Secretary:

(i) whether the partner has a tax file number; and

(ii) if the partner has a tax file number—the tax file number; and

(c) the Commissioner of Taxation has not told the Secretary that the partner has no tax file number.


(3) The person satisfies this subsection if:

(a)     the partners declaration states that an application by the partner for a tax file number is pending; and

(b)     the person has given the Secretary a document by the partner that authorises the Commissioner of Taxation to tell the Secretary:

(i) if a tax file number is issued to the partner—the tax file number; or

(ii) if the application is refused—that the application has been refused; or

(iii) if the application is withdrawn—that the application has been withdrawn; and

(c)     the Commissioner of Taxation has not told the Secretary that an application by the partner for a tax file number has been refused; and

(d)     the application for a tax file number has not been withdrawn.

(4) The Secretary may waive the requirement for a statement of the partners tax file number if the Secretary is satisfied that:

(a)     the person does not know the partners tax file number; and

(b)     the person can obtain none of the following from the partner:

(i) the partners tax file number;

(ii) a statement of the partners tax file number;

(iii) a declaration by the partner under subparagraph (1) (c) (ii).

Multiple entitlement exclusion

103. (1) A disability support pension is not payable to a person if the person is already receiving a service pension.

(2) If:

(a)     a person is receiving a disability support pension; and

(b)     another social security pension or a social security benefit or service pension becomes payable to the person;

the disability support pension is not payable to the person.

Note 1: another payment type will generally not become payable to the person until the person claims it.

Note 2: social security benefit includes job search and newstart allowances.

Note 3: for the day on which the disability support pension ceases to be payable see section 136.

Rehabilitation and assistance programs

104. The Secretary may request a person who is receiving disability support pension to undertake a program of assistance or a rehabilitation program.


Refusal to attend interview etc.

105. (1) A disability support pension is not payable to a person if:

(a)     the person is receiving a disability support pension; and

(b)     the Secretary is of the opinion that the person should:

(i) contact a specified officer of the Department; or

(ii) attend an interview at a specified place; or

(iii) complete a questionnaire; or

(iv) attend a medical, psychiatric or psychological examination; and

(c) the Secretary notifies the person that the person is required to:

(i) contact that officer; or

(ii) attend that interview; or

(iii) complete that questionnaire; or

(iv) attend that examination; or

(v) if the person has undergone an examination—provide to the Secretary a report on that examination in the approved form; and

(d)     the Secretary is satisfied that it is reasonable for this section to apply to the person; and

(e)     the person does not take reasonable steps to comply with the Secretarys requirements within the time specified in the notice.

Note: the persons pension will be cancelled or suspended by a determination of the Secretary under section 146.

(2) A notice under paragraph (1) (c) must be in writing and must inform the person of the effect of this section.

Division 2Claim for disability support pension

Need for a claim

106. (1) A person who wants to be granted a disability support pension must make a proper claim for that pension.

Note: for proper claim—see section 107 (form), section 108 (manner of lodgment) and section 110 (residence/presence in Australia).

(2) For the purposes of subsection (1), where:

(a)     a claim for disability support pension is made by or on behalf of a person; and

(b)    at the time the claim is made, the claim cannot be granted because the person is not qualified for that pension;

the claim is, subject to subsection 100 (3), to be taken not to have been made.


Form of claim

107. To be a proper claim, a claim must be made in writing and must be in accordance with a form approved by the Secretary.

Lodgment of claim

108. (1) To be a proper claim, a claim must be lodged:

(a)     at an office of the Department; or

(b)     at a place approved for the purpose by the Secretary; or

(c)     with a person approved for the purpose by the Secretary.

(2) Subject to subsection (3), a place or person approved under subsection (1) must be a place or person in Australia.

(3) The Secretary may approve a place or person outside Australia under subsection (1) for the purpose of lodgment of claims made under an international agreement.

Note: for international agreements see Part 4.1.

Claimant must be under pension age

109. A claim by a person is not a proper claim unless the person is under the pension age on the day on which the claim is lodged.

Note: the pension age is 65 for a man and 60 for a woman.

Claimant must be Australian resident and in Australia

110. A claim by a person is not a proper claim unless the person is:

(a)     an Australian resident; and

(b)     in Australia;

on the day on which the claim is lodged.

Note 1: for Australian resident see subsections 7 (2) and (3).

Note 2: the provisions of a scheduled international agreement may permit a proper claim to be made by a person who is not an Australian resident or not in Australia: see section 1208.

Secretary may require claimant to give statement of claimants tax file number

111. If a claimant for a disability support pension is in Australia, the Secretary may require the claimant to give the Secretary a written statement of the claimants tax file number.

Note 1: for the consequences of a failure to comply with the requirement see section 101.

Note 2: in some cases the requirement can be satisfied by giving the Secretary a declaration by the claimant about the claimants tax file number and an authority by the claimant to the Commissioner of Taxation to give the Secretary certain information about the claimants tax file number: see subsections 101 (2) and (3).


Secretary may require claimant to give statement of partners tax file number

112. If:

(a)     a claimant for a disability support pension is a member of a couple; and

(b)     the claimants partner is in Australia;

the Secretary may require the claimant to give the Secretary a written statement of the tax file number of the claimants partner.

Note 1: for the consequences of a failure to comply with the requirement see section 102.

Note 2: in some cases the requirement can be satisfied by giving the Secretary a declaration by the partner about the partners tax file number and an authority by the partner to the Commissioner of Taxation to give the Secretary certain information about the partners tax file number: see subsections 102 (2) and (3).

Note 3: the Secretary can waive the requirement in some cases: see subsection 102 (4).

Division 3Determination of claim

Secretary to determine claim

113. The Secretary must, in accordance with this Act, determine the claim.

Grant of claim

114. The Secretary is to determine that the claim is to be granted if the Secretary is satisfied that:

(a)     the person is qualified for a disability support pension; and

(b)     the pension is payable.

Date of effect of determination

115. (1) Subject to subsections (2), (3) and (4), a determination under section 114 takes effect on the day on which the determination is made or on such later day or earlier day as is specified in the determination.

Notified decisionreview sought within 3 months

(2) If:

(a)     a decision (in this subsection called the previous decision) is made rejecting a persons claim for disability support pension; and

(b)     a notice is given to the person advising the person of the making of the previous decision; and

(c)     the person applies to the Secretary under section 1240, within 3 months after the notice is given, for review of the previous decision; and

(d)     a determination granting the claim is made as a result of the application for review;


the determination takes effect on the day on which the previous decision took effect.

Notified decisionreview sought after 3 months

(3) If:

(a)     a decision (in this subsection called the previous decision) is made rejecting a persons claim for disability support pension; and

(b)     a notice is given to the person advising the person of the making of the previous decision; and

(c)     the person applies to the Secretary under section 1240, more than 3 months after the notice is given, for review of the previous decision; and

(d)     a determination granting the claim is made as a result of the application for review;

the determination takes effect on the day on which the person sought the review.

Decision not notified

(4) If:

(a)     a decision (in this subsection called the previous decision) is made rejecting a persons claim for disability support pension; and

(b)     no notice is given to the person advising the person of the making of the previous decision; and

(c)     the person applies to the Secretary under section 1240, for review of the previous decision; and

(d)     a determination granting the claim is made as a result of the application for review;

the determination takes effect on the day on which the previous decision took effect.

Division 4Medical examination following claim

Examination by medical practitioner

116. (1) The Secretary must direct that a claimant for disability support pension be examined by a medical practitioner or practitioners unless:

(a) it is manifest that:

(i) the claimant has a physical, intellectual or psychiatric impairment of 20% or more under the Impairment Tables; and

(ii) the claimant has a continuing inability to work; or

(b) it is manifest that the claimant is permanently blind; or


(c)     the claimants rate of disability support pension, if granted, would be nil; or

(d)     the claimant does not satisfy the requirements of paragraph 94 (1) (d) or section 109 (age requirements) or paragraph 94 (1) (f) or section 110 (residence requirements).

Note: for continuing inability to work see section 94.

(2) If the claimant resides in a place that is remote from any medical practitioner, the Secretary may direct that:

(a)     subsection (1) does not apply to the claimant; and

(b)    the claimant is to submit to the Department a written report by a medical practitioner that relates to the impairment in respect of which the claimant is claiming disability support pension.

(3) The medical practitioner who has examined the claimant because of a direction under subsection (1) is to give a certificate stating the practitioners opinion as to:

(a) whether the claimant:

(i) has a physical, intellectual or psychiatric impairment; or (ii) is permanently blind;

(as the case requires); and

(b) if the claimant does have a physical, intellectual or psychiatric impairment—the effect of the impairment on the claimants ability to work.

(4) The medical practitioner must, if required to do so by the Secretary, include in the certificate the practitioners opinion as to the percentage of the persons impairment (if any) under the Impairment Tables.

(5) A certificate under this section must be in accordance with a form approved by the Secretary.

Division 5Rate of disability support pension

How to work out a persons disability support pension rate

117. A persons disability support pension rate is worked out:

(a)     if the person is not permanently blind and paragraph (b) does not apply to the person—using Pension Rate Calculator A at the end of section 1064 (see Part 3.2); or

(b)     if the person is not permanently blind and has not turned 21—using Pension Rate Calculator D at the end of section 1066a (see Part 3.4a); or

(c)     if the person is permanently blind and paragraph (d) does not apply to the person—using Pension Rate Calculator B at the end of section 1065 (see Part 3.3); or


(d) if the person is permanently blind and has not turned 21—using Pension Rate Calculator E at the end of section 1066b (see Part 3.4b).

Division 6Payment of disability support pension

Commencement of disability support pension

118. A disability support pension becomes payable to a person on the first day on which:

(a)     the person is qualified for the pension; and

(b)     no provision of this Act makes the pension not payable to the person.

Note 1: for qualification see sections 94 and 95.

Note 2: for the circumstances in which a disability support pension is not payable see section 98.

Payment by instalments

119. (1) A full instalment of disability support pension is payable to a person on each pension payday on which:

(a)     the person is qualified for the pension; and

(b)     the pension is payable to the person.

(2) If a person who is qualified for disability support pension is outside Australia, the instalments referred to in subsection (1) are to be paid to the person on such pension paydays as the Secretary determines for the purposes of this subsection.

Effect on instalments of backdating claim

120. If:

(a)     a person lodges a claim for disability support pension on a particular day (in this section called the claim day); and

(b)     the persons provisional commencement day is before the claim day;

any instalment of disability support pension that would, but for this section, be payable, is payable to the person:

(c)     if the claim day was a pension payday—on that day; or

(d)     the first pension payday after the claim day.

Note: for provisional commencement day see section 100.

Calculation of amount of instalment

121. (1) The amount of an instalment of disability support pension is the amount worked out by dividing the amount of the annual rate of the pension by 26.

(2) If an amount that is payable to a person on a pension payday is not a multiple of 10 cents, the amount is, subject to subsection (3), to be increased or decreased to the nearest multiple of 10 cents.


(3) If the amount that is payable to a person on a pension payday is a multiple of 5 cents, the amount is to be increased by 5 cents.

(4) If, apart from this subsection, the amount of an instalment of disability support pension would be less than $1.00, the amount of the instalment is to be increased to $1.00.

Inmates of benevolent homes

122. (1) While a person who is receiving disability support pension is an inmate of a benevolent home:

(a)     so much of the persons pension as does not exceed the pensioner contribution is to be paid to the person who controls the benevolent home for the maintenance of the person in the benevolent home; and

(b)     the balance (if any) is to be paid to the person receiving the pension.

(2) For the purposes of this section, the pensioner contribution is, subject to subsection (3), 364 times the amount in force from time to time for the purposes of subparagraph 47 (2) (b) (iii) of the National Health Act 1953.

(3) If the amount worked out under subsection (2) is not a multiple of $2.60, the pensioner contribution is the next lower amount that is a multiple of $2.60.

Payment to person

123. A persons disability support pension is, subject to section 124, to be paid to that person.

Nominee payments

124. (1) The Secretary may direct that the whole, or a part, of the amount of a persons disability support pension is to be paid to someone else on behalf of the person.

(2) If the Secretary makes a direction under subsection (1), the disability support pension is to be paid in accordance with the direction.

Payment into bank account etc.

125. (1) Subject to subsection (6), disability support pension payable to a person is to be paid, at the intervals that the Secretary specifies, to the credit of a bank account, credit union account or building society account.

(2) The account must be an account nominated and maintained by the person to whom the disability support pension is payable.


(3) The account may be an account that is maintained by a person to whom the disability support pension is payable either alone or jointly or in common with another person.

(4) Where a person to whom disability support pension is payable has not nominated an account for the purposes of subsection (1), then, subject to subsection (6), that pension is not to be paid.

(5) Where:

(a) a person is not being paid disability support pension because of subsection (4); and

(b) the person nominates an account for the purposes of subsection (1);

the pension (including any amounts that would have been paid but for subsection (4)) is to be paid under subsection (1).

(6) The Secretary may direct that the whole or a part of an amount of disability support pension that is payable to a person may be paid to the person in a different way from that provided for by subsection (1).

(7) If the Secretary gives a direction under subsection (6), the disability support pension is to be payable in accordance with the direction.

Where pension payday would fall on public holiday etc.

126. If the Secretary is satisfied that an amount of disability support pension that would normally be paid on a particular day cannot reasonably be paid on that day (because, for example, it is a public holiday or a bank holiday), the Secretary may direct that the amount be paid on an earlier day.

Payment of pension after death

127. (1) If:

(a)     a disability support pension is payable to a person; and

(b)     the person dies; and

(c)     at the date of the persons death the person had not received an amount of disability support pension payable to him or her; and

(d)     another person applies to receive that amount; and

(e)     the application is made:

(i) within 6 months after the death; or

(ii) within a further period allowed by the Secretary in special circumstances;

the Secretary may pay the amount to the person who, in the Secretarys opinion, is best entitled to it.


(2) If the Secretary pays an amount of disability support pension under subsection (1), the Commonwealth has no further liability to any person in respect of that amount of disability support pension.

Division 7Protection of disability support pension

Disability support pension to be absolutely inalienable

128. (1) Subject to subsection (2) and section 1359, disability support pension is absolutely inalienable, whether by way of, or in consequence of, sale, assignment, charge, execution, bankruptcy or otherwise.

Payments to Commissioner of Taxation at recipients request

(2) The Secretary may make deductions from the instalments of disability support pension payable to a person where the recipient asks the Secretary:

(a)     to make the deductions; and

(b)    to pay the amounts to be deducted to the Commissioner of Taxation.

Note: the Secretary must make deductions from a persons pension, benefit or allowance if requested by the Commissioner of Taxation—see section 1359.

Effect of garnishee or attachment order

129. (1) If:

(a)     a person has an account with a financial institution; and

(b)     instalments of disability support pension payable to the person (whether on the persons own behalf or not) are being paid to the credit of that account; and

(c)     a court order in the nature of a garnishee order comes into force in respect of the account;

the court order does not apply to the saved amount (if any) in the account.

(2) The saved amount is worked out as follows:

Method statement

Step 1.

Work out the total amount of disability support pension payable to the person that has been paid to the credit of the account during the 4 week period immediately before the court order came into force.

Step 2.

Subtract from that amount the total amount withdrawn from the account during the same 4 week period: the result is the saved amount.


(3) This section applies to an account whether it is maintained by a person:

(a)    alone; or

(b)    jointly with another person; or

(c)    in common with another person.

Division 8Recipient obligations

Secretary may require recipient to give statement of recipients tax file number

130. If a recipient of a disability support pension is in Australia, the Secretary may require the recipient to give the Secretary a written statement of the recipients tax file number.

Note 1: for the consequences of a failure to comply with the requirement see section 101.

Note 2: in some cases the requirement can be satisfied by giving the Secretary a declaration by the recipient about the recipients tax file number and an authority by the recipient to the Commissioner of Taxation to give the Secretary certain information about the recipients tax file number: see subsections 101 (2) and (3).

Secretary may require recipient to give statement of partners tax file number

131. If:

(a)     a disability support pension recipient is a member of a couple; and

(b)     the recipients partner is in Australia;

the Secretary may require the recipient to give the Secretary a written statement of the tax file number of the recipients partner.

Note 1: for the consequences of a failure to comply with the requirement see section 102.

Note 2: in some cases the requirement can be satisfied, by giving the Secretary a declaration by the partner about the partners tax file number and an authority by the partner to the Commissioner of Taxation to give the Secretary certain information about the partners tax file number: see subsections 102 (2) and (3).

Note 3: the Secretary can waive the requirement in some cases: see subsection 102 (4).

Secretary may require notice of the happening of an event or a change in circumstances

132. (1) The Secretary may give a person to whom disability support pension is being paid a notice that requires the person to inform the Department if:

(a)     a specified event or change of circumstances occurs; or

(b)     the person becomes aware that a specified event or change of circumstances is likely to occur.

(2) An event or change of circumstances is not to be specified in a notice under subsection (1) unless the occurrence of the event or change of circumstances might affect the payment of the pension.


(3) A notice under subsection (1):

(a)     must be in writing; and

(b)     may be given personally or by post; and

(c)     must specify how the person is to give the information to the Department; and

(d)     must specify the period within which the person is to give the information to the Department; and

(e)     must specify that the notice is given under this section.

(4) The period specified under paragraph (3) (d) must end at least 14 days after:

(a)     the day on which the event or change of circumstances occurs; or

(b)     the day on which the person becomes aware that the event or change of circumstances is likely to occur.

(5) A person must not refuse or fail to comply with a notice under subsection (1) to the extent that the person is capable of complying with the notice.

Penalty: $1,000 or imprisonment for 6 months, or both.

(6) A person must not, in purporting to comply with a notice under subsection (1), knowingly or recklessly give information that is false or misleading in a material particular.

Penalty: $1,000 or imprisonment for 6 months, or both.

(7) This section extends to:

(a)     acts, omissions, matters and things outside Australia whether or not in a foreign country; and

(b)     all persons irrespective of their nationality or citizenship.

Secretary may require recipient to give particular information relevant to payment of disability support pension

133. (1) The Secretary may give a person to whom disability support pension is being paid a notice that requires the person to give the Department a statement about a matter that might affect the payment of the pension to the person.

(2) A notice under subsection (1):

(a)     must be in writing; and

(b)     may be given personally or by post; and

(c)     must specify how the statement is to be given to the Department; and

(d)     must specify the period within which the person is to give the statement to the Department; and

(e)     must specify that the notice is given under this section.


(3) The period specified under paragraph (2) (d) must end at least 14 days after the day on which the notice is given.

(4) A statement given in response to a notice under subsection (1) must be in writing and in accordance with a form approved by the Secretary.

(5) A person must not refuse or fail to comply with a notice under subsection (1) to the extent that the person is capable of complying with the notice.

Penalty: $1,000 or imprisonment for 6 months, or both.

(6) A person must not, in purporting to comply with a notice under subsection (1), knowingly or recklessly give information that is false or misleading in a material particular.

Penalty: $1,000 or imprisonment for 6 months, or both.

(7) This section extends to:

(a)     acts, omissions, matters and things outside Australia whether or not in a foreign country; and

(b)     all persons irrespective of their nationality or citizenship.

Self incrimination

134. (1) A person is not excused from giving information pursuant to a notice under section 132 or 133 on the ground that the information may tend to incriminate the person.

(2) Information given by a person pursuant to a notice under section 132 or 133 is not admissible in evidence against the person in a criminal proceeding other than a proceeding under, or arising out of, subsection 132 (5) or (6) or 133 (5) or (6).

Division 9Continuation, variation and termination

Subdivision AGeneral

Continuing effect of determination

Entitlement determination

135. (1) A determination that:

(a)     a persons claim for disability support pension is granted; or

(b)     disability support pension is payable to a person;

continues in effect until:

(c)     the pension ceases to be payable under section 136, 137 or 138; or

(d)     the determination is revoked under subsection 139 (3); or

(e)     a further determination in relation to the pension under section 146 or 146a has taken effect.


Note 1: for paragraph (a) see section 114.

Note 2: for paragraph (b) see section 146c—this paragraph is relevant where the determination in question reverses an earlier cancellation or suspension.

Rate determination

(2) A determination of the rate of disability support pension continues in effect until:

(a)     the pension becomes payable at a lower rate under section 141, 142 or 143; or

(b)     a further determination in relation to the pension under section 144 or 145 has taken effect.

Subdivision BAutomatic termination

Automatic termination—transfer to new payment type

136. If:

(a)     a person is receiving a disability support pension; and

(b)     another social security pension or a social security benefit or service pension becomes payable to the person;

the disability support pension ceases to be payable to the person immediately before the day on which the other pension or benefit becomes payable to the person.

Automatic termination—recipient complying with section 132 notification obligations

137. If:

(a)     a person who is receiving disability support pension is given a notice under section 132; and

(b)     the notice requires the person to inform the Department of the occurrence of an event or change in circumstances within a specified period (in this section called the notification period); and

(c)     the event or change in circumstances occurs; and

(d)     the person informs the Department of the occurrence of the event or change in circumstances within the notification period in accordance with the notice; and

(e)     because of the occurrence of the event or change in circumstances:

(i) the person ceases to be qualified for the pension; or

(ii) the pension would, but for this section, cease to be payable to the person; and

(f) the pension is not cancelled before the end of the notification period;


the pension continues to be payable to the person until the end of the notification period and then ceases to be payable to the person.

Note: if the person informs the Department, within the notification period, of an event or change in circumstances that reduces the rate of the persons pension, there is no automatic rate reduction and a determination under section 145 must be made in order to bring the rate reduction into effect.

Automatic termination—recipient not complying with section 132 notification obligations

138. If:

(a)     a person who is receiving disability support pension is given a notice under section 132; and

(b)     the notice requires the person to inform the Department of the occurrence of an event or change in circumstances within a specified period (in this section called the notification period); and

(c)     the event or change in circumstances occurs; and

(d)     the person does not inform the Department of the occurrence of the event or change in circumstances within the notification period in accordance with the notice; and

(e)     because of the occurrence of the event or the change in circumstances:

(i) the person ceases to be qualified for the pension; or

(ii) the pension ceases to be payable to the person;

the pension ceases to be payable to the person immediately after the day on which the event or change in circumstances occurs.

Suspension may occur instead of automatic termination in some circumstances

139. (1) If:

(a)     a person ceases to be qualified for disability support pension because the person obtains paid work that is for at least 30 hours per week; and

(b)     the person has notified the Secretary that the person has obtained that work within the notification period referred to in paragraph 137 (b);

the Secretary may determine:

(c)     that section 137 does not apply to the persons pension; and

(d)     that the persons pension is to be suspended.

Note: the determination to suspend is made under section 146.

(2) Subsection (1) does not apply to a person if:

(a) the Secretary gives notice to the person that the person is no longer qualified for disability support pension; and


(b) the Secretarys notice is given before the person notifies the Secretary that the person has obtained work.

(3) If:

(a)     a persons disability support pension is suspended because of subsection (1); and

(b)    the determination suspending the disability support pension continues in effect throughout the period of 2 years from the date of effect of the determination;

then, at the end of that 2 year period, the determination granting the person disability support pension is automatically revoked.

(4) If:

(a)     the Secretary suspends a persons pension under subsection (1); and

(b)     the person has a partner who is receiving:

(i) age pension; or

(ii) disability support pension; or

(iii) sole parent pension in a case where the recipient is qualified for the pension because of subparagraph 249 (1) (a) (iv) (illness-separation); or

(iv) service pension;

then, for the period of the suspension, the partner is taken to be partnered (partner getting neither pension nor benefit).

Note 1: the partners rate of pension for the suspension period will be determined under Subdivision D of Division 9.

Note 2: for partnered (partner getting neither pension nor benefit) see paragraph 4 (11) (b).

(5) If:

(a)     the Secretary suspends a persons pension under subsection (1); and

(b)     the person has a partner who was, immediately before the suspension, receiving wife pension or carer pension;

the Secretary must determine that the partners pension is not to be cancelled but is to be suspended.

Note: the determination to suspend is made under section 146.

Suspension may be taken to have occurred

140. (1) If:

(a)     a person ceases to be qualified for disability support pension because the person obtains paid work that is for at least 30 hours per week; and

(b)    disability support pension ceases to be payable to the person under section 137; and

(c)     within the period of 2 years after the pension ceases to be


payable, the person ceases to do work of the kind referred to in paragraph (a);

the Secretary may determine that the person is to be treated as if:

(d)     section 137 had not applied to the persons disability support pension; and

(e)     the disability support pension had been suspended under section 139.

(2) If:

(a)     the Secretary makes a determination under subsection (1) in respect of a person; and

(b)     the persons partner had ceased to be qualified for wife pension or carer pension when the person ceased to be qualified for disability support pension as mentioned in paragraph (1) (a);

the Secretary may determine that the partner is to be treated as if the partners wife or carer pension had not been cancelled but had been suspended under section 139.

Subdivision CAutomatic rate reduction

Automatic rate reduction—partner starting to receive pension or benefit

141. If:

(a)     a person is receiving a disability support pension; and

(b)     the persons partner starts to receive:

(i) a social security pension or benefit; or

(ii) a service pension; and

(c) the persons disability support pension rate is reduced because of the partners receipt of that pension or benefit;

the disability support pension becomes payable to the person at the reduced rate on the day on which the partner starts to receive that pension or benefit.

Automatic rate reduction—recipient not complying with section 132 notification obligations

142. If:

(a)     a person who is receiving disability support pension is given a notice under section 132; and

(b)     the notice requires the person to inform the Department of the occurrence of an event or change in circumstances within a specified period (in this section called the notification period); and

(c)     the event or change in circumstances occurs; and

(d)     the person does not inform the Department of the occurrence


of the event or change in circumstances within the notification period in accordance with the notice; and

(e) because of the occurrence of the event or change in circumstances, the persons rate of pension is to be reduced;

the pension becomes payable to the person at the reduced rate immediately after the day on which the event or change in circumstance occurs.

Automatic rate reduction—failure to inform Department of payment for remunerative work where earnings credit account balance available

143. If:

(a)     a person who is receiving disability support pension is given a notice under section 132; and

(b)     the notice requires the person to inform the Department of income for remunerative work undertaken by the person; and

(c)     the person fails to notify the Department of income of that kind in accordance with the notice; and

(d)     the person has an earnings credit account balance for the purposes of Division 4 of Part 3.10;

the pension becomes payable to the person at the reduced rate from the first pension payday after the day on which the persons earnings credit account balance is reduced to nil.

Subdivision DDeterminations

Rate increase determination

144. If the Secretary is satisfied that the rate at which disability support pension is being, or has been, paid is less than the rate provided for by this Act, the Secretary is to determine that the rate is to be increased to the rate specified in the determination.

Note: for the date of effect of a determination under this section see section 146d.

Rate reduction determination

145. If the Secretary is satisfied that the rate at which disability support pension is being, or has been, paid is more than the rate provided for by this Act, the Secretary is to determine that the rate is to be reduced to the rate specified in the determination.

Note 1: a determination under this section is not necessary in a case where an automatic rate reduction is produced by section 142 or 143 (see subsection 12 (2)).

Note 2: for the date of effect of a determination under this section see section 146e.


Cancellation or suspension determination

146. If the Secretary is satisfied that disability support pension is being, or has been, paid to a person to whom it is not, or was not, payable under this Act, the Secretary is to determine that the pension is to be cancelled or suspended.

Note 1: a determination under this section is not necessary in a case where an automatic termination is produced by section 137 or 138 (see subsection 12 (1)).

Note 2: for the date of effect of a determination under this section see section 146e.

Cancellation or suspension for failure to comply with section 132, 1304 or 1305 notice

146a. If:

(a)     a person who is receiving a disability support pension is given a notice under section 132, 1304 or 1305 requiring the person to give the Department a statement; and

(b)     the person does not comply with the notice;

the Secretary may determine that the pension is to be cancelled or suspended.

Note 1: this section will not apply in a case where section 146 applies.

Note 2: for the date of effect of a determination under this section see section 146e.

Changes to payments by computer

146b. If:

(a)     payment of a disability support pension to a person is based upon data in a computer; and

(b)     the pension rate is increased or reduced, or the pension is cancelled or suspended, because of the operation of a computer program approved by the Secretary; and

(c)     the program causes the change for a reason for which the Secretary could determine the change;

the change is taken to have been made because of a determination by the Secretary for that reason.

Resumption of payment after cancellation or suspension

146c. (1) If the Secretary:

(a)     cancels or suspends a persons disability support pension under section 146 or 146a; and

(b)     reconsiders the decision to cancel or suspend; and

(c)     becomes satisfied that because of the decision to cancel or suspend:

(i) the person did not receive a disability support pension that was payable to the person; or

(ii) the person is not receiving a disability support pension that is payable to the person;


the Secretary is to determine that disability support pension was or is payable to the person.

(2) The reconsideration referred to in paragraph (1) (b) might be a reconsideration on an application under section 1240 for review or a reconsideration on the Secretarys own initiative.

Note: for the date of effect of a determination under this section see section 146d.

Subdivision EDate of effect of determinations

Date of effect of favourable determination

146d. (1) The day on which a determination under section 144 or 146c (in this section called the favourable determination) takes effect is worked out in accordance with this section.

Notified decisionreview sought within 3 months

(2) If:

(a)     a decision (in this subsection called the previous decision) is made in relation to a persons disability support pension; and

(b)     a notice is given to the person to whom the pension is payable advising the person of the making of the previous decision; and

(c)     the person applies to the Secretary under section 1240, within 3 months after the notice is given, for review of the previous decision; and

(d)     the favourable determination is made as a result of the application for review; and

(e)     subsections (6), (7) and (8) do not apply to the determination;

the determination takes effect on the day on which the previous decision took effect.

Notified decisionreview sought after 3 months

(3) If:

(a)     a decision (in this subsection called the previous decision) is made in relation to a persons disability support pension; and

(b)     a notice is given to the person to whom the pension is payable advising the person of the making of the previous decision; and

(c)     the person applies to the Secretary under section 1240, more than 3 months after the notice is given, for review of the previous decision; and

(d)     the favourable determination is made as a result of the application for review; and

(e)     subsections (6), (7) and (8) do not apply to the determination;

the determination takes effect on the day on which the person sought the review.


Decision not notified

(4) If:

(a)     a decision (in this subsection called the previous decision) is made in relation to a persons disability support pension; and

(b)     no notice is given to the person to whom the pension is payable advising the person of the making of the previous decision; and

(c)     the person applies to the Secretary under section 1240, for review of the previous decision; and

(d)     the favourable determination is made as a result of the application for review; and

(e)     subsections (6), (7) and (8) do not apply to the determination;

the determination takes effect on the day on which the previous decision took effect.

Notified change of circumstances

(5) If:

(a)     the favourable determination is made following a person having advised the Department of a change in circumstances; and

(b)     the change is not a decrease in the rate of the persons maintenance income;

the determination takes effect on the day on which the advice was received or on the day on which the change occurred, whichever is the later.

Prescribed student child determination

(6) If:

(a)     the favourable determination is made as a result of the Secretary forming the opinion, for the purposes of subsections 5 (12) and (13), that a young person will not, or would not, receive payments under a prescribed educational scheme; and

(b)     the Secretary is notified that the young person has been refused payment under a prescribed educational scheme within 28 days after the person is notified of that refusal;

the determination takes effect on the day when the determination is made or on such earlier or later day as is specified in the determination.

(7) If:

(a)     the favourable determination is made because, under subsection 5 (13), a young person is not qualified to receive a payment under a prescribed educational scheme; and

(b)     the young person, or another person, was previously in receipt of a payment under a prescribed educational scheme in respect of that young person, and the young person or other person has since ceased to receive that payment; and


(c) the Secretary was notified, within 28 days after the payment ceased, that it was no longer being received;

the determination takes effect on the day when the determination is made or such earlier or later day as is specified in the determination.

(8) If:

(a)     the favourable determination is made because, under paragraph 5 (12) (c), a young person is not qualified to receive payments under any of the prescribed educational schemes; and

(b)     no applications have been made for payments in respect of that young person under any of the prescribed educational schemes; and

(c)     the Secretary is satisfied that it is reasonable for such applications not to be made; and

(d)     the young person ceased to be a prescribed student child because of the operation of paragraph 5 (12) (c) within 3 months after becoming a prescribed student child;

the determination takes effect on the day on which the young person became a prescribed student child.

Other determinations

(9) In any other case, the favourable determination takes effect on the day on which the determination was made or on such later day or earlier day (not being a day more than 3 months before the determination was made) as is specified in the determination.

Date of effect of adverse determination

General

146e. (1) The day on which a determination under section 145, 146 or 146a (in this section called the adverse determination) takes effect is worked out in accordance with this section.

Note: if the adverse determination depends on a discretion or opinion and a person affected by the determination applies for review, the Secretary may continue payment pending the outcome of the review: see section 1241 (internal review) and section 1251 (review by Social Security Appeals Tribunal).

(2) The adverse determination takes effect on:

(a)     the day on which the determination is made; or

(b)     if another day is specified in the determination—on that day.

(3) Subject to subsections (4), (5) and (6), the day specified under paragraph (2) (b) must be later than the day on which the determination is made.

Contravention of Act

(4) If:

(a) the person whose disability support pension is affected by the


adverse determination has contravened a provision of this Act (other than section 133, 1304, 1305, 1306 or 1307); and

(b) the contravention causes a delay in making the determination;

the day specified under paragraph (2) (b) may be earlier than the day on which the determination is made.

False statement or misrepresentationsuspension or cancellation

(5) If:

(a)     a person has made a false statement or misrepresentation; and

(b)     because of the false statement or misrepresentation, the pension has been paid to a person when it should have been cancelled or suspended;

the day specified under paragraph (2) (b) may be earlier than the day on which the determination is made.

False statement or misrepresentationrate reduction

(6) If:

(a)     a person has made a false statement or misrepresentation; and

(b)     because of the false statement or misrepresentation, the rate at which the pension was paid to a person was more than it should have been;

the day specified under paragraph (2) (b) may be earlier than the day on which the determination is made.

Division 10Bereavement payments

Subdivision ADeath of pensioner partner

Qualification for payments under this Subdivision

146f. (1) If:

(a)     a person is receiving disability support pension; and

(b)     the person is a member of a couple; and

(c)     the persons partner dies; and

(d)     immediately before the partner died, the partner was receiving:

(i) an age pension; or

(ii) a disability support pension; or

(iii) a wife pension; or

(iv) a carer pension; or

(v) a sole parent pension under subparagraph 249 (1) (a) (iv) (illness separated couple); or

(vi) a rehabilitation allowance; or

(vii) a special needs age, disability support, wife or sole parent pension; or

(viii) a service pension; and


(e) on the pension payday immediately before the first available bereavement adjustment payday, the amount that would be payable to the person if the person were not qualified for payments under this Subdivision is less than the sum of:

(i) the amount that would otherwise be payable to the person under section 146e (continued payment of partners pension or allowance); and

(ii) the amount that would otherwise be payable to the person under section 146g (persons continued rate);

the person is qualified for payments under this Subdivision to cover the bereavement period.

Note 1: section 146g provides for the payment to the person, up to the first available bereavement adjustment payday, of amounts equal to the instalments that would have been paid to the persons partner during that period if the partner had not died.

Note 2: section 146h provides for a lump sum that represents the instalments that would have been paid to the persons partner, between the first available bereavement adjustment payday and the end of the bereavement period, if the partner had not died.

(2) A person who is qualified for payments under this Subdivision may choose not to receive payments under this Subdivision.

(3) An election under subsection (2):

(a)     must be made by written notice to the Secretary; and

(b)    may be made after the person has been paid an amount or amounts under this Subdivision; and

(c)     cannot be withdrawn after the Department has taken all the action required to give effect to that election.

(4) If a person is qualified for payments under this Subdivision in relation to the partners death, the rate at which disability support pension is payable to the person during the bereavement period is, unless the person has made an election under subsection (2), governed by section 146j.

Continued payment of partners pension or allowance

146g. If a person is qualified for payments under this Subdivision in relation to the death of the persons partner, there is payable to the person, on each of the pension paydays in the bereavement rate continuation period, an amount equal to the amount that would have been payable to the persons partner on that payday if the partner had not died.

Lump sum payable in some circumstances

146h. If:

(a)     a person is qualified for payments under this Subdivision in relation to the death of the persons partner; and

(b)     the first available bereavement adjustment payday occurs before the end of the bereavement period;


there is payable to the person as a lump sum an amount worked out using the lump sum calculator at the end of this section.

LUMP SUM CALCULATOR

This is how to work out the amount of the lump sum:

Method statement

Step 1.

Add up:

 

(a) the amount that, if the persons partner had not died, would have been payable to the person on the pension payday immediately before the first available bereavement adjustment payday; and

 

(b) the amount that, if the partner had not died, would have been payable to the partner on the pension payday immediately before the first available bereavement adjustment payday;

 

the result is called the combined pensioner couple rate.

Step 2.

Work out the amount that, but for section 146j, would have been payable to the person on the pension payday immediately before the first available bereavement adjustment payday: the result is called the persons individual rate.

Step 3.

Take the persons individual rate away from the combined pensioner couple rate: the result is called the partners instalment component.

Step 4.

Work out the number of pension paydays in the bereavement lump sum period.

Step 5.

Multiply the partners instalment component by the number of pension paydays in the bereavement lump sum period: the result is the amount of the lump sum payable to the person under this section.

Adjustment of persons disability support pension rate

146j. If:

(a)     a person is qualified for payments under this Subdivision; and

(b)     the person does not elect under subsection 146f (2) not to receive payments under this Subdivision;

the rate of the persons disability support pension during the bereavement period is worked out as follows:

(c) during the bereavement rate continuation period, the rate of disability support pension payable to the person is the rate at which the pension would have been payable to the person if the persons partner had not died;


(d) during the bereavement lump sum period (if any), the rate at which disability support pension is payable to the person is the rate at which the disability support pension would be payable to the person apart from this Subdivision.

Effect of death of person entitled to payments under this Subdivision

146k. If:

(a)     a person is qualified for payments under this Subdivision in relation to the death of the persons partner; and

(b)    the person dies within the bereavement period; and

(c)     the Secretary does not become aware of the death of the persons partner before the person dies;

there is payable, to such person as the Secretary thinks appropriate, as a lump sum, an amount worked out using the lump sum calculator at the end of this section.

LUMP SUM CALCULATOR

This is how to work out the amount of the lump sum:

 

Method statement

Step 1.

Add up:

 

(a) the amount that, if neither the person nor the persons partner had died, would have been payable to the person on the pension payday immediately after the day on which the person dies; and

 

(b) the amount that, if neither the person nor the persons partner had died, would have been payable to the persons partner on that pension payday;

 

the result is called the combined pensioner couple rate.

Step 2.

Work out the amount that, but for section 140, would have been payable to the person on the pension payday immediately after the day on which the person died if the person had not died: the result is called the persons individual rate.

Step 3.

Take the persons individual rate away from the combined pensioner couple rate: the result is called the partners instalment component.

Step 4.

Work out the number of pension paydays in the period that commences on the day after the person dies and ends on the day on which the bereavement period ends.

Step 5.

Multiply the partners instalment component by the number obtained in Step 4: the result is the amount of the lump sum payable under this section.


Matters affecting payment of benefits under this Subdivision

146l. (1) If:

(a)     a person is qualified for payments under this Subdivision in relation to the death of the persons partner; and

(b)     after the persons partner died, an amount to which the partner would have been entitled if the partner had not died has been paid under this Act or under Part III of the Veterans Entitlements Act; and

(c)     the Secretary is not satisfied that the person has not had the benefit of that amount;

the following provisions have effect:

(d)     the amount referred to in paragraph (b) is not recoverable from the person or from the personal representative of the persons partner, except to the extent (if any) that the amount exceeds the amount payable to the person under this Subdivision;

(e)     the amount payable to the person under this Subdivision is to be reduced by the amount referred to in paragraph (b).

(2) If:

(a)     a person is qualified for payments under this Subdivision in relation to the death of the persons partner; and

(b)     an amount to which the persons partner would have been entitled if the persons partner had not died has been paid under this Act or under Part III of the Veterans Entitlements Act, within the bereavement period, into an account with a bank, credit union or building society (in this subsection called the financial institution); and

(c)     the financial institution pays to the person, out of that account, an amount not exceeding the total of the amounts paid as mentioned in paragraph (b);

the financial institution is, in spite of anything in any other law, not liable to any action, claim or demand by the Commonwealth, the personal representative of the persons partner or anyone else in respect of the payment of that money to the person.

Subdivision BDeath of dependent child

Bereavement payments on death of dependent child

146m. If:

(a)     a person is receiving disability support pension; and

(b)     a dependent child of the person dies; and

(c)     immediately before the child died, the persons disability support pension rate included:

(i) a dependent child add-on in respect of the child; or


(ii) guardian allowance in respect of the child;

the person is qualified for payments under this Subdivision to cover the bereavement period.

Note 1: section 146n provides for disability support pension to be paid to the person, up to the first available bereavement adjustment payday, at the rate at which it would have been paid if the child had not died but were disregarded for the purposes of working out the persons income test free areas.

Note 2: section 146p provides for a lump sum to be paid to the person if the person was receiving family allowance for the child and the first available bereavement adjustment payday occurs before the end of the bereavement period: the lump sum represents the difference, over the bereavement lump sum period, between the persons new disability support pension rate and the rate at which the pension would have been paid if the child had not died but were disregarded for the purposes of working out the persons income test free areas.

Note 3: the additional payments preserved by this Subdivision are:

  dependent child add-on;

  guardian allowance;

  additional rent assistance;

  additional remote area allowance.

Continued payment of child-related amounts

146n. If a person is qualified for payments under this Subdivision in relation to the death of a dependent child, the persons disability support pension rate during the bereavement rate continuation period is to be calculated as if:

(a)     the child had not died; and

(b)     the child was disregarded in calculating the persons ordinary income free area and maintenance income free area.

Lump sum payable in some circumstances

146p. If:

(a)     a person is qualified for payments under this Subdivision in relation to the death of a dependent child; and

(b)     the first available bereavement adjustment payday occurs before the end of the bereavement period; and

(c)     the person was, immediately before the child died, receiving family allowance for the child;

a lump sum (worked out using the lump sum calculator at the end of this section) is payable to the person.

Note: if the person qualified for payments under this Subdivision was not receiving family allowance in respect of the dependent child and somebody else was receiving family allowance in respect of the dependent child, a corresponding lump sum may be payable to the other person under section 890.


LUMP SUM CALCULATOR

This is how to work out the amount of the lump sum:

Method statement

Step 1.

Work out the instalment of disability support pension payable to the person on the pension payday immediately before the first available bereavement adjustment payday: the result is called the continued rate.

 

Note: section 146n applies in working out the amount of this instalment because the payday on which it is payable is within the bereavement rate continuation period.

Step 2.

Work out the instalment of disability support pension that would have been payable to the person on the payday immediately before the first available bereavement adjustment payday if the persons disability support pension rate were not calculated under section 146n: the result is called the new rate.

Step 3.

Take the new rate away from the continued rate: the result is called the deceased child component.

Step 4.

Work out the number of pension paydays in the bereavement lump sum period.

Step 5.

Multiply the deceased child component by the number of pension paydays in the bereavement lump sum period: the result is the amount of the lump sum payable to the person under this section.

Subdivision CDeath of recipient

Death of recipient

146q. (1) If:

(a)     a person is receiving disability support pension; and

(b)     either:

(i) the person is not a member of a couple; or

(ii) the person is a member of a couple and the persons partner:

(a) is not receiving a social security pension; and

(b) is not receiving a social security benefit; and

(c) is not receiving a service pension; and

(c) the person dies;

there is payable, to such person as the Secretary thinks appropriate, an amount equal to the amount that would have been payable to the person under this Act on the pension payday after the persons death if the person had not died.


(2) If an amount is paid under subsection (1) in respect of a person, the Commonwealth is not liable to any action, claim or demand for any further payment under that subsection in respect of the person.

Note 1: for amounts owing to the recipient before the recipients death see section 127.

Note 2: for death of a person qualified for bereavement payments under Subdivision A see section 146k.

(3) If:

(a)     a person is receiving disability support pension; and

(b)     the person is a member of a couple; and

(c)     the person dies; and

(d)     the person:

(i) was qualified at the time of the persons death for payments under Subdivision B in relation to the death of a dependent child; or

(ii) would have been so qualified if the person had not died; and

(e) the persons partner claims the payments referred to in paragraph (d) within 3 months after the death of the child;

there is payable to the partner an amount equal to the sum of the following amounts:

(f) the difference between:

(i) the amount of disability support pension that would have been payable to the person under section 146l if the person had not died; and

(ii) the amount of disability support pension that would have been payable to the person apart from Subdivision B for the same period if the person had not died;

(g) any lump sum that would have been payable to the person under section 146m if the person had not died.

(4) If:

(a)     a person is receiving disability support pension; and

(b)     the person is not a member of a couple; and

(c)     the person dies; and

(d)     the person:

(i) was qualified at the time of the persons death for payments under Subdivision B in relation to the death of a dependent child; or

(ii) would have been so qualified if the person had not died;

there is payable, to such person as the Secretary thinks appropriate, an amount equal to the sum of the following amounts:

(e) the difference between:

(i) the amount of disability support pension that would have


been payable to the person under section 146l if the person had not died; and

(ii) the amount of disability support pension that would have been payable to the person apart from Subdivision B for the same period if the person had not died;

(f) any lump sum that would have been payable to the person under section 146m if the person had not died.

Division 11Fringe benefits

Fringe benefits

146r. If a person who is receiving disability support pension qualifies for fringe benefits in accordance with this Division, benefits and concessions of various kinds may be made available to the person under other Commonwealth legislation (for example, the National Health Act 1953).

Note 1: a person whose disability support pension is not being paid because of a deferment period can still qualify for fringe benefits (see subsection 104 (7)).

Note 2: if a person qualifies for fringe benefits in accordance with this Division, the person will also qualify for pharmaceutical allowance under Part 2.22.

Qualification for fringe benefits

146s. (1) A person who is receiving disability support pension is qualified for fringe benefits if:

(a)     the person is permanently blind; or

(b)     the persons disability support pension rate is neither income reduced nor assets reduced.

(2) If:

(a)     a person who is receiving disability support pension is not qualified for fringe benefits under subsection (1); and

(b)     the persons disability support pension rate is income reduced;

the person is qualified for fringe benefits only if the person satisfies the fringe benefits ordinary income test.

Note: the Fringe Benefits Ordinary Income Test Calculator at the end of section 1071 is to be used in working out whether a person satisfies the fringe benefits ordinary income test.

(3) If:

(a) a person who is receiving disability support pension is not qualified for fringe benefits under subsection (1); and

(b) the persons disability support pension rate is assets reduced; the person is qualified for fringe benefits only if the person satisfies the fringe benefits assets test.

Note: the Fringe Benefits Assets Test Calculator at the end of section 1072 is to be used in working out whether a person satisfies the fringe benefits assets test.


12 month extension of fringe benefits—person ceasing to be on disability support pension because of employment

146t. (1) For the purposes of this Division, if:

(a)     a person is receiving disability support pension; and

(b)     the person ceases to be qualified for disability support pension because the person obtains work that is for at least 30 hours per week; and

(c)     immediately before the person ceased to be qualified for disability support pension, the person was qualified for fringe benefits under this Division;

then, for the period of 12 months after the person ceases to be qualified for disability support pension:

(d)     the person is taken to be receiving disability support pension; and

(e)     for the purposes of applying section 146s to the person during the 12 month period, the persons rate of disability support pension is taken not to be income reduced.

(2) Subsection (1) ceases to apply to the person if the person ceases work.

12 month extension of fringe benefits—person failing income test because of employment income

146u. (1) For the purposes of this Division, if:

(a)     a person is receiving disability support pension; and

(b)     the person ceases to satisfy the fringe benefits ordinary income test; and

(c)     the person ceased to satisfy the fringe benefits ordinary income test when the person began to earn income from employment at a rate that causes the persons annual rate of ordinary income to exceed the fringe benefits ordinary income free area;

then, for the period of 12 months after the person begins to earn income at that rate:

(d)     the person is taken to be receiving disability support pension; and

(e)     for the purposes of applying section 146s to the person during the 12 month period, the persons rate of disability support pension is taken not to be income reduced.

Note: for fringe benefits ordinary income free area see point 1071-4 (Fringe Benefits Means Test Calculator).

(2) Subsection (1) ceases to apply to the person if the person ceases to earn income from employment.

(3) If:

(a) this section applies to a person; and


(b) before the end of the 12 month period referred to in this section, section 146t also applies to the person;

the period of 12 months referred to in section 146t is taken to have commenced on the day the person began to earn income from employment at a rate that causes the persons annual rate of ordinary income to exceed the fringe benefits ordinary income free area and not on the day the person ceased to be qualified for disability support pension..

Qualification for wife pension

11. Section 147 of the Principal Act is amended:

(a)     by omitting from subsection (1) A person and substituting Subject to subsection (1a), a person;

(b)    by inserting after subsection (1) the following subsection:

(1a) If:

(a)     the persons partner was granted the age pension or disability support pension on or after 1 October 1991; and

(b)     the person or the persons partner has not turned 21; and

(c)     the person does not have a dependent child; and

(d) the persons partner does not have a dependent child;

the person is not qualified for wife pension..

12. After section 664b of the Principal Act the following sections are inserted:

Disability support pension recipients

664c. (1) A person is qualified for an employment entry payment under this section if:

(a) the person is in paid employment (other than sheltered employment); and

(i) the employment is for at least 30 hours per week; or

(ii) the persons income from the employment exceeds the threshold amount; and

(b) immediately before the person commenced the employment:

(i) the person was receiving a disability support pension; and

(ii) the person had been a qualified recipient for a continuous period of at least 12 months; and

(d)     in the Secretarys opinion the persons employment is likely to continue for more than 4 weeks; and

(e)     the person has not, within the last 12 months, received a payment under this Part.


Note 1: the amount in subparagraph (a) (ii) is adjusted twice a year by legislative amendment.

Note 2: for qualified recipient see subsection (4).

(2) If the Secretary is satisfied that:

(a)     a person has entered an agreement under which the person is to be employed; and

(b)     on the start of that employment, the person would but for receiving a payment under this subsection, be qualified for a payment under subsection (1);

the following provisions have effect:

(c)     subject to paragraph (d), the person is qualified for an employment entry payment which is payable to the person at such time as the Secretary determines;

(d)     the person is not qualified for the employment entry payment unless the Secretary is still satisfied as mentioned in paragraphs (a) and (b) at the time at which the payment is payable to the person.

(3) The time determined under paragraph (2) (c) is not to be more than 28 days before the person is to commence the employment.

(4) In this section:

qualified recipient means a person receiving:

(a)     disability support pension; or

(b)     sickness allowance; or

(c)     invalid pension; or

(d)     sickness benefit; or

(e)     sheltered employment allowance; or

(f) rehabilitation allowance in place of invalid pension or disability support pension;

threshold amount means the maximum amount per fortnight that a person receiving newstart allowance can earn, derive or receive without the allowance ceasing to be payable, if the person:

(a)     is not a member of a couple; and

(b)     is not receiving rent assistance; and

(c)     is not receiving remote area allowance; and

(d)     has turned 21 but has not turned 60; and

(e)     has no dependent children.

Amount of section 664c payment

664d. The amount of an employment entry payment under section 664c is $200..

13. Parts 2.9 and 2.10 of the Principal Act are repealed.


14. Part 2.14 of the Principal Act is repealed and the following Part is substituted:

PART 2.14—SICKNESS ALLOWANCE

Division 1Qualification for and payability of sickness allowance

Subdivision ABasic qualification

Qualification for sickness allowance

666. (1) A person is qualified for sickness allowance in respect of a period if:

(a)     the person is incapacitated for work throughout the period because of sickness or an accident; and

(b)     the incapacity is caused wholly or virtually wholly by a medical condition arising from the sickness or accident; and

(c)     the incapacity is, or is likely to be, of a temporary nature; and

(d)     either:

(i) the person satisfies the Secretary that the person has suffered, or is likely to suffer, a loss of salary, wages or other income of a similar nature because of the incapacity; or

(ii) the person satisfies the Secretary that, if the person were able to work, the person would have, or would be likely to be, qualified for job search allowance or newstart allowance in respect of the period; or

(iii) the person was receiving, or is likely to be receiving, a social security pension immediately before the beginning of the period; and

(e) before the period begins the person has turned 16; and

(f) before the period ends the person has not turned, or is not likely to turn, pension age; and

(g) a person is, or is likely to be an Australian resident throughout the period; and

(h) the person is, or is likely to be, in Australia throughout the period.

Note 1: see section 677 for the circumstances in which sickness allowance is not payable to a person even though the person is qualified for the allowance.

Note 2: for loss of income see section 675.

Note 3: for pension age see section 23.

Work

(2) For the purposes of this section:

work means, in relation to a person:

(a) if:


(i) the person had a contract of employment immediately before the person becomes incapacitated; and

(ii) the persons contract of employment continues after the person becomes incapacitated;

the work that the person has contracted to perform under the contract; or

(b) in any other case—work of a kind that the person could, in the Secretarys opinion, be reasonably expected to do.

(3) The work referred to paragraph (b) of the definition of work in subsection (2) is work that is:

(a)     for at least 8 hours per week at award wages or above: and

(b)     full-time, part-time, permanent or casual work.

Person cannot qualify for sickness allowance in respect of same medical condition within 2 years

(4) If a person ceases to be qualified for sickness allowance in respect of a medical condition because of the operation of section 670 or 672, the person cannot be qualified again for sickness allowance during the period of 104 weeks after the person so ceases to be qualified unless subsection (5) applies to the person.

(5) This subsection applies to a person:

(a)     if the persons incapacity for work is caused by a medical condition that is different, or significantly more serious, than the medical condition referred to in subsection (4); or

(b)    if:

(i) the medical condition referred to in subsection (4) is a chronically relapsing condition; and

(ii) the persons incapacity for work is caused by a relapse of that condition; or

(c) if:

(i) the person is undergoing a program of counselling, treatment or therapy for drug or alcohol abuse; and

(ii) the persons participation in the program is not likely to extend beyond 78 weeks; and

(iii) the program is approved by the Secretary in writing for the purposes of this section.

Person receiving job search allowance or newstart allowance immediately before qualifying for sickness allowance

(6) If a person who is incapacitated for work:

(a)     has not turned 18; and

(b)     was receiving job search allowance immediately before the person became so incapacitated;


the person is not qualified for sickness allowance under subsection (1).

Note: subsection 514 (2) provides that a person under 18 who becomes qualified for sickness allowance while the person is receiving job search allowance continues to be qualified for the job search allowance even though the person is incapacitated for work.

(7) If a person who is incapacitated for work:

(a)     has turned 18; and

(b)     was receiving job search allowance immediately before the person became so incapacitated;

the person is not qualified for sickness allowance under subsection (1) for the period of 6 weeks beginning on the day the person became incapacitated.

Note: subsection 514 (3) provides that a person over 18 who becomes qualified for sickness allowance while receiving job search allowance continues to be qualified for the job search allowance for 6 weeks even though the person is incapacitated for work.

(8) If a person who is incapacitated for work was receiving newstart allowance immediately before the person became so incapacitated, the person is not qualified for sickness allowance under subsection (1) for the period of 13 weeks beginning on the date the person became incapacitated.

Note: subsection 594 (2) provides that a person who becomes qualified for sickness allowance while the person is receiving newstart allowance continues to be qualified for the newstart allowance for 13 weeks even though the person is incapacitated for work.

Person not qualified in certain circumstances

(9) A person is not qualified for sickness allowance in respect of an incapacity if the Secretary is satisfied that the incapacity is brought about with a view to obtaining sickness allowance or disability support pension.

Person undertaking rehabilitation program may qualify for sickness allowance

667. (1) A person is qualified for sickness allowance in respect of a period if:

(a)    immediately before the period began the person was receiving job search allowance or newstart allowance; and

(b)    the person is undertaking a rehabilitation program during the period; and

(c)    the program is intended to enhance the persons ability to work; and

(d)    if the person was receiving:

(i) job search allowance—the length of the persons participation in the program is, or is likely to be, at least 6 weeks; or

(ii) newstart allowance—the length of the persons


participation in the program is, or is likely to be, at least 6 weeks; and

(e) subsection (4) applies to the person.

(2) If a person is qualified for sickness allowance under subsection (1), subsections 514 (2), 514 (3) and 594 (2) do not apply to the person.

Note 1: subsection 514 (2) provides that a person under 18 who becomes qualified for sickness allowance while the person is receiving job search allowance continues to be qualified for the job search allowance even though the person is incapacitated for work.

Note 2: subsection 514 (3) provides that a person over 18 who becomes qualified for sickness allowance while receiving job search allowance continues to be qualified for the job search allowance for 6 weeks even though the person is incapacitated for work.

Note 3: subsection 594 (2) provides that a person who becomes qualified for sickness allowance while the person is receiving newstart allowance continues to be qualified for the newstart allowance for 13 weeks even though the person is incapacitated for work.

(3) A person is qualified for sickness allowance in respect of a period (in this subsection called the rehabilitation period) if:

(a) immediately before the rehabilitation period began the person was receiving:

(i) sickness benefit; or

(ii) sickness allowance; or

(iii) sickness benefit and sickness allowance;

in respect of a period; and

(b)     the person is undertaking a rehabilitation program during the rehabilitation period; and

(c)     the program is intended to enhance the persons ability to work; and

(d)     the persons participation in the program is, or is likely to, end within the period of 208 weeks after the benefit or allowance commenced to be payable to the person; and

(e)     subsection (4) applies to the person.

(4) This subsection applies to a person during a period if:

(a)     before the period begins the person has turned 16; and

(b)     before the period ends the person has not turned, or is not likely to turn, pension age; and

(c)     a person is, or is likely to be, an Australian resident throughout the period; and

(d)     the person is, or is likely to be, in Australia throughout the period.

Note: for pension age see section 23.


Person not qualified in certain circumstances

(5) A person is not qualified for sickness allowance in respect of an incapacity if the Secretary is satisfied that the incapacity is brought about with a view to obtaining sickness allowance or disability support pension.

Refusal to attend interview etc. may lead to disqualification

668. (1) A person is not qualified for a sickness allowance if:

(a)     the person has lodged a claim for sickness allowance, but the claim has not yet been determined; and

(b)     the Secretary is of the opinion that the person should:

(i) contact a specified officer of the Department; or

(ii) attend an interview at a specified place; or

(iii) complete a questionnaire; or

(iv) attend a medical, psychiatric or psychological examination; and

(c) the Secretary notifies the person that the person is required to:

(i) contact that officer; or

(ii) attend that interview; or

(iii) complete that questionnaire; or

(iv) attend that examination; or

(v) if the person has undergone an examination—provide to the Secretary a report on that examination in the approved form; and

(d)     the Secretary is satisfied that it is reasonable for this section to apply to the person; and

(e)     the person does not take reasonable steps to comply with the Secretarys requirements within the time specified in the notice.

(2) A notice under paragraph (1) (c) must be in writing and must inform the person of the effect of this section.

Time limit on qualification for sickness allowance

669. (1) A person who is receiving sickness allowance ceases to be qualified for sickness allowance if the persons maximum allowance period ends.

(2) The maximum allowance period for a person is the period specified in the determination granting the persons claim for sickness allowance as the maximum period for which the sickness allowance is payable to the person.

(3) The period specified in the determination is not to be more than:

(a) if the persons claim for sickness allowance is supported by a medical certificate:


(i) the period specified in the medical certificate as the period for which the person is incapacitated for work; or

(ii) the period of 13 weeks;

whichever is the lesser; or

(b)    if the claim is not supported by a medical certificate because of the persons participation in a rehabilitation program—the period of the persons participation in the program; or

(c)     in any other case—the period of 4 weeks.

(4) For the purposes of subsection (3), the persons maximum allowance period commences on the first day the allowance becomes payable to the person.

Note: for the day on which sickness allowance becomes payable to a person see section 715.

Secretary may extend maximum allowance period

(5) If:

(a)    a person is receiving sickness allowance; and

(b)    the person gives the Secretary a certificate of a medical practitioner containing the matters listed in subsection 704 (1) and in accordance with the form approved under subsection 704 (2); and

(c)    the Secretary is satisfied that the persons incapacity for work will continue after the end of the persons maximum allowance period;

the Secretary may extend the maximum allowance period by a period of not more than 13 weeks.

(6) If:

(a)     a person is receiving sickness allowance; and

(b)     the person gives the Secretary written evidence (other than a certificate referred to in paragraph (5) (b)) that the persons incapacity for work will continue after the end of the persons maximum allowance period; and

(c)     the Secretary is satisfied that:

(i) the persons circumstances make it unreasonable to expect the person to obtain a certificate referred to in paragraph (5) (b) before the persons maximum allowance period ends; and

(ii) the persons incapacity for work will continue after the end of the persons maximum allowance period;

the Secretary may extend the maximum allowance period by a period of not more than 4 weeks.


Person ceases to be qualified for sickness allowance after one year

670. (1) A person ceases to be qualified for sickness allowance if the person has received sickness allowance in respect of the immediately preceding period of 52 weeks.

(2) The Secretary may make a determination in writing that subsection (1) does not apply to a person if the Secretary is satisfied that:

(a)     the persons incapacity will end during the next 52 weeks; or

(b)     the medical condition that now wholly or virtually wholly causes the persons incapacity for work is different from, or significantly more serious than, the medical condition because of which the persons claim for sickness allowance was granted in respect of the beginning of the period of the immediately preceding 52 weeks; or

(c)     the persons incapacity is caused by a chronically relapsing medical condition; or

(d)     the following circumstances apply:

(i) the person is undergoing a program of counselling, treatment or therapy for drug or alcohol abuse; and

(ii) the persons participation in the program is not likely to extend beyond 78 weeks; and

(iii) the program is approved by the Secretary in writing for the purposes of this section.

(3) If the Secretary makes a determination under subsection (2) in respect of a person:

(a)     the maximum allowance period specified for the person at the time the determination is made cannot be extended under subsection 669 (5) or (6); and

(b)     if the person wants to continue to receive sickness allowance when the maximum allowance period ends, he or she must make a proper claim for that allowance.

(4) For the purposes of subsection (1), a person who has not received sickness allowance continuously in respect of the immediately preceding 52 weeks is taken to have received sickness allowance in respect of that period if the period, or each period, in respect of which the person ceased to receive sickness allowance was less than 6 weeks.

Certain extensions at end of 52nd week

671. (1) If:

(a) a person has received sickness allowance in respect of the immediately preceding period of 52 weeks (in this subsection called the first year); and


(b)     before the end of the first year, the person has made a claim for sickness allowance in respect of a period beginning after the end of the first year; and

(c)     the Secretary has not, before the end of the 50th week of the first year, decided whether or not to make a determination under subsection 670 (2) in relation to the person;

subsection 670 (1) does not apply to the person until:

(d)     the period of 4 weeks after the end of the first year has ended; or

(e)     the Secretary decides whether or not to make a determination under subsection 670 (2) in relation to the person;

whichever happens first.

(2) If:

(a)     a person has received sickness allowance in respect of the immediately preceding period of 52 weeks (in this subsection called the first year); and

(b)     before the end of the first year, the person has made a claim for disability support pension in respect of a period beginning after the end of the first year; and

(c)     that claim has not been determined before the end of the first year;

subsection 670 (1) does not apply to the person until the claim for disability support pension has been determined by the Secretary.

(3) If:

(a)     a person has received sickness allowance in respect of the immediately preceding period of 52 weeks (in this subsection called the first year); and

(b)     the person claims sickness allowance in respect of a period beginning after the end of the first year; and

(c)     the person fails to make the claim before the end of the first year but makes the claim within 4 weeks after the end of the first year; and

(d)     the sole or dominant cause of the person failing to make the claim before the end of the first year is either:

(i) the persons medical condition; or

(ii) an act or omission of an officer of the Department;

the persons claim is taken to have been made on the last day of the first year.

Note: for the person to receive sickness allowance as described in this section the person must continue to meet all the other qualification and payability requirements for sickness allowance.


Where Secretary makes determination, person ceases to be qualified after 2 years

672. (1) If the Secretary makes a determination under subsection 670 (2) in relation to a person, the person ceases to be qualified for sickness allowance if the person has received sickness allowance in respect of the immediately preceding period of 104 weeks.

(2) For the purposes of subsection (1), a person who has not received sickness allowance continuously in respect of the immediately preceding 104 weeks is taken to have received sickness allowance in respect of that period if the period, or each period, in respect of which the person ceased to receive sickness allowance was less than 6 weeks.

Special case—person undertaking rehabilitation program

‘“673. (1) Sections 670 and 672 do not apply to a person who is receiving sickness allowance because of qualifying under section 667.

Note: section 667 provides that a person may be qualified for sickness allowance because of undertaking a rehabilitation program.

(2) A person referred to in subsection (1) ceases to be qualified for sickness allowance if the person has received sickness allowance in respect of the immediately preceding period of 208 weeks.

(3) For the purposes of subsection (2), a person who has not received sickness allowance continuously in respect of the immediately preceding 208 weeks is taken to have received sickness allowance in respect of that period if the period, or each period, in respect of which the person ceased to receive sickness allowance was less than 6 weeks.

Temporary absence from Australia

674. For the purposes of sections 666 and 667, where:

(a)     a person is temporarily absent from Australia; and

(b)     the person is absent in order to seek medical treatment of a kind that is not available in Australia;

the person is taken to be in Australia during:

(c)     if the period does not exceed 3 months—the whole of that period; or

(d)     if the period exceeds 3 months—the first 3 months of that period.

Loss of income

675. (1) For the purposes of subsection 666 (1), a persons income of a similar nature to salary or wages includes:

(a)     a payment received by the person under the New Enterprise Incentive Scheme (see Part 3.15); and

(b)    any amount payable to the person or to the persons partner under Part 2.18 (family allowance supplement).


(2) If:

(a)     a person makes a payment to someone else who acts as the persons substitute during a period of incapacity; and

(b)     the Secretary is satisfied that the payment is made justifiably and genuinely;

the Secretary may, for the purposes of subsection 666 (1), regard the person as having suffered a loss of income of a similar nature to salary or wages (equal to the amount of the payment).

Liquid assets test waiting period

676. (1) If the value of a persons liquid assets exceeds the persons maximum reserve on:

(a)     the day on which the person becomes incapacitated for work; or

(b)     the day on which the person claims sickness allowance;

the person is not qualified for sickness allowance for a period unless the person has served the liquid assets test waiting period in relation to the claim before the beginning of that period.

Note 1: for liquid assets see section 14a.

Note 2: for maximum reserve see section 14a.

Note 3: for transferee to sickness allowance see subsections 23 (6) and (7).

Note 4: for serving the liquid assets test waiting period see subsection 23 (10a).

(2) Subsection (1) does not apply to a person if:

(a)     the person is a transferee to sickness allowance; or

(b)     the person has been in receipt of sickness allowance in respect of any period during the 4 weeks immediately before the persons current claim for sickness allowance is made.

(3) The liquid assets test waiting period in relation to the claim lasts for 4 weeks.

(4) Subject to subsection (5), the liquid assets test waiting period in relation to the claim starts on the day on which the person becomes incapacitated for work.

(5) If:

(a)     a person becomes unemployed; and

(b)     because of section 519 (job search allowance liquid assets test disqualification) or section 598 (newstart allowance liquid assets test disqualification), the person is not qualified for job search allowance or newstart allowance during the period of 4 weeks that starts on the day on which the person becomes unemployed; and

(c)     within that period of 4 weeks:

(i) the person becomes incapacitated for work; and

(ii) the person claims sickness allowance;


the liquid assets test waiting period starts on the day on which the person becomes unemployed.

Subdivision BSituations where allowance not payable (general)

Sickness allowance not payable in certain circumstances

677. (1) A sickness allowance is not payable to a person for a period during which the person is qualified for sickness allowance (see sections 666 and 667) if during that period:

(a)     the person has not provided a tax file number (see section 678) or for the persons partner (see section 679); or

(b)     the value of the persons assets exceeds the persons assets value limit (see sections 680 and 681); or

(c)     the person is receiving job search allowance or newstart allowance (see sections 682, 683 and 684); or

(d)     the person is a full-time student (see section 685); or

(e)     another income support payment is being paid to the person (see section 686); or

(f) the sickness allowance has not commenced to be payable (see sections 687 and 715); or

(g) the person is subject to an unused annual leave waiting period and has not served that waiting period (see sections 689 to 691); or

(h) the person is subject to an ordinary waiting period and has not served that waiting period (see sections 692 and 693); or

(i) the person is subject to an education leavers waiting period and that period has not ended (see sections 694 and 695); or

(j) the person fails to comply with a requirement that the person:

(i) contact an officer; or

(ii) attend an interview; or

(iii) complete a questionnaire; or

(iv) attend a medical, psychiatric or psychological examination;

as required by section 697; or

(k) the person is in gaol (see Part 3.13); or

(l) the person or the persons partner is subject to a compensation preclusion period (see Part 3.14); or

(m) the person has not nominated a bank, credit union or building society account for payment of the allowance (see section 721).

(2) A sickness allowance is not payable to a person if the persons sickness allowance rate would be nil.


Provision of tax file number

678. (1) Sickness allowance is not payable unless:

(a)     a person has given the Secretary a written statement of the persons tax file number; or

(b)     a person has given the Secretary an employment declaration and satisfies either subsection (2) or (3).

Note: the Secretary can require a person to quote their tax file number under section 1308.

(2) A person satisfies this subsection if:

(a) the employment declaration states that the person:

(i) has a tax file number but does not know what it is; and

(ii) has asked the Commissioner of Taxation to inform him or her of the number; and

(b) the person has given the Secretary a document authorising the Commissioner of Taxation to tell the Secretary:

(i) whether the person has a tax file number; and

(ii) if the person has a tax file number—the tax file number; and

(c) the Commissioner of Taxation has not told the Secretary that the person has no tax file number.

(3) A person satisfies this subsection if:

(a)     the employment declaration states that an application by the person for a tax file number is pending; and

(b)     the person has given the Secretary a document authorising the Commissioner of Taxation to tell the Secretary:

(i) if a tax file number is issued to the person—the tax file number; or

(ii) if the application is refused—that the application has been refused; or

(c) the Commissioner of Taxation has not told the Secretary that an application by the person for a tax file number has been refused; and

(d) the application for a tax file number has not been withdrawn.

Provision of partners tax file number

679. (1) Subject to subsection (4), sickness allowance is not payable to a person if:

(a)     the person is a member of a couple; and

(b)    the person is required under section 705 or 726 to give the Secretary a written statement of the tax file number of the persons partner; and

(c)     at the end of the period of 28 days after the requirement is made the person has neither:


(i) given the Secretary a written statement of the partners tax file number; nor

(ii) given the Secretary a declaration by the partner in a form approved by the Secretary and satisfied either subsection (2) or (3).

(2) The person satisfies this subsection if:

(a) the partners declaration states that the partner:

(i) has a tax file number but does not know what it is; and

(ii) has asked the Commissioner of Taxation to inform the partner of the partners number; and

(b) the person has given the Secretary a document by the partner that authorises the Commissioner of Taxation to tell the Secretary:

(i) whether the partner has a tax file number; and

(ii) if the partner has a tax file number—the tax file number; and

(c) the Commissioner of Taxation has not told the Secretary that the partner has no tax file number.

(3) The person satisfies this subsection if:

(a)     the partners declaration states that an application by the partner for a tax file number is pending; and

(b)     the person has given the Secretary a document by the partner that authorises the Commissioner of Taxation to tell the Secretary:

(i) if a tax file number is issued to the partner—the tax file number; or

(ii) if the application is refused—that the application has been refused; or

(iii) if the application is withdrawn—that the application has been withdrawn; and

(c)     the Commissioner of Taxation has not told the Secretary that an application by the partner for a tax file number has been refused; and

(d)     the application for a tax file number has not been withdrawn.

(4) The Secretary may waive the requirement for a statement of the partners tax file number if the Secretary is satisfied that:

(a)     the person does not know the partners tax file number; and

(b)     the person can obtain none of the following from the partner:

(i) the partners tax file number;

(ii) a statement of the partners tax file number;

(iii) a declaration by the partner under subparagraph (1) (c) (ii).


Assets test—allowance not payable if assets value limit exceeded

680. (1) A sickness allowance is not payable to a person if:

(a)       the person is not excluded from the sickness allowance assets test; and

(b)      the value of the persons assets exceeds the persons assets value limit.

(2) A person is excluded from the sickness allowance assets test if the person:

(a)     has not turned 18; and

(b)     is not a member of a couple; and

(c)     does not have a dependent child; and

(d)     is not an independent young person; and

(e)     is not a homeless person.

(3) A persons assets value limit is worked out using the following Table: work out which family situation applies to the person; the assets value limit is the corresponding amount in column 3.

ASSETS VALUE LIMIT TABLE

column 1

column 2

column 3

assets value limit

item

persons family situation

column 3a

either person or partner homeowner

column 3b

neither person nor partner homeowner

1.

Not member of couple

$110,750

$190,250

2.

Partnered (partner getting neither pension nor benefit)

$157,500

$237,000

3.

Partnered (partner getting pension or benefit)

$78,750

$118,500

Note 1: for member of a couple, partnered (partner getting neither pension nor benefit) and partnered (partner getting pension or benefit) see section 4.

Note 2: for homeowner see section 11.

Note 3: if item 2 applies to a person, the value of all the assets of the persons partner is to be taken as being included in the value of the persons assets (see subsection 680 (1)—this is why the assets value limit is so high. If, on the other hand, item 3 applies to a person, the value of the persons assets is only half the combined value of the persons assets and the assets of the persons partner (see subsection 680 (2)).

Note 4: if a job search or newstart allowance is not payable to a person because of the value of the persons assets, the person may be able to take advantage of provisions dealing with financial hardship (sections 1131 and 1132).

Note 5: the assets value limits of items 1 and 3 in column 3a and item 3 in column 3b are indexed annually in line with CPI increases (see sections 1191 to 1194).


Note 6: the assets value limit of item 1 in column 3b is adjusted annually (see subsection 1204 (1)).

Note 7: the item 2 assets value limits are adjusted annually so that they arc twice the corresponding item 3 limits (see subsections 1204 (2) and (3)).

Value of assets of members of couples

681. (1) If:

(a)     the person is a member of a couple; and

(b)     the persons partner:

(i) is not in receipt of a social security or service pension; and

(ii) is not in receipt of a social security allowance;

the value of the persons assets, or of assets of a particular kind of the person, includes the value of the partners assets or of assets of that kind of the partner.

(2) If:

(a)     the person is a member of a couple; and

(b)     the persons partner is in receipt of:

(i) a social security or service pension; or

(ii) a social security allowance;

the value of:

(c)     the persons assets is taken to be 50% of the sum of the value of the persons assets and the value of the partners assets; and

(d)     the persons assets of a particular kind is taken to be 50% of the sum of the value of the assets of that kind of the person and the value of assets of that kind of the persons partner.

Person previously receiving job search allowance (under 18)

682. (1) If:

(a)     a person has not turned 18; and

(b)     the person was receiving a job search allowance immediately before the person became qualified for a sickness allowance;

sickness allowance is not payable to the person.

(2) Subsection (1) does not apply to a person who is qualified for sickness allowance under section 666.

Note: where a person who is receiving a job search allowance becomes qualified for sickness allowance, the person remains qualified for a job search allowance—see subsection 514 (2).

Person previously receiving job search allowance (18 or over)

683. (1) If:

(a)     a person has turned 18; and

(b)     the person was receiving a job search allowance immediately before the person became qualified for a sickness allowance;


sickness allowance is not payable to the person during the period of 6 weeks beginning on the day the person became qualified for a sickness allowance.

(2) Subsection (1) does not apply to a person who is qualified for sickness allowance under section 666.

Note: where a person who has turned 18 is receiving a job search allowance becomes qualified for sickness allowance, the person remains qualified for a job search allowance for 6 weeks—see subsection 514 (3).

Person previously receiving newstart allowance

684. (1) If a person was receiving newstart allowance immediately before the person became qualified for a sickness allowance, sickness allowance is not payable to the person during the period of 13 weeks beginning on the day the person became qualified for a sickness allowance.

(2) Subsection (1) does not apply to a person who is qualified for sickness allowance under section 666.

Note: where a person who is receiving a newstart allowance becomes qualified for sickness allowance, the person remains qualified for newstart allowance—see subsection 594 (2).

Full-time students

685. (1) Subject to subsection (2), sickness allowance is not payable to a person who is enrolled in a full-time course of education or vocational training for the period that:

(a)     starts when the person starts the course; and

(b)     finishes when the person:

(i) completes the course; or

(ii) abandons the course; or

(iii) gives notice to the provider of the course that the person:

(a) wishes to withdraw from the course; or

(b) wishes to withdraw from such number of subjects that the persons course will no longer be a full-time course; and

(c)     includes periods of vacation; and

(d)     does not include periods of deferment.

(2) Subsection (1) does not prevent a sickness allowance from being payable for any period during which:

(a)     a person is enrolled in a course that the Secretary has required the person to undertake under section 696; or

(b)    the person has deferred a course of education.


Multiple entitlement exclusion

686. (1) Sickness allowance is not payable to a person if the person is already receiving a service pension.

(2) If:

(a)     a person is receiving sickness allowance; and

(b)     a social security pension, another social security benefit or service pension becomes payable to the person;

the sickness allowance is not payable to the person.

Note 1: another payment type will generally not become payable to the person until the person claims it.

Note 2: social security benefit includes job search and newstart allowances.

Note 3: for the day on which the sickness allowance ceases to be payable see section 728c.

(3) Sickness allowance is not payable to a woman if:

(a)     the woman is an armed services widow; and

(b)     the woman is receiving:

(i) a pension under Part II or IV of the Veterans Entitlements Act at a rate determined under or by reference to subsection 30 (1) of that Act; or

(ii) a pension under the Seamens War Pensions and Allowances Act 1940 at a rate determined under subsection 18 (2) of that Act;

unless:

(c)     the woman has been receiving a payment referred to in subparagraph (b) (i) or (ii) continuously since before 1 November 1986; and

(d)     before 1 November 1986 the woman was also receiving a social security benefit.

Note: for armed services widow see subsection 4 (1).

(4) Sickness allowance is not payable to a man if the man is a widower who is receiving a pension under Part II or IV of the Veterans Entitlements Act at a rate determined under or by reference to subsection 30 (1) of that Act.

(5) Sickness allowance is not payable to a person for a period if a payment has been or may be made in respect of the person for that period under:

(a)     a prescribed educational scheme other than the ABSTUDY Tertiary Scheme to the extent that it applies to part-time students; or

(b)     the scheme to provide an allowance known as the Adult Migrant Education Program Living Allowance; or

(c)     the scheme to provide an allowance known as the Maintenance Allowance for Refugees; or


(d) the scheme to provide an allowance known as the English as a Second Language Allowance to the extent that the scheme applies to full-time students.

Note: for prescribed educational scheme see section 5.

(6) If:

(a)     a person starts a full-time course of education; and

(b)     a payment under a scheme referred to in subsection (5) may be made in respect of the person;

the Secretary may decide that, in spite of subsection (5), sickness allowance is payable to the person for a period before the person starts the course.

Provisional commencement day

687. (1) A persons provisional commencement day is, subject to subsection (2), the day on which the person becomes incapacitated for work.

(2) If:

(a)     the person is a transferee to the sickness allowance; and

(b)     the person claims the sickness allowance within 4 weeks after the persons transfer day;

the persons provisional commencement day is the persons transfer day.

Note: for transferee to a social security benefit and transfer day see subsections 23 (6) and (7).

(3) If:

(a)     a person is subject to an education leavers waiting period (see subsection 696 (1)); and

(b)     the person became incapacitated for work while undertaking the course of education;

the persons provisional commencement day is the last day on which the person was undertaking the course.

Claim resulting from a major disaster

(4) If a person:

(a)     claims a disaster relief payment; and

(b)     is qualified for the payment; and

(c)     as a result of the major disaster to which the payment relates, claims sickness allowance within 14 days of claiming the disaster relief payment;

the persons provisional commencement day is the day on which he or she was affected by the disaster.


Commencement of sickness allowance

688. (1) If a person is qualified for a sickness allowance, the allowance is not payable to the person before the day worked out in accordance with subsections (2) to (7) and section 689.

Claim within 5 weeks of incapacity and no waiting period applying

(2) If the person:

(a)     claims the allowance within 5 weeks after the day on which the person becomes incapacitated for work; and

(b)     the person is not subject to an ordinary waiting period; and

(c)     the person is not subject to an unused annual leave waiting period;

the allowance is not payable to the person before the persons provisional commencement day.

Note 1: for ordinary waiting period see sections 693 and 694 and for unused annual leave waiting period see sections 690 to 692.

Note 2: for provisional commencement day see section 687.

Claim within 5 weeks of incapacity and ordinary waiting period applying

(3) If the person:

(a)     claims the allowance within 5 weeks after the day on which the person becomes incapacitated for work; and

(b)     the person is subject to an ordinary waiting period;

the allowance is not payable to the person before the first day after the end of the ordinary waiting period.

Note 1: for ordinary waiting period see sections 693 and 694.

Note 2: a person who is a transferee to the sickness allowance and claims within 4 weeks of the persons transfer day will not be subject to an ordinary waiting period.

Note 3: the ordinary waiting period will follow an unused annual leave waiting period if there is one (see subsection 694 (2)).

Claim within 5 weeks of incapacity and unused annual leave waiting period applying

(4) If the person:

(a)     claims the allowance within 5 weeks after the day on which the person becomes incapacitated; and

(b)     the person is subject to an unused annual leave waiting period but not subject to an ordinary waiting period;

the allowance is not payable to the person before the first day after the end of the unused annual leave waiting period.

Note 1: for unused annual leave waiting period see sections 690 to 692 and for ordinary waiting period see sections 693 and 694.

Note 2: if a person is subject to both an ordinary waiting period and an unused annual leave waiting period, the ordinary waiting period will follow the unused annual leave waiting period (see subsection 694 (2)) and subsection (3) of this section will apply.


Claim more than 5 weeks after incapacity and delay due to incapacity (5) If:

(a)     the person claims the allowance more than 5 weeks after the day on which the person becomes incapacitated for work; and

(b)     the Secretary is satisfied that the incapacity is the sole or dominant cause for the failure to claim the allowance within 5 weeks after that day;

the allowance is not payable to the person before the day determined by the Secretary.

(6) The day determined under subsection (5):

(a)     must not be more than 4 weeks before the day on which the person lodges the claim for the allowance; and

(b)     must not, if the person is subject to an ordinary waiting period, be earlier than the first day after the end of the ordinary waiting period; and

(c)     must not, if the person is subject to an unused annual leave waiting period and not subject to an ordinary waiting period, be earlier than the first day after the end of the unused annual leave waiting period.

Claim more than 5 weeks after incapacity and delay not due to incapacity

(7) If:

(a)     the person claims the allowance more than 5 weeks after the day on which the person becomes incapacitated for work; and

(b)     the Secretary is not satisfied that the incapacity is the sole or dominant cause for the failure to claim the allowance within 5 weeks after that day;

the allowance is not payable to the person before the day on which the claim is lodged.

Initial incorrect claim followed by claim for sickness allowance

689. If:

(a) a person makes a claim (in this section called the initial claim) for:

(i) a social security or service pension or a social security allowance; or

(ii) a pension, allowance, benefit or other payment under another Act, or under a program administered by the Commonwealth, that is similar in character to sickness allowance; and

(b) on the day on which the person makes the initial claim, the person is qualified for sickness allowance; and


(c)     the person subsequently makes a claim for sickness allowance; and

(d)     the Secretary is satisfied that it is reasonable for this section to apply to the person;

section 688 applies to the person as if the person had made the claim for sickness allowance on the day on which the person made the initial claim.

Subdivision CSituations where allowance not payable (waiting periods)

Unused annual leave waiting period

690. A person is subject to an unused annual leave waiting period if:

(a)     the persons employment with an employer has ended; and

(b)     when that employment ended, the person became entitled to receive a payment for unused annual leave; and

(c)     the persons provisional commencement day occurs within the notional leave period.

Note 1: for unused annual leave see subsection 23 (1).

Note 2: for notional leave period see section 691.

Note 3: for provisional commencement day see section 687.

Notional leave period

691. (1) A persons notional leave period is the period that:

(a)     starts on the day after the day on which the persons employment has ended; and

(b)     runs for the number of days for which the person has unused annual leave as calculated under subsections (2) and (3).

(2) Subject to subsection (3), the number of days for which the person has unused annual leave is worked out as follows:

(a)     if the period of unused annual leave is expressed in weeks—multiply by 7 the number of weeks (including fractions of weeks) in the period of unused annual leave and disregard any fraction that results;

(b)     in any other case—multiply by 7 the number of working weeks (including any fraction of a working week) represented by the period of unused annual leave and disregard any fraction that results.

(3) The number of days for which a person has unused annual leave cannot exceed 28 days.


Duration of unused annual leave waiting period

692. A persons unused annual leave waiting period starts on the persons provisional commencement day and finishes on the last day of the notional leave period.

Note 1: for notional leave period see section 691.

Note 2: an unused leave waiting period may apply to a person whether or not the person is subject to an ordinary waiting period. If the person is subject to an ordinary waiting period, that period will start after the unused leave waiting period—see subsection 694 (2).

Note 3: for provisional commencement day see section 687.

Ordinary waiting period

693. A person is subject to an ordinary waiting period unless:

(a)     immediately before becoming qualified for the sickness allowance, the person was receiving a job search allowance or a newstart allowance; or

(b)     the person has served an ordinary waiting period that ended not more than 12 weeks before the persons provisional commencement day; or

(c)     the person is a transferee to the sickness allowance and claims the sickness allowance within 4 weeks after the persons transfer day; or

(d)     the person has been in receipt of sickness allowance in respect of any period during the 4 weeks immediately before the persons current claim for sickness allowance is made.

Note 1: for transferee and transfer day to a social security benefit see subsections 23 (6) and (7).

Note 2: for provisional commencement day see section 687.

Duration of ordinary waiting period

No unused annual leave waiting period

694. (1) If a person:

(a)     is subject to an ordinary waiting period; and

(b)     is not subject to an unused annual leave waiting period; and

(c)     is not disqualified for sickness allowance under section 676 (liquid assets test);

the ordinary waiting period is the period of 7 days that starts on the persons provisional commencement day.

Unused annual leave waiting period

(2) If a person:

(a)     is subject to an ordinary waiting period; and

(b)     is subject to an unused annual leave waiting period; and

(c)     is not disqualified for sickness allowance under section 676 (liquid assets test);


the ordinary waiting period is the period of 7 days that starts on the day after the day on which the persons unused annual leave waiting period ends.

Note 1: for unused annual leave wailing period see sections 690 to 692.

Note 2: for provisional commencement day see section 687.

(3) If a person:

(a)     is subject to an ordinary waiting period; and

(b)     is not subject to an unused annual leave waiting period; and

(c)     is disqualified for sickness allowance under section 676 (liquid assets test);

the ordinary waiting period is the period of 7 days that starts on the day after the end of the period of 4 weeks referred to in subsections 676 (2), (3) and (4).

(4) If a person:

(a)     is subject to an ordinary waiting period; and

(b)     is subject to an unused annual leave waiting period; and

(c)     is disqualified for sickness allowance under section 676 (liquid assets test);

the ordinary waiting period is the period of 7 days that starts on the day after the end of the period of 4 weeks referred to in subsections 676 (2), (3) and (4).

Education leavers waiting period

Persons subject to waiting period

695. (1) A person is subject to an education leavers waiting period if the person:

(a)     was undertaking a full-time course of education of at least 6 months duration; and

(b)     has stopped the course; and

(c)     was, immediately before stopping the course, receiving neither:

(i) a social security or service pension; nor

(ii) a social security benefit; and

(d)     has a provisional commencement day within 6 months after stopping the course; and

(e)     is not covered by subsection (2) (recipients stopping courses after 4 weeks).

Note: for provisional commencement day see section 687.

No education leavers waiting period in some cases where already served

(2) A person who would otherwise be subject to an education leavers waiting period in relation to sickness allowance is not subject to such a period if:


(a)     the person had previously been subject to an education leavers waiting period; and

(b)    an unemployment benefit, newstart allowance, job search allowance or sickness allowance had been payable to the person continuously from the end of the education leavers waiting period until immediately before the person started the course; and

(c)     the persons provisional commencement day is within 4 weeks after starting the course.

Note 1: for provisional commencement day see section 687.

Note 2: for education leavers waiting period see subsection 23 (1).

Duration of education leavers waiting period

General rule

696. (1) Subject to this section, the education leavers waiting period starts on the persons provisional commencement day and lasts for:

(a) 13 weeks if, on the persons provisional commencement day, the person:

(i) is not a member of a couple; and

(ii) is under 21; and

(iii) does not have a dependent child; or

(b) 6 weeks if, on the persons provisional commencement day, the person:

(i) is a member of a couple; or

(ii) is over 21; or

(iii) has a dependent child.

Note 1: the duration of the education leavers waiting period may be modified by:

(a)   subsections (2) and (3) (change of status during waiting period);

(b)   subsection (5) (periods of employment or periods on special benefit);

(c)   subsection (6) (previous periods of non-payment because of education leavers waiting period);

(d)   subsection (7) (6 months ceiling).

Note 2: for provisional commencement day see section 687.

Change of status in first 6 weeks

(2) Subject to subsection (4), where:

(a) a person who is covered by paragraph (1) (a):

(i) becomes a member of a couple; or

(ii) turns 21; or

(b) a young person becomes a dependent child of a person who is covered by paragraph (1) (a);

within 6 weeks from and including the persons provisional commencement day, the education leavers waiting period starts on the persons provisional commencement day and lasts for 6 weeks.


Note: for provisional commencement day see section 687.

Change of status after 6 weeks

(3) Subject to subsection (4), where:

(a) a person who is covered by paragraph (1) (a):

(i) becomes a member of a couple; or

(ii) turns 21; or

(b) a young person becomes a dependent child of a person who is covered by paragraph (1) (a);

in the period:

(c)     starting at the end of 6 weeks from the persons provisional commencement day; and

(d)     lasting for 6 weeks;

the education leavers waiting period starts on the persons provisional commencement day and ends on the day before the day on which the person is first covered by paragraph (a) or (b).

Note: for provisional commencement day see section 687.

Notification required

(4) For the purposes of subsections (2) and (3):

(a)     a person is not to be taken to have become a member of a couple; and

(b)     a young person is not to be taken to have become a dependent child of a person;

until the person notifies the Department that this is the case.

Reduction of waiting period for periods of special benefit and employment

(5) The waiting period imposed by subsection (1) or (2) is to be reduced by a period equivalent to:

(a)     if the person is subject to a 13 week education leavers waiting period—any period during which the person was employed on a full-time basis after stopping the course; and

(b)     if the person is subject to a 6 week education leavers waiting period—any period during which the person has been employed, at any time, on a full-time basis; and

(c)     any period during which the person was paid special benefit after stopping the course.

Reduction of education leavers waiting period where already partially served

(6) If:

(a) a person is required to serve an education leavers waiting period; and


(b)     the person started the course concerned at a time when an unemployment benefit, sickness benefit, newstart allowance, job search allowance or sickness allowance was not payable to the person because of an education leavers waiting period; and

(c)     the persons provisional commencement day is within 4 weeks after the person started the course concerned;

the duration of the education leavers waiting period is reduced by the number of days of the previous education leavers waiting period that the person had served immediately before starting the course.

Note 1: for provisional commencement day see section 687.

Note 2: for education leavers waiting period see section 23.

6 month ceiling

(7) An education leavers waiting period that applies in respect of a course of study undertaken by a person is not to extend more than 6 months after the person has stopped the course.

Subdivision DSituations where allowance not payable (recipient non-compliance)

Rehabilitation programs

697. The Secretary may request a person who is receiving sickness allowance to undertake a rehabilitation program.

Refusal to attend interview etc.

698. (1) A sickness allowance is not payable to a person if:

(a)     the person is receiving a sickness allowance; and

(b)     the Secretary is of the opinion that the person should:

(i) contact a specified officer of the Department; or

(ii) attend an interview at a specified place; or

(iii) complete a questionnaire; or

(iv) attend a medical, psychiatric or psychological examination; and

(c) the Secretary notifies the person that the person is required to:

(i) contact that officer; or

(ii) attend that interview; or

(iii) complete that questionnaire; or

(iv) attend that examination; or

(v) if the person has undergone an examination—provide to the Secretary a report on that examination in the approved form; and

(d) the Secretary is satisfied that it is reasonable for this section to apply to the person; and


(e) the person does not take reasonable steps to comply with the Secretarys requirements within the time specified in the notice.

Note: the persons allowance will be cancelled or suspended by a determination of the Secretary under section 728l.

(2) A notice under paragraph (1) (c) must be in writing and must inform the person of the effect of this section.

Division 2Claim for sickness allowance

Need for a claim

699. (1) A person who wants to be granted a sickness allowance must make a proper claim for that allowance.

Note: for proper claim see section 700 (form), section 701 (manner of lodgment) and section 702 (residence/presence in Australia).

(2) For the purposes of subsection (1), where:

(a)     a claim for sickness allowance is made by or on behalf of a person; and

(b)    at the time the claim is made, the claim cannot be granted because the person is not qualified for sickness allowance, otherwise than because of section 676 (liquid assets test waiting period);

the claim is taken not to have been made.

Form of claim

700. To be a proper claim, a claim must be made in writing and must be in accordance with a form approved by the Secretary.

Lodgment of claim

701. (1) To be a proper claim, a claim must be lodged:

(a)     at an office of the Department; or

(b)     at a place approved for the purpose by the Secretary; or

(c)     with a person approved for the purpose by the Secretary.

(2) A place or person approved under subsection (1) must be a place or person in Australia.

Claimant must be Australian resident and in Australia

702. Subject to section 703, a claim by a person is not a proper claim unless the person is:

(a)     an Australian resident; and

(b)     in Australia;

on the day on which the claim is lodged.

Note: for Australian resident* see subsection 7 (2).


Temporary absence from Australia

703. For the purposes of section 702, where:

(a)     the person is temporarily absent from Australia; and

(b)     the person is absent in order to seek medical treatment of a kind that is not available in Australia;

the person is taken to be in Australia during:

(c)     if the period does not exceed 3 months—the whole of that period; or

(d)     if the period exceeds 3 months—the first 3 months of that period.

Medical certificate to accompany claim

704. (1) Subject to subsection (2), a claim for sickness allowance must be supported by the certificate of a medical practitioner which states:

(a)     the medical practitioners diagnosis; and

(b)     the medical practitioners prognosis; and

(c)     that the person is incapacitated for work; and

(d)     the period for which the person is incapacitated for work; and

(e)     whether the persons condition is likely to benefit if the person:

(i) receives treatment; or

(ii) undertakes a rehabilitation program.

(2) A certificate under subsection (1) must be in accordance with a form approved by the Secretary.

(3) A persons claim for sickness allowance need not be supported by a medical certificate if the person is claiming to be qualified for sickness allowance under section 667 (participation in a rehabilitation program).

(4) The Secretary may, in special circumstances, direct that subsection (1) or (2) not apply in relation to a claim.

Secretary may require claimant to give statement of partners tax file number

705. If:

(a)     a claimant for sickness allowance is a member of a couple; and

(b)     the claimants partner is in Australia;

the Secretary may require the claimant to give the Secretary a written statement of the tax file number of the claimants partner.

Note 1: for the consequences of a failure to comply with the requirement see section 679.

Note 2: under section 678 the claimant is automatically required to give a statement of the claimants own tax file number.

Note 3: in some cases the requirement can be satisfied by giving the Secretary a declaration by the partner about the partners tax file number and an authority by the partner to the


Commissioner of Taxation to give the Secretary certain information about the partners tax file number: see subsections 679 (2) and (3).

Note 4: the Secretary can waive the requirement in some cases: see subsection 679 (4).

Division 3Determination of claim

Secretary to determine claim

706. The Secretary must, in accordance with this Act, determine the claim.

Grant of claim

707. The Secretary is to determine that the claim is to be granted if the Secretary is satisfied that:

(a)     the person is qualified for a sickness allowance; and

(b)     the allowance is payable.

Date of effect of determination

708. (1) Subject to subsections (2), (3) and (4), a determination under section 707 takes effect on the day on which the determination is made or on such later day or earlier day as is specified in the determination.

Notified decisionreview sought within 3 months

(2) If:

(a)     a decision (in this subsection called the previous decision) is made rejecting a persons claim for sickness allowance; and

(b)     a notice is given to the person advising the person of the making of the previous decision; and

(c)     the person applies to the Secretary under section 1240, within 3 months after the notice is given, for review of the previous decision; and

(d)     a determination granting the claim is made as a result of the application for review;

the determination takes effect on the day on which the previous decision took effect.

Notified decisionreview sought after 3 months

(3) If:

(a)     a decision (in this subsection called the previous decision) is made rejecting a persons claim for sickness allowance; and

(b)     a notice is given to the person advising the person of the making of the previous decision; and

(c)     the person applies to the Secretary under section 1240, more than 3 months after the notice is given, for review of the previous decision; and


(d) a determination granting the claim is made as a result of the application for review;

the determination takes effect on the day on which the person sought the review.

Decision not notified

(4) If:

(a)     a decision (in this subsection called the previous decision) is made rejecting a persons claim for sickness allowance; and

(b)     no notice is given to the person advising the person of the making of the previous decision; and

(c)     the person applies to the Secretary under section 1240 for review of the previous decision; and

(d)     a determination granting the claim is made as a result of the application for review;

the determination takes effect on the day on which the previous decision took effect.

Division 4Rate of sickness allowance

How to work out a persons sickness allowance rate

709. Subject to sections 710, 711 and 712, a persons sickness allowance rate is worked out:

(a)     if the person has not turned 18—using Benefit Rate Calculator A at the end of section 1067; or

(b)    if the person has turned 18—using Benefit Rate Calculator B at the end of section 1068.

Note: for double payments on release from gaol see section 1161.

Limitation on rate—loss of salary, wages or income

General rule

710. (1) If a person is qualified for sickness allowance through subparagraph 666 (1) (d) (i) (loss of salary, wages or other income of a similar nature), the rate per fortnight of the persons allowance is not to exceed the rate that, in the Secretarys opinion, is the rate per fortnight of the salary, wages or other income that the person has lost because of the persons incapacity for work.

Loss of salary, wages or income includes NEIS and FAS payments

(2) For the purposes of subsection (1), the income that a person has lost because of the persons incapacity for work includes:

(a)     a payment received by the person under the New Enterprise Incentive Scheme; and

(b)     any family allowance supplement payable to the person or to the persons partner.


Payment to a substitute

(3) If:

(a)     a person makes a payment to someone else who acts as the persons substitute during a period of incapacity; and

(b)     the Secretary is satisfied that the payment is made justifiably and genuinely;

the Secretary may, for the purposes of subsection (1), regard the payment as income that the person has lost because of the persons incapacity for work.

Limitation on rate—loss of job search or newstart allowance qualification

711. If a person is qualified for sickness allowance through subparagraph 666 (1) (d) (ii) (loss of qualification for allowance), the rate per fortnight of the persons allowance is not to exceed the rate per fortnight of the job search allowance or newstart allowance that would be payable to the person if the person were receiving job search allowance or newstart allowance.

Limitation on rate—transferee

Partner getting wife or carer pension

712. (1) If:

(a)     a person is qualified for sickness allowance through subparagraph 666 (1) (d) (iii) (transfer from social security pension); and

(b)    a wife pension or carer pension was, immediately before the person ceased to receive the social security pension, payable to the persons partner;

the rate per fortnight of the persons allowance is not to exceed the sum of the rates per fortnight of the social security pension and the wife pension or carer pension that was payable to the persons partner.

Other transferee cases

(2) If:

(a)     a person is qualified for sickness allowance through subparagraph 666 (1) (d) (iii) (transfer from social security pension); and

(b)     subsection (1) does not apply to the person;

the rate per fortnight of the persons allowance is not to exceed the rate per fortnight of the social security pension.

Sickness allowance recipient may ask Secretary to change appropriate tax year

713. (1) If:

(a) the maximum basic rate of a persons sickness allowance has been reduced because of the parental income test provided in Module G of Benefit Rate Calculator A (see section 1067); and


(b)     the person asks the Secretary to make a determination under this section; and

(c)     the taxable income of the persons income test parent or parents for the tax year in which the request is made is 75% or less than 75% of the taxable income of the income test parent or parents for the tax year that is the appropriate tax year immediately before the request is made;

the Secretary must determine that the appropriate tax year, for the purposes of applying that Module to the person for the period:

(d) starting on the day on which the request is made; and

(e) finishing on the first anniversary of that day;

is the tax year in which the request is made.

(2) A request under paragraph (1) (b) must be made in writing, in accordance with a form approved by the Secretary.

(3) Terms used in subsection (1) have the same meaning as they have in Module G of Benefit Rate Calculator A.

Rate of persons receiving sickness allowance with rent assistance since before 1 July 1987

714. If:

(a) immediately before 1 July 1987:

(i) sickness benefit was payable to a person; and

(ii) an allowance was payable to the person under section 120 of the 1947 Act (supplementary allowance for rent); and

(b)     sickness benefit was payable to the person continuously from 1 July 1987 to 30 September 1991; and

(c)     sickness allowance has been payable to the person continuously from 1 October 1991;

the maximum payment rate of the person must be not less than twice the sum of:

(d)     the rate of sickness benefit payable to the person immediately before 1 July 1987 without applying section 122 of the 1947 Act (income and assets test); and

(e)     the rate of the allowance payable to the person immediately before 1 July 1987 under section 120 of the 1947 Act (supplementary allowance for rent).

Division 5Payment of sickness allowance

Commencement of sickness allowance

715. Sickness allowance becomes payable to a person on the first day on which:

(a) the person is qualified for the allowance; and


(b) no provision of this Act makes the allowance not payable to the person.

Note 1: for qualification see sections 666 and 667.

Note 2: for the circumstances in which a sickness allowance is not payable see section 677.

Instalments

716. (1) Sickness allowance is to be paid by instalments for periods determined by the Secretary.

(2) Instalments of sickness allowance are to be paid at the times determined by the Secretary.

Instalments for period less than a fortnight

717. (1) If:

(a)     an instalment of sickness allowance is for a period; and

(b)     the period is less than a fortnight;

the instalment for the period is:

(2) If:

(a)     an instalment of sickness allowance is for a period; and

(b)     the period consists of:

(i) a number of whole fortnights; and

(ii) a period that is less than a fortnight;

the instalment, insofar as it relates to the period that is less than a fortnight, is:

Rounding off instalment

718. (1) If the amount of an instalment is:

(a)     a number of whole dollars and a part of a cent; or

(b)     a number of whole dollars and cents and a part of a cent;

the amount is, subject to subsection (2), to be increased or decreased to the nearest whole cent.

(2) If the amount of an instalment is:

(a)     a number of whole dollars and 0.5 cent; or

(b)     a number of whole dollars and cents and 0.5 cent;

the amount is to be increased by 0.5 cent.

(3) If, apart from this section, the amount of an instalment would be less than $1.00, the amount is to be increased to $1.00.


Payment to person

719. A persons sickness allowance is, subject to section 720, to be paid to that person.

Nominee payments

720. (1) The Secretary may direct that the whole, or a part, of the amount of sickness allowance payable to a person is to be paid to someone else on behalf of the person.

(2) If the Secretary makes a direction under subsection (1), the sickness allowance is to be paid in accordance with the direction.

Payment into bank account etc.

721. (1) Subject to subsection (6), sickness allowance payable to a person is to be paid, at the intervals that the Secretary specifies, to the credit of a bank account, credit union account or building society account.

(2) The account must be an account nominated and maintained by the person to whom the sickness allowance is payable.

(3) The account may be an account that is maintained by a person to whom the sickness allowance is payable either alone or jointly or in common with another person.

(4) Where a person to whom sickness allowance is payable has not nominated an account for the purposes of subsection (1), then, subject to subsection (6), that allowance is not to be paid.

(5) Where:

(a)       a person is not being paid sickness allowance because of subsection (4); and

(b)      the person nominates an account for the purposes of subsection (1);

the allowance (including any amounts that would have been paid but for subsection (4)) is to be paid under subsection (1).

(6) The Secretary may direct that the whole or a part of an amount of sickness allowance that is payable to a person may be paid to the person in a different way from that provided for by subsection (1).

(7) If the Secretary gives a direction under subsection (6), the sickness allowance is to be payable in accordance with the direction.

Where allowance payday would fall on public holiday etc.

722. If the Secretary is satisfied that an amount of sickness allowance that would normally be paid on a particular day cannot reasonably be paid on that day (because, for example, it is a public


holiday or a bank holiday), the Secretary may direct that the amount be paid on an earlier day.

Payment of allowance after death

723. (1) If:

(a)     a sickness allowance is payable to a person; and

(b)     the person dies; and

(c)     at the date of the persons death the person had not received an amount of sickness allowance payable to him or her; and

(d)     another person applies to receive that amount; and

(e)     the application is made:

(i) within 6 months after the death; or

(ii) within a further period allowed by the Secretary in special circumstances;

the Secretary may pay the amount to the person who, in the Secretarys opinion, is best entitled to it.

(2) If the Secretary pays an amount of sickness allowance under subsection (1), the Commonwealth has no further liability to any person in respect of that amount of sickness allowance.

Division 6Protection of sickness allowance

Sickness allowance to be absolutely inalienable

724. (1) Subject to subsection (2) and section 1359, sickness allowance is absolutely inalienable, whether by way of, or in consequence of, sale, assignment, charge, execution, bankruptcy or otherwise.

Payments to Commissioner of Taxation at recipients request

(2) The Secretary may make deductions from the instalments of sickness allowance payable to a person where the recipient asks the Secretary:

(a)     to make the deductions; and

(b)     to pay the amounts to be deducted to the Commissioner of Taxation.

Note: the Secretary must make deductions from a persons allowance if requested by the Commissioner of Taxation—see section 1359.

Effect of garnishee or attachment order

725. (1) If:

(a)     a person has an account with a financial institution; and

(b)     instalments of sickness allowance payable to the person (whether on the persons own behalf or not) are being paid to the credit of that account; and


(c)     a court order in the nature of a garnishee order comes into force in respect of the account;

the court order does not apply to the saved amount (if any) in the account.

“(2) The saved amount is worked out as follows:

Method statement

Step 1.

Work out the total amount of sickness allowance payable to the person that has been paid to the credit of the account during the 4 week period immediately before the court order came into force.

Step 2.

Subtract from that amount the total amount withdrawn from the account during the same 4 week period: the result is the saved amount.

(3) This section applies to an account whether it is maintained by a person:

(a)    alone; or

(b)    jointly with another person; or

(c)    in common with another person.

Division 7Recipient obligations

Secretary may require recipient to give statement of partners tax file number

726. If:

(a)     a sickness allowance recipient is a member of a couple; and

(b)     the recipients partner is in Australia;

the Secretary may require the recipient to give the Secretary a written statement of the tax file number of the recipients partner.

Note 1: for the consequences of a failure to comply with the requirement see section 679.

Note 2: in some cases the requirement can be satisfied by giving the Secretary a declaration by the partner about the partners tax file number and an authority by the partner to the Commissioner of Taxation to give the Secretary certain information about the partners tax file number: see subsections 679 (2) and (3).

Note 3: the Secretary can waive the requirement in some cases: see subsection 679 (4).

Secretary may require notice of the happening of an event or a change in circumstances

727. (1) The Secretary may give a person to whom a sickness allowance is being paid a notice that requires the person to inform the Department if:

(a)     a specified event or change of circumstances occurs; or

(b)     the person becomes aware that a specified event or change of circumstances is likely to occur.


(2) An event or change of circumstances is not to be specified in a notice under subsection (1) unless the occurrence of the event or change of circumstances might affect the payment of the allowance.

(3) A notice under subsection (1):

(a)     must be in writing; and

(b)     may be given personally or by post; and

(c)     must specify how the person is to give the information to the Department; and

(d)     must specify the period within which the person is to give the information to the Department; and

(e)     must specify that the notice is given under this section.

(4) The period specified under paragraph (3) (d) must end at least 7 days after:

(a)     the day on which the event or change of circumstances occurs; or

(b)     the day on which the person becomes aware that the event or change of circumstances is likely to occur.

(5) A person must not refuse or fail to comply with a notice under subsection (1) to the extent that the person is capable of complying with the notice.

Penalty: $1,000 or imprisonment for 6 months, or both.

(6) A person must not, in purporting to comply with a notice under subsection (1), knowingly or recklessly give information that is false or misleading in a material particular.

Penalty: $1,000 or imprisonment for 6 months, or both.

(7) This section extends to:

(a)     acts, omissions, matters and things outside Australia whether or not in a foreign country; and

(b)    all persons irrespective of their nationality or citizenship.

Secretary may require recipient to give particular information relevant to payment of sickness allowance

728. (1) The Secretary may give a person to whom a sickness allowance is being paid a notice that requires the person to give the Department a statement about a matter that might affect the payment of the allowance to the person.

(2) A notice under subsection (1):

(a)     must be in writing; and

(b)     may be given personally or by post; and

(c)     must specify how the statement is to be given to the Department; and


(d)     must specify the period within which the person is to give the statement to the Department; and

(e)     must specify that the notice is given under this section.

(3) The period specified under paragraph (2) (d) must end at least 7 days after the day on which the notice is given.

(4) A statement given in response to a notice under subsection (1) must be in writing and in accordance with a form approved by the Secretary.

(5) A person must not refuse or fail to comply with a notice under subsection (1) to the extent that the person is capable of complying with the notice.

Penalty: $1,000 or imprisonment for 6 months, or both.

(6) A person must not, in purporting to comply with a notice under subsection (1), knowingly or recklessly give information that is false or misleading in a material particular.

Penalty: $1,000 or imprisonment for 6 months, or both.

(7) This section extends to:

(a)     acts, omissions, matters and things outside Australia whether or not in a foreign country; and

(b)     all persons irrespective of their nationality or citizenship.

Self incrimination

728a. (1) A person is not excused from giving information pursuant to a notice under section 727 or 728 on the ground that the information may tend to incriminate the person.

(2) Information given by a person pursuant to a notice under section 727 or 728 is not admissible in evidence against the person in a criminal proceeding other than a proceeding under, or arising out of, subsection 727 (5) or (6) or 728 (5) or (6).

Division 8Continuation, variation and termination

Subdivision AGeneral

Continuing effect of determination

Entitlement determination

728b. (1) A determination that:

(a)     a persons claim for sickness allowance is granted; or

(b)    a sickness allowance is payable to a person;

continues in effect until:

(c) the allowance ceases to be payable under section 728c, 728d, 728e or 728f; or


(d) a further determination in relation to the benefit under section 728l or 728m has taken effect.

Note 1: for paragraph (a) see section 706.

Note 2: for paragraph (b) see section 728p—this paragraph is relevant where the determination in question reverses an earlier cancellation or suspension.

Rate determination

(2) A determination of the rate of a sickness allowance continues in effect until:

(a)     the allowance becomes payable at a lower rate under section 728g or 728h; or

(b)     a further determination in relation to the allowance under section 728j or 728k has taken effect.

Subdivision BAutomatic termination

Automatic termination when maximum allowance period ends

728c. If:

(a)     a person is receiving sickness allowance; and

(b)     the person ceases to be qualified for sickness allowance under section 669, 670, 672 or 673;

the allowance ceases to be payable to the person immediately after the day on which the person so ceases to be qualified.

Automatic termination—transfer to new payment type

728d. If:

(a)     a person is receiving sickness allowance; and

(b)     a social security pension, another social security benefit or service pension becomes payable to the person;

the sickness allowance ceases to be payable to the person immediately before the day on which the other pension or benefit becomes payable to the person.

Automatic termination—recipient complying with section 727 notification obligations

728e. If:

(a)     a person who is receiving sickness allowance is given a notice under section 727; and

(b)     the notice requires the person to inform the Department of the occurrence of an event or change in circumstances within a specified period (in this section called the notification period); and

(c)     the event or change in circumstances occurs; and

(d)     the person informs the Department of the occurrence of the


event or change in circumstances within the notification period in accordance with the notice; and

(e) because of the occurrence of the event or change in circumstances:

(i) the person ceases to be qualified for the allowance; or

(ii) the allowance would, but for this section, cease to be payable to the person; and

(f) the allowance is not cancelled before the end of the notification period;

the allowance continues to be payable to the person until the end of the notification period and then ceases to be payable to the person.

Note: if the person informs the Department, within the notification period, of an event or change in circumstances that reduces the rate of the persons allowance, there is no automatic rate reduction and a determination under section 728k must be made in order to bring the rate reduction into effect.

Automatic termination—recipient not complying with section 727 notification obligations

728f. If:

(a)     a person who is receiving sickness allowance is given a notice under section 727; and

(b)     the notice requires the person to inform the Department of the occurrence of an event or change in circumstances within a specified period (in this section called the notification period); and

(c)     the event or change in circumstances occurs; and

(d)     the person does not inform the Department of the occurrence of the event or change in circumstances within the notification period in accordance with the notice; and

(e)     because of the occurrence of the event or the change in circumstances:

(i) the person ceases to be qualified for the allowance; or

(ii) the allowance ceases to be payable to the person;

the allowance ceases to be payable to the person immediately after the day on which the event or change in circumstances occurs.

Subdivision CAutomatic rate reduction

Automatic rate reduction—partner starting to receive pension or benefit

728g. If:

(a)     a person is receiving sickness allowance; and

(b)     the persons partner starts to receive:

(i) a social security pension or benefit; or

(ii) a service pension; and


(c) the persons sickness allowance rate is reduced because of the partners receipt of that pension or benefit;

the sickness allowance becomes payable to the person at the reduced rate on the day on which the partner starts to receive that pension or benefit.

Automatic rate reduction—recipient not complying with section 727 notification obligations

728h. If:

(a)     a person who is receiving sickness allowance is given a notice under section 727; and

(b)     the notice requires the person to inform the Department of the occurrence of an event or change in circumstances within a specified period (in this section called the notification period); and

(c)     the event or change in circumstances occurs; and

(d)     the person does not inform the Department of the occurrence of the event or change in circumstances within the notification period in accordance with the notice; and

(e)     because of the occurrence of the event or change in circumstances, the persons rate of allowance is to be reduced;

the allowance becomes payable to the person at the reduced rate immediately after the day on which the event or change in circumstances occurs.

Subdivision DDeterminations

Rate increase determination

728j. If the Secretary is satisfied that the rate at which sickness allowance is being, or has been, paid is less than the rate provided for by this Act, the Secretary is to determine that the rate is to be increased to the rate specified in the determination.

Note: for the date of effect of a determination under this section see section 728q.

Rate reduction determination

728k. If the Secretary is satisfied that the rate at which sickness allowance is being, or has been, paid is more than the rate provided for by this Act, the Secretary is to determine that the rate is to be reduced to the rate specified in the determination.

Note 1: a determination under this section is not necessary in a case where an automatic rate reduction is produced by section 728h (sec subsection 728b (2)).

Note 2: for the date of effect of a determination under this section see section 728r.


Cancellation or suspension determination

728l. If the Secretary is satisfied that sickness allowance is being, or has been, paid to a person to whom it is not, or was not, payable under this Act, the Secretary is to determine that the allowance is to be cancelled or suspended.

Note 1: a determination under this section is not necessary in a case where an automatic termination is produced by section 728e or 728f (see subsection 728b (1)).

Note 2: for the date of effect of a determination under this section see section 728r.

Cancellation or suspension for failure to comply with section 727, 1304 or 1305 notice

728m. If:

(a)     a person who is receiving a sickness allowance is given a notice under section 727, 1304 or 1305 requiring the person to give the Department a statement; and

(b)    the person does not comply with the notice;

the Secretary may determine that the allowance is to be cancelled or suspended.

Note 1: this section will not apply in a case where section 728l applies.

Note 2: for the date of effect of a determination under this section, see section 728r.

Changes to payments by computer

728n. If:

(a)     payment of a sickness allowance to a person is based upon data in a computer, and

(b)     the pension rate is increased or reduced, or the pension is cancelled or suspended, because of the operation of a computer program approved by the Secretary; and

(c)     the program causes the change for a reason for which the Secretary could determine the change;

the change is taken to have been made because of a determination by the Secretary for that reason.

Resumption of payment after cancellation or suspension

728p. (1) If the Secretary:

(a)     cancels or suspends a persons sickness allowance under section 728l or 728m; and

(b)     reconsiders the decision to cancel or suspend; and

(c)     becomes satisfied that because of the decision to cancel or suspend:

(i) the person did not receive sickness allowance that was payable to the person; or

(ii) the person is not receiving sickness allowance that is payable to the person;


the Secretary is to determine that sickness allowance was or is payable to the person.

(2) The reconsideration referred to in paragraph (1) (b) might be a reconsideration on an application under section 1240 for review or a reconsideration on the Secretarys own initiative.

Note: for the date of effect of a determination under this section see section 728q.

Subdivision EDate of effect of determinations

Date of effect of favourable determination

728q. (1) The day on which a determination under section 728j or 728p (in this section called the favourable determination) takes effect is worked out in accordance with this section.

Notified decisionreview sought within 3 months

(2) If:

(a)     a decision (in this subsection called the previous decision) is made in relation to a sickness allowance; and

(b)     a notice is given to the person to whom the allowance is payable advising the person of the making of the previous decision; and

(c)     the person applies to the Secretary under section 1240, within 3 months after the notice is given, for review of the previous decision; and

(d)     a favourable determination is made as a result of the application for review; and

(e) subsections (6), (7) and (8) do not apply to the determination;

the determination takes effect on the day on which the previous decision took effect.

Notified decisionreview sought after 3 months

(3) If:

(a)     a decision (in this subsection called the previous decision) is made in relation to a sickness allowance; and

(b)     a notice is given to the person to whom the allowance is payable advising the person of the making of the previous decision; and

(c)     the person applies to the Secretary under section 1240, more than 3 months after the notice is given, for review of the previous decision; and

(d)     a favourable determination is made as a result of the application for review; and

(e)     subsections (6), (7) and (8) do not apply to the determination;

the determination takes effect on the day on which the person sought the review.


Decision not notified

(4) If:

(a)     a decision (in this subsection called the previous decision) is made in relation to a sickness allowance; and

(b)     no notice is given to the person to whom the allowance is payable advising the person of the making of the previous decision; and

(c)     the person applies to the Secretary under section 1240, for review of the previous decision; and

(d)     a favourable determination is made as a result of the application for review; and

(e) subsections (6), (7) and (8) do not apply to the determination; the determination takes effect on the day on which the previous decision took effect.

Notified change of circumstances

(5) If:

(a)     the favourable determination is made after a person has advised the Department of a change in circumstances; and

(b)    the change is not a decrease in the rate of the persons maintenance income;

the determination takes effect on the day on which the advice was received or on the day on which the change occurred, whichever is the later.

Prescribed student child determination

(6) If:

(a)     the favourable determination is made as a result of the Secretary forming the opinion for the purposes of subsections 5 (12) and (13) that a young person will not, or would not, receive payments under a prescribed educational scheme; and

(b)     the Secretary is notified that the young person has been refused payment under a prescribed educational scheme within 28 days after the person is notified of that refusal;

the determination takes effect on the day when the determination is made or on such earlier or later day as is specified in the determination.

(7) If:

(a)     the favourable determination is made because, under subsection 5 (13), a young person is not qualified to receive a payment under a prescribed educational scheme; and

(b)     the young person, or another person, was previously in receipt of a payment under a prescribed educational scheme in respect of that young person, and the young person or other person has since ceased to receive that payment; and


(c) the Secretary was notified, within 28 days after the payment was granted, that it was no longer being received;

the determination takes effect on the day when the determination is made or such earlier or later day as is specified in the determination.

(8) If:

(a)     the favourable determination is made because, under paragraph 5 (12) (c), a young person is not qualified to receive payments under any of the prescribed educational schemes; and

(b)     no applications have been made for payments in respect of that young person under any of the prescribed educational schemes; and

(c)     the Secretary is satisfied that it is reasonable for such applications not to be made; and

(d)     the young person ceased to be a prescribed student child because of the operation of paragraph 5 (12) (c) within 3 months after becoming a prescribed student child;

the determination takes effect on the day on which the young person became a prescribed student child.

Other determinations

(9) In any other case, the favourable determination takes effect on the day on which the determination was made or on such later day or earlier day (not being a day more than 3 months before the determination was made) as is specified in the determination.

Date of effect of adverse determination

General

728r. (1) The day on which a determination under section 728k, 728l or 728m (in this section called the adverse determination) takes effect is worked out in accordance with this section.

Note: if the adverse determination depends on a discretion or opinion and a person affected by the determination applies for review, the Secretary may continue payment pending the outcome of the review: see section 1241 (internal review) and section 1251 (review by Social Security Appeals Tribunal).

(2) The adverse determination takes effect on:

(a)     the day on which the determination is made; or

(b)     if another day is specified in the determination—on that day.

(3) Subject to subsections (4), (5) and (6), the day specified under paragraph (2) (b) must be later than the day on which the determination is made.

Contravention of Act

(4) If:

(a) the person whose allowance is affected by the adverse


determination has contravened a provision of this Act (other than section 727, 1304, 1305, 1306 or 1307); and

(b) the contravention causes a delay in making the determination;

the day specified under paragraph (2) (b) may be earlier than the day on which the determination is made.

False statement or misrepresentationsuspension or cancellation

(5) If:

(a)     a person has made a false statement or misrepresentation; and

(b)    because of the false statement or misrepresentation, the allowance has been paid to a person when it should have been cancelled or suspended;

the day specified under paragraph (2) (b) may be earlier than the day on which the determination is made.

False statement or misrepresentationrate reduction

(6) If:

(a)     a person has made a false statement or misrepresentation; and

(b)    because of the false statement or misrepresentation, the rate at which the allowance was paid to a person was more than it should have been;

the day specified under paragraph (2) (b) may be earlier than the day on which the determination is made.

Division 9Bereavement payments

Subdivision ADeath of dependent child

Bereavement payments on death of dependent child

728s. If:

(a)     a person is receiving sickness allowance; and

(b)     a dependent child of the person dies; and

(c)     immediately before the child died, the persons sickness allowance rate included:

(i) a dependent child add-on in respect of the child; or

(ii) guardian allowance in respect of the child;

the person is qualified for payments under this Division to cover the bereavement period.

Note 1: section 728t provides for sickness allowance to be paid to the person, up to the first available bereavement adjustment payday, at the rate at which it would have been paid if the child had not died but were disregarded for the purposes of working out the persons income test free areas.

Note 2: section 728u provides for a lump sum to be paid to the person if the person was receiving family allowance for the child and the first available bereavement adjustment payday occurs before the end of the bereavement period: the lump sum represents the difference, over the bereavement lump sum period, between the persons new sickness allowance rate and the rate at which the allowance would have been paid if the child


had not died but were disregarded for the purposes of working out the persons income test free areas.

Note 3: the additional payments preserved by this Division are:

dependent child add-on;

guardian allowance;

additional rent assistance;

additional remote area allowance.

Continued payment of child-related amounts

728t. If a person is qualified for payments under this Division in relation to the death of a dependent child, the persons sickness allowance rate during the bereavement rate continuation period is to be calculated as if:

(a)     the child had not died; and

(b)     the child was disregarded in calculating the persons ordinary income free area and maintenance income free area.

Lump sum payable in some circumstances

728u. If:

(a)     a person is qualified for payments under this Division in relation to the death of a dependent child; and

(b)     the first available bereavement adjustment payday occurs before the end of the bereavement period; and

(c)     the person was, immediately before the child died, receiving family allowance in respect of the child;

a lump sum (worked out using the lump sum calculator at the end of this section) is payable to the person.

Note: if the person qualified for payments under this Division was not receiving family allowance in respect of the dependent child and somebody else was receiving family allowance in respect of the dependent child, a corresponding lump sum may be payable to the other person under section 890.


LUMP SUM CALCULATOR

This is how to work out the amount of the lump sum:

Method statement

Step 1.

Work out the amount of sickness allowance payable to the person on the payday immediately before the first available bereavement adjustment payday: the result is called the continued rate.

 

Note: section 728t applies in working out this amount because the payday on which it is payable is within the bereavement rate continuation period.

Step 2.

Work out the amount of sickness allowance that would have been payable to the person on the payday immediately before the first available bereavement adjustment payday if the persons sickness allowance rate were not calculated under section 728t: the result is called the new rate.

Step 3.

Take the new rate away from the continued rate: the result is called the deceased child component.

Step 4.

Work out the number of paydays in the bereavement lump sum period.

Step 5.

Multiply the deceased child component by the number of paydays in the bereavement lump sum period: the result is the amount of the lump sum payable to the person under this section.

Subdivision BDeath of recipient

Death of recipient

728v. (1) If:

(a)     a person is receiving a sickness allowance; and

(b)     the person is a member of a couple; and

(c)     the person dies; and

(d)     the person:

(i) was qualified at the time of the persons death for payments under Subdivision A in relation to the death of a dependent child; or

(ii) would have been so qualified if the person had not died; and

(e) the persons partner claims the payments referred to in paragraph (d) within 3 months after the death of the child;

there is payable to the partner an amount equal to the sum of the following amounts:


(f) the difference between:

(i) the amount of sickness allowance that would have been payable to the person under section 728t if the person had not died; and

(ii) the amount of sickness allowance that would have been payable to the person apart from Subdivision A for the same period if the person had not died;

(g) any lump sum that would have been payable to the person under section 728u if the person had not died.

(2) If:

(a)     a person is receiving a sickness allowance; and

(b)     the person is not a member of a couple; and

(c)     the person dies; and

(d)     the person:

(i) was qualified at the time of the persons death for payments under Subdivision A in relation to the death of a dependent child; or

(ii) would have been so qualified if the person had not died;

there is payable, to such person as the Secretary thinks appropriate, an amount equal to the sum of the following amounts:

(e) the difference between:

(i) the amount of sickness allowance that would have been payable to the person under section 728t if the person had not died; and

(ii) the amount of sickness allowance that would have been payable to the person apart from Subdivision A for the same period if the person had not died;

(f) any lump sum that would have been payable to the person under section 728u if the person had not died..

Qualification for mobility allowance

15. Section 1035 of the Principal Act is amended:

(a)     by omitting from sub-subparagraph (a) (iii) (c) 20 and substituting 8;

(b)    by omitting from sub-subparagraph (b) (iii) (c) 20 and substituting 8.

Rate of mobility allowance

16. (1) Section 1044 of the Principal Act is amended by omitting $22 and substituting $40.

(2) The amendment made by subsection (1) applies in relation to payments that fall due on or after 12 November 1991.


Effect on mobility allowance when person ceases to be qualified

17. Section 1058 of the Principal Act is amended by omitting from paragraph (1) (b) 20 and substituting 8.

Rate of age, disability support (over 20), wife and carer pensions (people who are not blind)

18. Section 1064 of the Principal Act is amended by omitting paragraph (1) (b) and substituting the following paragraph:

(b) disability support pension of a person who has turned 21; and.

Rate of age and disability support (over 20) pensions (blind people)

19. Section 1065 of the Principal Act is amended by omitting paragraph (1) (b) and substituting the following paragraph:

(b) disability support pension of a person who:

(i) is permanently blind; and

(ii) has turned 21;.

20. After Part 3.4 of Chapter 3 of the Principal Act the following Parts are inserted:

PART 3.4A—PENSION RATE CALCULATOR D

Rate of disability support pension (people under 21 who are not blind)

1066a. (1) The rate of disability support pension of a person who has not turned 21 is, subject to subsection (2), to be calculated in accordance with the Rate Calculator at the end of this section.

Note: Module A of the Rate Calculator establishes the overall rate calculation process and the remaining Modules provide for the calculation of the component amounts used in the overall rate calculation.

(2) Subsection (1) does not apply to a persons disability support pension if the person is permanently blind.

Note: the rate for a disability support pension payable to a person under 21 who is permanently blind is dealt with in section 1066B.

(3) A persons pension rate is not to exceed the rate at which a pension would be payable to that person if the persons rate were calculated using Pension Rate Calculator A at the end of section 1064.

(4) If:

(a)     a person is a member of a couple; and

(b)     the persons partner:

(i) is not receiving a social security or service pension; and

(ii) is not receiving a social security benefit;

the persons pension rate is not to exceed twice the rate at which a pension would be payable to that person if the persons partner were receiving a pension or benefit of that kind.


(5) If:

(a)     a person is living with another person as the spouse of that other person on a genuine domestic basis although not legally married to the other person; and

(b)    the other person is of the opposite sex; and

(c)     either or both of them are under the age of consent applicable in the State or Territory in which they are living;

the persons pension rate is not to exceed the rate at which it would be payable to the person if the other person were the persons partner.

Note: this provision has the effect of taking into account the ordinary income, maintenance income and assets of the partner in applying the ordinary income test, maintenance income test and assets test respectively.

PENSION RATE CALCULATOR D

MODULE A—OVERALL RATE CALCULATION PROCESS

Method of calculating rate

1066A-A1. The rate of pension is an annual rate (fortnightly amounts are provided for information only).


Method statement

Step 1.

Work out the persons maximum basic rate using MODULE B below.

Step 2.

Work out the amount per year for youth disability, Supplement using MODULE C below.

Step 3.

Work out the amount per year (if any) for dependent children using MODULE D below.

Step 4.

Work out the amount per year (if any) for rent using MODULE EA below for persons under 18 and MODULE EB below for persons who have turned 18.

Step 5.

Add up the amounts obtained in Steps 1, 2, 3 and 4: the result is called the maximum payment rate.

Step 6.

Apply the ordinary income test using MODULE F below to work out the reduction for ordinary income.

Step 7.

Apply the maintenance income test using MODULE G below to work out the reduction for maintenance income.

Step 8.

Add up the reduction for ordinary income and the reduction for maintenance income: the result is called the total income reduction.

Step 9.

Take the total income reduction away from the maximum payment rate: the result is called the income reduced rate.

Step 10.

Apply the assets test using MODULE H below to work out the reduction for assets.

Step 11.

Take the reduction for assets away from the maximum payment rate: the result is called the assets reduced rate.

Step 12.

Compare the income reduced rate and the assets reduced rate: the rate of pension is:

 

(a) the income reduced rate if it is lower than the assets reduced rate; or

 

(b) the assets reduced rate if it is lower than the income reduced rate; or

 

(c) the income reduced rate if the income reduced rate and the assets reduced rate are exactly equal;

 

plus any amount per year payable by way of remote area allowance (see MODULE I below).

Note: 1: if a persons assets reduced rate is less than the persons income reduced rate, the person may be able to take advantage of provisions dealing with:

  financial hardship (sections 1129 and 1130);

  pensions loan scheme (section 1133).

Note 2: if a persons rate is reduced under Step 12 the order in which the reduction is to be made against the components of the maximum payment rate is laid down by section 1207 (maximum basic rate and youth disability supplement first, then rent assistance and finally child amounts).


Note 3: the rate calculation for a member of a couple is affected by the operation of points 1066A-A2.

Note 4: points 1066A-A3 and 1066A-A4 explain the special treatment given to certain members of couples with dependent children.

Members of a couple

1066A-A2. Where 2 people are members of a couple, they will be treated as pooling their resources (income and assets) and sharing them on a 50/50 basis (see points 1066A-F2, 1066A-G3 and 1066A-H2 below). They will also be treated as sharing expenses (e.g. for rent) on a 50/50 basis (see points 1066A-EA14, 1066A-EA15, 1066A-EB15 and 1066A-EB16 below).

Explanation/background informationpensioner couples with dependent children

1066A-A3. This Rate Calculator has special income and assets test rules for pensioner couples with dependent children (see points 1066A-F9 to 1066A-F11, points 1066A-G5 to 1066A-G14 and points 1066A-H4 to 1066A-H7 below). Without these special rules, pensioner couples with dependent children could, in some circumstances, receive unfairly favourable treatment compared with other couples. This could arise because:

(a)     the member of a pensioner couple to whom dependent children are allocated (see point 1066A-D2 below) starts from a maximum payment rate that is higher than that of the other member of the couple (see Module D below); and

(b)     the ordinary income, maintenance income and assets of the couple are taken to be shared between them on a 50/50 basis (see points 1066A-F2, 1066A-G3 and 1066A-H2 below); and

(c)     the member of the couple who starts from the lower maximum payment rate could reach a nil income reduced rate or a nil assets reduced rate while the other member has an income reduced rate or an assets reduced rate higher than nil; and

(d)     if this occurs, part of the couples ordinary income, maintenance income or assets would not be taken into account in the operation of the income and assets tests.

1066A-A4. To remove this potentially unfairly favourable treatment, this Rate Calculator provides for:

(a)     an initial double reduction for excess income or assets against the additional amounts for dependent children (these are in the hands of the member who is receiving those additional amounts); and

(b)     if any excess income or assets remains—a normal reduction for the remaining excess against the maximum payment rate of each member.


Under these rules, both members of pensioner couples with dependent children should always reach a nil income reduced rate or a nil assets reduced rate at the same time.

MODULE B—MAXIMUM BASIC RATE

Maximum basic rate

1066A-B1. A persons maximum basic rate is to be worked out using Table B. Work out the family situation and whether the person has a dependent child. The maximum basic rate is the corresponding amount in column 3.


TABLE B

MAXIMUM BASIC RATES

column 1

column 2

column 3

rate per year

column 4

rate per fortnight

item

persons family situation

column 3a

person with dependent child

column 3b

person without dependent child

column 4a

person with dependent child

column 4b

person without dependent child

1.

Not member of a couple and person:

$7,841.60

$3,226.60

$301.60

$124.10

 

(a) has not turned 18; and

 

 

 

 

 

(b) is not a homeless person; and

 

 

 

 

 

(c) is not an independent young person; and

 

 

 

 

 

(d) is not living away from the persons parental home because of medical condition

 

 

 

 

2.

Not member of a couple and person:

$7,841.60

$5,324.80

$301.60

$204.80

 

(a) has not turned 18; and

 

 

 

 

 

(b) is:

 

 

 

 

 

(i) a homeless person; or

 

 

 

 

 

(ii) an independent young person; or

 

 

 

 

 

(iii) is living away from the persons parental home because of medical condition

 

 

 

 


column 1

column 2

column 3

rate per year

column 4

rate per fortnight

item

person’s family situation

column 3a

person with dependent child

column 3b

person without dependent child

column 4a

person with dependent child

column 4b

person without dependent child

3.

Not member of a couple and person:

$7,841.60

$3,876.60

$301.60

$149.10

 

(a) has turned 18; and

 

 

 

 

 

(b) is living at a home of parent or parents

 

 

 

 

4.

Not member of a couple and person:

$7,841.60

$5,889.00

$301.60

$226.50

 

(a) has turned 18; and

 

 

 

 

 

(b) is not living at a home of parent or parents

 

 

 

 

5.

Partnered (partner getting neither pension nor benefit) and person has not turned 18

$6,539.00

$5,324.80

$251.50

$204.80

6.

Partnered (partner getting neither pension nor benefit) and person has turned 18

$6,539.00

$5,889.00

$251.50

$226.50

7.

Partnered (partner getting pension or benefit) and person has not turned 18

$6,539.00

$5,324.80

$251.50

$204.80

8.

Partnered (partner getting pension or benefit) and person has turned 18

$6,539.00

$5,889.00

$251.50

$226.50

9.

Member of illness separated couple and person has not turned 18.

$7,841.60

$5,324.80

$301.60

$204.80

10.

Member of illness separated couple and person has turned 18

$7,841.60

$5,889.00

$301.60

$226.50


Note 1: for member of a couple, partnered (partner getting neither pension nor benefit), partnered (partner getting pension or benefit) and illness separated couple see section 4.

Note 2: for dependent child, homeless person and independent young person see section 5.

Note 3: for living away from the persons parental home see subsection 23 (4d).

Note 4: the rates in column 3a are adjusted 6 monthly in line with CPI changes (see section 1198a).

Note 5: the rates in column 3b are adjusted annually in line with CPI changes (see section 1198b).

MODULE C—YOUTH DISABILITY SUPPLEMENT

Youth disability supplement

1066A-C1. An amount by way of youth disability supplement is to be added to a persons rate. The rate of youth disability supplement is $1,557.40 per year ($59.90 per fortnight).

Note: the rate of youth disability supplement is adjusted annually in line with CPI increases (see section 1198c).

MODULE D—ADDITIONAL AMOUNTS FOR DEPENDENT CHILDREN

Additional amounts for dependent children

1066A-D1. This is how to work out the amount per year to be added to a persons maximum basic rate for dependent children:

Method statement

Step 1.

Work out the amount of the dependent child add-on (if any) for each dependent child of the person using points 1066A-D3 to 1066A-D6.

Step 2.

Work out the amount per year of the persons guardian allowance (if any) using points 1066A-D7 to 1066A-D9.

Step 3.

Add up all of the amounts obtained in Steps 1 and 2: the result is called the DC total and is the amount to be added to the persons maximum basic rate under this Module.

Note 1: a dependent child add-on may not apply to a dependent child if reasonable action has not been taken to obtain maintenance in respect of the child (see point 1066A-D4). the child is covered by the Veterans Entitlements Act (see point 1066A-D5) or is a prescribed student child (see point 1066A-D6).

Note 2: guardian allowance is a single amount per year for parents who are not members of a couple or who are members of illness separated couples.

Children of a couple

1066A-D2. If either or both members of a couple have dependent children, this is how the children are taken into account for the purposes of this Module:


(a) a dependent child of the man is to be taken into account as a dependent child of the woman and not of the man unless:

(i) the woman is not receiving a social security pension; or

(ii) the couple is an illness separated couple because of the illness or infirmity of the woman; and

(b) a dependent child of the woman is to be taken into account as a dependent child of the man and not of the woman if:

(i) the woman is not receiving a social security pension; or

(ii) the couple is an illness separated couple because of the illness or infirmity of the woman.

Note 1: the following Table summarises the rules established by this point: work out which column applies to the mans payment entitlements (if any); work out the item that applies to the womans payment entitlements (if any); find the box in that column that corresponds to that item; if the box contains the word woman, the dependent children are allocated to the woman; if the box contains the word man, the dependent children are allocated to the man;

ALLOCATION OF DEPENDENT CHILDREN TABLE

column 1

column 2

 

column 3

man

 

 

 

column 3a

column 3b

column 3c

item

woman

social security pension

social security pension (illness separation)

nothing

1.

social security pension

woman

woman

woman

2.

social security pension (illness separation)

man

woman

3.

nothing

man

man

 

social security pension

= the person is receiving a social security pension and the couple is not an illness separated couple because of the persons illness or infirmity.

social security pension (illness separation)

= the person is receiving a social security pension and the couple is an illness separated couple because of the persons illness or infirmity.

nothing

= the person is not receiving a social security pension (but may be receiving a social security benefit or a service pension).

Note 2: if the woman is receiving a social security pension and the man is receiving an age service pension or an invalid service pension, the Veterans Entitlements Act will allocate the dependent children to the man; the woman, although allocated the dependent children under point 1066A-D2, will not receive additional amounts for the children because of point 1066A-D5.


Note 3: if one partner is receiving a social security pension and the other is receiving a social security benefit, the Benefit Rate Calculators operate to deny the social security benefit recipient from receiving anything for the dependent children (see point 1067-E3 of Benefit Rate Calculator A and point 1068-E3 of Benefit Rate Calculator B).

Dependent child add-ons

1066A-D3. If a person has a dependent child, there is, subject to points 1066A-D4, 1066A-D5 and 1066A-D6, a dependent child add-on for the child. The amount of the add-on depends on the childs age and is worked out using Table D.

TABLE D

ADD-ON FOR DEPENDENT CHILD

column 1

column 2

column 3

column 4

item

childs age

rate per

year

rate per

fortnight

1.

Under 13

$1,378.00

$53.00

2.

13 or over but under 16

$2,009.80

$77.30

3.

16 or over

$884.00

$34.00

Note 1: the item 1 rate is adjusted annually so that the combined family allowance and additional pension amounts for children covered by this item do not fall below 15% of the combined pensioner couple maximum basic rate (see subsections 1200 (1) and (2)).

Note 2: the item 2 rate is adjusted annually so that the combined family allowance and additional pension amounts for children covered by this item do not fall below 20% of the combined pensioner couple maximum basic rate (see subsections 1200 (3) and (4)).

Note 3: the item 3 rate is not indexed.

Failure to reasonably pursue maintenance claim

1066A-D4. If:

(a)     a person is entitled to claim maintenance from someone else for a dependent child of the person; and

(b)     the Secretary considers that it is reasonable that the person should have taken action to obtain the maintenance; and

(c)     the person has not taken action that the Secretary considers reasonable to obtain the maintenance;

there is no dependent child add-on for the dependent child.

No add-on for child covered by Veterans Entitlements Act

1066A-D5. There is no dependent child add-on for a dependent child if the maximum rate of someones service pension is increased because of the child under the following provisions of the VEA:

(a)     Service Pension Rate Calculator Where There Are Dependent Children (point 42-C3);

(b)     Service Pension Rate Calculator For Blinded Veterans (point 43-C3).


No add-on for prescribed student children

1066A-D6. Once a dependent child of a person turns 16, there is no dependent child add-on for the child if the child is a prescribed student child.

Note 1: for prescribed student child and dependent child see section 5.

Note 2: even though no child add-on applies to a particular dependent child, the child:

(a)  may attract guardian allowance under points 1066A-D7 to 1066A-D9; and

(b)  will attract additional free area under point 1066A-F3 for the purposes of the ordinary income test.

Guardian allowance

1066A-D7. Subject to point 1066A-D8, a person who has a dependent child or dependent children is to have a single amount per year by way of guardian allowance if:

(a)     the person is not a member of a couple; or

(b)    the person is a member of an illness separated couple.

No guardian allowance in respect of certain dependent children who have turned 18

1066A-D8. Once a dependent child of a person turns 18, the child is not to be taken into account for the purposes of point 1066A-D7 unless:

(a)     the child is a student child but not a prescribed student child; or

(b)    the person receives child disability allowance in respect of the child.

Rate of guardian allowance

1066A-D9. The rate of guardian allowance is $722.80 a year ($27.80 a fortnight).

Note: the rate of guardian allowance is indexed annually in line with CPI increases (see sections 1191 to 1194).

MODULE EA—RENT ASSISTANCE (UNDER 18)

Application

1066A-EA1. This Module applies to the disability support pension of a person who has not turned 18 and is not permanently blind.

Rent assistance

1066A-EA2. Subject to points 1066A-EA3 and 1066A-EA4, an amount to help cover the cost of rent is to be added to the maximum basic rate of:

(a) a member of a couple; or


(b) a person who has a pension increase child; or

(c) a person who is in disability accommodation;

if:

(d) the person is not an ineligible homeowner; and

(e) the person pays, or is liable to pay, rent (other than Government rent); and

(f) the rent is payable at a rate of more than $1,300 per year; and

(g) the person is in Australia.

Note 1: for pension increase child see subsection 5 (15).

Note 2: for in disability accommodation see subsection 23 (4c).

Note 3: for rent, Government rent and ineligible homeowner see section 13.

No rent assistance if partner getting incentive allowance

1066A-EA3. If the person is a member of a couple and the persons partner is living with the person in their home, an amount is not to be added to the persons maximum basic rate under point 1066A-EA2 if the persons partner is receiving incentive allowance.

Note: for incentive allowance see Module J of Pension Rate Calculator A and Module F of Pension Rate Calculator B.

Rent assistance waiting period

1066A-EA4. Subject to point 1066A-EA5, no amount is to be added to a persons maximum basic rate under point 1066A-EA2 unless the person has a current accumulated rent assistance waiting period credit of at least 26 weeks.

Note: for current accumulated rent assistance waiting period credit see points 1066A-EA7 and 1066A-EA9.

Some people do not have to serve rent assistance waiting period

1066A-EA5. A person does not have to satisfy point 1066A-EA4 if:

(a)      the person has a pension increase child; or

(b)      the person is in disability accommodation and paying rent; or

(c)      the person was, immediately before becoming qualified for the disability support pension, receiving:

(i) a social security or service pension or a social security benefit; and

(ii) an amount by way of:

(a) rent assistance; or

(b) incentive allowance.

Note 1: for pension increase child see subsection 5 (15).

Note 2: for in disability accommodation see subsection 23 (4c).


Serving the rent assistance waiting period

1066A-EA6. A person acquires an accumulated rent assistance waiting period credit by accumulating 26 weeks of eligible rent assistance waiting periods.

Accumulated eligible rent assistance waiting periods

1066A-EA7. For the purposes of point 1066A-EA4, a person is to be taken to have accumulated 26 weeks of eligible rent assistance waiting periods if:

(a)      the person has an eligible waiting period that is a continuous period of 26 weeks; or

(b)      the person has eligible waiting periods that together form a continuous period of 26 weeks; or

(c)      the person has eligible waiting periods that add up to 26 weeks and none of the eligible waiting periods start more than 4 weeks after the end of the immediately preceding waiting period.

Eligible rent assistance waiting period

1066A-EA8. A period is an eligible waiting period for a person if during the whole of the period the person:

(a)      is receiving a social security or service pension or a social security benefit; or

(b)     would, but for the application of an ordinary income test or maintenance income test or assets test, be receiving a social security benefit; or

(c)      is receiving payments as a trainee in full-time training under a program included in the programs known as Labour Force Programs; or

(d)     is in continuous full-time training under a program included in the programs known as Labour Force Programs and is receiving payments by way of remuneration in respect of that training; or

(e)      is receiving payments under the Adult Migrant Education Program; or

(f)       is in gaol.

Note: for in gaol see subsection 23 (5).

Credit ceases to be current in some circumstances

1066A-EA9. A persons accumulated rent assistance credit ceases to be current at a particular time if the persons last eligible rent assistance waiting period ended more than 4 weeks before that time.


Factors affecting rate of rent assistance

1066A-EA10. The rate of rent assistance depends on:

(a)      the annual rent paid or payable by the person; and

(b)      the number of pension increase children in relation to the person; and

(c)      whether or not the person has a partner who has a rent increased pension; and

(d)      whether or not the person is in disability accommodation.

Note: for in disability accommodation see subsection 23 (4c).

Partner with rent increased pension

1066A-EA11. A person has a partner with a rent increased pension, for the purposes of this Module, if:

(a)       the partner is living with the person in their home; and

(b)      the partner is in receipt of a social security or service pension; and

(c)       the rate of the pension is increased to take account of rent paid or payable by the person.

Note: for the treatment of rent paid by a member of a couple see point 1066A-EA14.

Rate of rent assistance

1066A-EA12. The rate of rent assistance per year is worked out using Table EA. Work out the persons family situation and calculate Rate A for the person using the corresponding formula in column 3. This will be the persons rate of rent assistance but only up to the persons maximum rent assistance rate. The persons maximum rent assistance rate is Rate B for the person worked out using column 4 of the Table.


TABLE EA

RATE OF RENT ASSISTANCE

column 1

column 2

column 3

 

column 4

Rate B

 

 

 

 

column 4A

column 4B

column 4C

item

family situation

Rate A

No pension increase children

1 or 2 pension increase children

3 or more pension increase children

1.

Not member of a couple and not in disability accommodation

 

Annual rent-$1,300

 

Nil

$1,882.40

$2,150.20

 

 

2

 

 

 

 

2.

Not member of a couple and in disability accommodation

 

Annual rent -$1,300

 

$1,612.00

$1,882.40

$2,150.20

 

 

2

 

 

 

 

3.

Partnered—partner does not have rent increased pension

 

Annual rent-$1,300

 

$1,612.00

$1,882.40

$2,150.20

 

 

2

 

 

 

 

4.

Partnered—partner has rent increased pension

 

Annual rent-$1,300

 

$806.00

$941.20

$1,075.10

 

 

4

 

 

 

 

Note 1: for member of a couple and partnered see section 4.

Note 2: for partner with a rent increase pension see point 1066A-E11.

Note 3: for in disability accommodation see subsection 23 (4c).

Note 4: the Rate B amounts are indexed 6 monthly in line with CPI increases (see sections 1191 to 1194).

Annual rent

1066A-EA13. Annual rent is the annual rent paid or payable by the person whose rate of pension is being calculated.

Rent paid by a member of a couple

1066A-EA14. If a person is a member of a couple and the persons partner is living with the person in their home, any rent that the persons partner pays or is liable to pay in respect of the home is to be treated as paid or payable by the person.

Note: for member of a couple see section 4.

Rent paid by a member of an illness separated couple

1066A-EA15. If a person is a member of an illness separated couple, any rent that the persons partner pays or is liable to pay in respect of the premises or lodgings occupied by the person is to be treated as paid or payable by the person.

Note: for illness separated couple see section 4.


MODULE EB—RENT ASSISTANCE (18 AND OVER)

Application

1066A-EB1. This module applies to the disability support pension of a person who has turned 18 and is not permanently blind.

Rent assistance

1066A-EB2. Subject to points 1066A-EB4 and 1066A-EB5, an amount to help cover the cost of rent is to be added to the maximum basic rate of:

(a)     a member of a couple; or

(b)     a person who has a pension increase child; or

(c)     a person who is living permanently or indefinitely away from persons parental home; or

(d) a person in disability accommodation;

if:

(e) the person is not an ineligible homeowner; and

(f) the person pays, or is liable to pay, rent (other than Government rent); and

(g) the rent is payable at a rate of more than $1,300 per year; and

(h) the person is in Australia.

Note 1: for pension increase child see subsection 5 (15).

Note 2: for rent, Government rent and ineligible homeowner see section 13.

Note 3: for living away from parental home see subsection 23 (4d).

Note 4: for in disability accommodation see subsection 23 (4c).

Parent

1066A-EB3. For the purposes of point 1066A-EB2 a step-parent or guardian is to be taken to be a parent.

Note: parent, when used in this Act, does not normally include a step-parent or guardian (see subsection 5 (1)).

No rent assistance if partner getting incentive allowance

1066A-EB4. If the person is a member of a couple and the persons partner is living with the person in their home, an amount is not to be added to the persons maximum basic rate under point 1066A-EB2 if the persons partner is receiving incentive allowance.

Rent assistance waiting period

1066A-EB5. Subject to point 1066A-EB6, no amount is to be added to a persons maximum basic rate under point 1066A-EB2 unless the person has a current accumulated rent assistance waiting period credit of at least 26 weeks.


Some people do not have to serve rent assistance waiting period

1066A-EB6. A person does not have to satisfy point 1066A-EB5 if:

(a)     the person has a pension increase child; or

(b)     the person is in disability accommodation and paying rent; or

(c)     the person was, immediately before becoming qualified for the disability support pension receiving:

(i) a social security or service pension or a social security benefit; and

(ii) an amount by way of:

(a) rent assistance; or

(b) incentive allowance; or

(d) the person was previously receiving a social security benefit whose rate included an amount by way of rent assistance and:

(i) the person ceased to receive that other social security benefit; and

(ii) the person ceased to receive that other social security benefit otherwise than because of the operation of an ordinary income, maintenance income or assets test; and

(iii) the person ceased to receive that other social security benefit not more than 4 weeks before commencing to receive the disability support pension whose rate is being worked out.

Serving the rent assistance waiting period

1066A-EB7. A person acquires an accumulated rent assistance waiting period credit by accumulating 26 weeks of eligible rent assistance waiting periods.

Accumulated eligible rent assistance waiting periods

1066A-EB8. For the purposes of point 1066A-EB5, a person is to be taken to have accumulated 26 weeks of eligible rent assistance waiting periods if:

(a)     the person has an eligible waiting period that is a continuous period of 26 weeks; or

(b)     the person has eligible waiting periods that together form a continuous period of 26 weeks; or

(c)     the person has eligible waiting periods that add up to 26 weeks and none of the eligible waiting periods start more than 4 weeks after the end of the immediately preceding waiting period.


Eligible rent assistance waiting period

1066A-EB9. A period is an eligible waiting period for a person if during the whole of the period the person:

(a)     is receiving a social security or service pension or a social security benefit; or

(b)     would, but for the application of an ordinary income, maintenance income, or assets test, be receiving a social security benefit; or

(c)     is receiving payments as a trainee in full-time training under a program included in the programs known as Labour Force Programs; or

(d)     is in continuous full-time training under a program included in the programs known as Labour Force Programs and is receiving payments by way of remuneration in respect of that training; or

(e)     is receiving payments under the Adult Migrant Education Program; or

(f) is in gaol.

Credit ceases to be current in some circumstances

1066A-EB10. A persons accumulated rent assistance credit ceases to be current at a particular time if the persons last eligible rent assistance waiting period ended more than 4 weeks before that time.

Factors affecting rate of rent assistance

1066A-EB11. The rate of rent assistance depends on:

(a)     the annual rent paid or payable by the person; and

(b)     the number of pension increase children in relation to the person; and

(c)     whether or not the person has a partner who has a rent increased pension; and

(d)     whether or not the person is in disability accommodation; and

(e)     whether the person is living permanently or indefinitely away from the persons parental home.

Note 1: for in disability accommodation see subsection 23 (4c).

Note 2: for living away from parental home see subsection 23 (4d).

Partner with rent increased pension

1066A-EB12. A person has a partner with a rent increased pension, for the purposes of this Module if:

(a)     the partner is living with the person in their home; and

(b)     the partner is in receipt of a social security or service pension; and


(c) the rate of the pension is increased to take account of rent paid or payable by the person.

Rate of rent assistance

1066A-EB13. The rate of rent assistance per year is worked out using Table EB. Work out the persons family situation and calculate Rate A for the person using the corresponding formula in column 3. This will be the persons rate of rent assistance but only up to the persons maximum rent assistance rate. The persons maximum rent assistance rate is Rate B for the person worked out using column 4 of the Table.

TABLE EB

RATE OF RENT ASSISTANCE

column 1

column 2

column 3

 

column 4

Rate B

 

 

 

 

column 4A

column 4B

column 4C

item

family situation

Rate A

No pension increase children

1 or 2 pension increase children

3 or more pension increase children

1.

Not member of a couple and person:

 

Annual rent-$1,300

 

Nil

$1,882.40

$2,150.20

 

 

2

 

 

 

 

 

(a) is not in disability accommodation; and

 

 

 

 

 

 

 

(b) is not living permanently or indefinitely away from the person’s parental home

 

 

 

 

 

 

2.

Not member of a couple and in disability accommodation

 

Annual rent-$1,300

 

$1,612.00

$1,882.40

$2,150.20

 

 

2

 

 

 

 

3.

Not member of a couple and living permanently or indefinitely away from the person’s parental home

 

Annual rent-$1,300

 

$1,612.00

$1,882.40

$2,150.20

 

 

2

 

 

 

 

4.

Partnered—partner does not have rent increased pension

 

Annual rent-$1,300

 

$1,612.00

$1,882.40

$2,150.20

 

 

2

 

 

 

 

5.

Partnered—partner has rent increased pension

 

Annual rent - $1,040

 

$806.00

$914.20

$1,075.10

 

 

4

 

 

 

 

Note 1: for member of a couple and partnered see section 4.

Note 2: for partner with a rent increase pension see point 1066A-EB12.

Note 3: for in disability accommodation see subsection 25 (4c).

Note 4: for living away from parental home see subsection 23 (4d).

Note 5: the Rate B amounts are indexed 6 monthly in line with CPI increases (see sections 1191 to 1194).


Annual rent

1066A-EB14. Annual rent is the annual rent paid or payable by the person whose disability support pension rate is being calculated.

Rent paid by a member of a couple

1066A-EB15. If a person is a member of a couple and the persons partner is living with the person in their home, any rent that the persons partner pays or is liable to pay in respect of the home is to be treated as paid or payable by the person.

Note: for member of a couple see section 4.

Rent paid by a member of an illness separated couple

1066A-EB16. If a person is a member of an illness separated couple, any rent that the persons partner pays or is liable to pay in respect of the premises or lodgings occupied by the person is to be treated as paid or payable by the person.

Note: for illness separated couple see section 4.

MODULE F—ORDINARY INCOME TEST

Effect of income on maximum payment rate

1066A-F1. This is how to work out the effect of a persons ordinary income on the persons maximum payment rate:


Method statement

Step 1.

Work out the amount of the persons ordinary income on a yearly basis.

 

Note: for the treatment of the ordinary income of members of a couple see point 1066A-F2.

Step 2.

Work out the persons ordinary income free area (see points 1066A-F3 to 1066A-F8 below).

 

Note: a persons ordinary income free area is the amount of ordinary income that the person can have without any deduction being made from the persons maximum payment.

Step 3.

Work out whether the persons ordinary income exceeds the persons ordinary income free area.

Step 4.

If the persons ordinary income does not exceed the persons ordinary income free area, the persons ordinary income excess is nil.

Step 5.

If the persons ordinary income exceeds the persons ordinary income free area, the persons ordinary income excess is the persons ordinary income less the persons ordinary income free area.

Step 6.

Use the persons ordinary income excess to work out the persons reduction for ordinary income using points 1066A-F9 to 1066A-F11 below.

Note 1: see point 1066A-A1 (Steps 6 to 9) for the significance of the persons reduction for ordinary income.

Note 2: the application of the ordinary income test is affected by provisions concerning:

  investment income (sections 1073 to 1099);

  disposal of income (sections 1106 to 1112);

  earnings credit (sections 1113 to 1115).

Ordinary incomes of members of couples

1066A-F2. If a person is a member of a couple, add the couples ordinary incomes (on a yearly basis) and divide by 2 to work out the amount of the persons ordinary income for the purposes of this Module.

How to calculate a persons ordinary income free area

1066A-F3. A persons ordinary income free area is worked out using Table F-1. Work out which family situation in Table F-1 applies to the person. The ordinary income free area is the corresponding amount in column 3 plus an additional corresponding amount in column 5 for each dependent child of the person.


TABLE F-1

ORDINARY INCOME FREE AREA

column 1

column 2

column 3

column 4

column 5

column 6

item

category of person

basic free area per year

basic free area per fortnight

additional free area per year

additional free area per fortnight

1.

Not member of a couple

$2,080

$80

$624

$24

2.

Partnered (partner getting neither pension nor benefit)

$1,820

$70

$624

$24

3.

Partnered—(partner getting benefit)

$1,820

$70

$624

$24

4.

Partnered—(partner getting pension)

$1,820

$70

$312

$12

Note 1: for member of a couple, partnered (partner getting neither pension nor benefit), partnered (partner getting benefit) and partnered (partner getting pension) see section 4.

Note 2: for dependent child see section 5.

Note 3: items 2, 3 and 4 of Table F-1 apply to members of illness separated couples.

Note 4: the basic free area limits are indexed annually in line with CPI increases (see sections 1191 to 1194).

No additional free area for certain prescribed student children

1066A-F4. No additional free area is to be added for a dependent child who:

(a)     has turned 18; and

(b)     is a prescribed student child;

unless the person whose rate is being calculated, or the persons partner, receives child disability allowance for the child.

Reduction of additional free area for dependent children

1066A-F5. The additional free area for a dependent child of a person to whom item 1, 2 or 3 of Table F-1 applies is reduced by the annual amount of any payment received by the person or the persons partner for or in respect of that particular child. The payments referred to in point 1064-F7 do not result in a reduction.

1066A-F6. The additional free area for a dependent child of a person to whom item 4 of Table F-1 applies is reduced by 50% of the annual amount of any payment received by the person or the persons partner for or in respect of that particular child. The payments referred to in point 1066A-F7 do not result in a reduction.


1066A-F7. No reduction is to be made under point 1066A-F5 or 1066A-F6 for a payment:

(a)     under this Act; or

(b)     of maintenance income; or

(c)     under the VEA; or

(d)     under an Aboriginal study assistance scheme or the AUSTUDY scheme; or

(e)     under the Assistance for Isolated Children Scheme; or

(f)      that is similar to family allowance and that prevents a family allowance from being paid under section 837.

Note: for Aboriginal study assistance scheme see subsection 23 (1).

1066A-F8. Examples of the kinds of payments that result in a reduction under points 1066A-F5 and 1066A-F6 are:

(a)     amounts received from State authorities or benevolent societies in respect of the boarding out of the child; or

(b)     amounts of superannuation or compensation paid in respect of the child; or

(c)     amounts (other than amounts covered by point 1066A-F7 above) paid in respect of the child under educational schemes; or

(d)     a family allowance or similar payment made by another country where this does not preclude payment of Australian family allowance; or

(e)     foster care allowance payments made by a State welfare authority.

 

ORDINARY INCOME FREE AREA EXAMPLES

Example 1:

Facts

Wayne and Mary are members of a couple. They both receive pensions. They have 2 dependent children—Max and Angela. Angela is being fostered by Wayne and Mary and they receive $15 per week from the NSW Government by way of a foster care payment in respect of Angela.

Application

The foster care payment calculated on a yearly basis is $15 × 52 = $780. As point 1066A-F6 applies to Wayne and Mary (they are covered by item 4 of Table F-1 in point 1066A-F3), the reduction is at the 50% rate (i.e. $390 per year). The possible additional amount for Angela ($312) is therefore reduced to nil.

The amount that Wayne gets for Max is not subject to reduction and is $312 per year. Mary gets $312 for Max as well.

Waynes ordinary free area limit is $1,820 + $312 = $2,132. Marys ordinary free area limit is the same.

Example 2:

Facts

The same facts as in Example 1 except that Wayne and Mary receive only $10 a week ($520 a year) foster care payment for Angela.


Application

The amount that each person would be allowed for Angela is:

Then each would have an ordinary free area limit of $1,820 + $312 + $52 = $2,184.

Pension reduction for ordinary income in excess of ordinary income free area

1066A-F9. A persons reduction for ordinary income is worked out using Table F-2. Work out which family situation applies to the person. The reduction for ordinary income is the amount per year worked out using the corresponding calculation in column 3.

TABLE F-2

REDUCTION FOR ORDINARY INCOME

column 1

column 2

column 3

item

person’s family situation

reduction

1.

Not member of a couple

 

ordinary income excess

 

 

 

 

2

 

2.

Partnered (partner getting neither pension nor benefit)

 

ordinary income excess

 

 

 

2

 

3.

Partnered (partner getting benefit)

 

ordinary income excess

 

 

 

 

2

 

4.

Partnered (partner getting pension) neither person nor partner has additional amounts for dependent children

 

ordinary income excess

 

 

 

2

 

5.

Partnered (partner getting pension) person has additional amounts for dependent children

 

DC excess + remaining excess

 

 

 

2

 

6.

Partnered (partner getting pension) partner has additional amounts for dependent children

 

remaining excess

 

 

 

2

 

Note 1: for member of a couple, partnered (partner getting neither pension not benefit), partnered (partner getting benefit) and partnered (partner getting pension) see section 4.

Note 2: for additional amounts for dependent children see subsection 23 (1).

Note 3: for ordinary income excess see point 1066A-F10 below.

Note 4: for DC excess and remaining excess see point 1066A-F11 below.

Note 5: for background information on the special treatment given to people covered by items 5 and 6 of Table F-2 see points 1066A-A3 and 1066A-A4 above.


Ordinary income excess

1066A-F10. A persons ordinary income excess is the persons ordinary income less the persons ordinary income free area.

Working out DC excess and remaining excess

1066A-F11. For the purposes of Table F-2, if a member of a couple (in this point called the DC partner) has additional amounts for dependent children:

(a) the additional amounts for dependent children total (the DC total) is the sum of the amounts the DC partner has by way of additional amounts for dependent children; and

(b) if the DC partners ordinary income excess (see point 1066A-F10 above) is less than or equal to the DC total:

(i) the DC excess is the DC partners ordinary income excess; and

(ii) the remaining excess is nil; and

(c) if the DC partners ordinary income excess (see point 1066A-F10 above) is greater than the DC total:

(i) the DC excess is the DC total; and

(ii) the remaining excess is the DC partners ordinary income excess less the DC total.

Note: for additional amount for dependent children see subsection 23 (1).

MODULE G—MAINTENANCE INCOME TEST

Effect of maintenance income on maximum payment rate

1066A-G1. This is how to work out the effect of a persons maintenance income on the persons maximum payment rate:


Method statement

Step 1.

Work out the amount of the persons maintenance income on a yearly basis.

 

Note 1: for the treatment of the maintenance income of a member of a couple see points 1066A-G3 or 1066A-G4.

 

Note 2: special maintenance income (see subsection 10 (1)) can in some circumstances be disregarded under points I066A-G5 to 1066A-G6.

Step 2.

Work out the persons maintenance income free area (see points 1066A-G10 and 1066A-G11 below).

 

Note: a persons maintenance income free area is the amount of maintenance income that the person can have without any deduction being made from the persons maximum payment rate.

Step 3.

Work out whether the persons maintenance income exceeds the persons maintenance income free area.

Step 4.

If the persons maintenance income does not exceed the persons maintenance income free area, the persons maintenance income excess is nil.

Step 5.

If the persons maintenance income exceeds the persons maintenance income free area, the persons maintenance income excess is the persons maintenance income less the persons maintenance income free area.

Step 6.

Use the persons maintenance income excess to work out the persons reduction for maintenance income using points 1066A-G12 to 1066A-G14 below.

Note 1: see point 1066A-A1 (Steps 6 to 9) for the significance of the persons reduction for maintenance income.

Note 2: the application of the maintenance income test is affected by provisions concerning:

  apportionment of capitalised maintenance income (section 1116)

  non-cash housing maintenance—value of substitute, for family home (section 1117).

Dependent child

1066A-G2. In working out whether a young person is a dependent child for the purposes of this Module, disregard subsection 5 (3).

Maintenance incomes of members of couples

1066A-G3. If the person is a member of a couple, add the couples maintenance incomes (on a yearly basis) and divide by 2 to work out the amount of the persons maintenance income for the purposes of this Module.

1066A-G4. Point 1066A-G3 does not apply to a person if the persons partner:

(a) is not in receipt of:

(i) a social security or service pension; or

(ii) a social security benefit; and


(b) does not have maintenance income.

Special maintenance income

1066A-G5. Subject to points 1066A-G8 and 1066A-G9, if a person has special maintenance income in excess of the ceiling applicable to the person, the excess is disregarded for the purposes of this Module.

Note: see subsection 10 (1) for special maintenance income.

1066A-G6. If a person:

(a)     is a member of a couple; and

(b)     has a dependent child; and

(c)     the persons partner is in receipt of a social security or service pension;

the ceiling applicable to the person is the amount equal to the persons maintenance income free area plus:

where:

combined maximum rates is the sum of:

(a)     the maximum payment rate of pension applicable to the person; and

(b)     the maximum payment rate of social security or service pension applicable to the persons partner; and

(c)     any incentive allowance payable to the persons partner.

Note: social security pension includes a sheltered employment or rehabilitation allowance.

1066A-G7. If a person is not covered by point 1066A-G6, the ceiling applicable to the person is the amount equal to the persons maintenance income free area plus:

Special maintenance income not disregarded where child support available

1066A-G8. No amount is to be disregarded under point 1066A-G5 if:

(a)     child support is not payable under the Child Support (Assessment) Act 1989 to the person for a child; and

(b)    the person is entitled to make an application for assessment of child support under Part V of that Act for the child payable by another person; and

(c)     the person has:

(i) neither:

(a) properly made such an application; nor


(b) properly made an application under Part VI of that Act for acceptance of an agreement in relation to the child; or

(ii) the person has properly made an application of either kind, but:

(a) the person has subsequently withdrawn the application; or

(b) after child support has become payable by the other person under that Act for the child, the person has ended the entitlement to child support.

1066A-G9. No amount is to be disregarded under point 1066A-G5 if:

(a)    child support is payable under the Child Support (Assessment) Act 1989 to the person for a child; and

(b)    the person is entitled to make an application under section 128 of that Act; and

(c)    an application by the person under that section is not in force.

How to calculate a persons maintenance income free area

1066A-G10. A persons maintenance income free area is worked out using Table G-1. Work out which family situation in Table G-1 applies to the person. The maintenance income free area is the corresponding amount in column 3 plus an additional corresponding amount in column 5 for each dependent child after the first.


TABLE G-1

MAINTENANCE INCOME FREE AREA

column 1

column 2

column 3

column 4

column 5

column 6

item

persons family situation

basic free area per year

basic free area per fortnight

additional free area per year

additional free area per fortnight

1.

Not member of a couple

$780.00

$30.00

$260.00

$10.00

2.

Partnered (partner getting neither pension nor benefit

$780.00

$30.00

$260.00

$10.00

3.

Partnered (partner getting pension or benefit)—both the person and the partner are receiving maintenance income

$780.00

$30.00

$130.00

$5.00

4.

Partnered (partner getting pension or benefit)—either the person or the partner (but not both) are receiving maintenance income

$390.00

$15.00

$130.00

$5.00

Note 1: for member of a couple, partnered (partner getting neither pension nor benefit), and partnered (partner getting pension or benefit) see section 4.

Note 2: for dependent child see section 5.

Note 3: items 2, 3 and 4 of Table G-1 apply to members of illness separated couples.

Note 4: the amounts are indexed in line with CPI increases (see sections 1191 to 1194).

1066A-G11. In determining whether or not item 3 or 4 of Table G-1 applies to a person, point 1066A-G3 is to be disregarded. This has the effect of taking into account only maintenance income that the person actually receives rather than any income that the person is to be taken to receive because of maintenance income received by the persons partner.

Pension reduction for maintenance income in excess of maintenance income free area

1066A-G12. A persons reduction for maintenance income is worked out using Table G-2. Work out which family situation applies to the person. The reduction for maintenance income is the amount per year worked out using the corresponding calculation in column 3.


TABLE G-2

REDUCTION FOR MAINTENANCE INCOME

column 1

column 2

column 3

item

persons family situation

reduction

1.

Not member of a couple

maintenance income excess

2

2.

Partnered (partner getting neither pension nor benefit)

maintenance income excess

2

3.

Partnered (partner getting benefit)

maintenance income excess

2

4.

Partnered (partner getting pension) neither person nor partner has additional amounts for dependent children

maintenance income excess

2

5.

Partnered (partner getting pension) person has additional amounts for dependent children

DC excess + remaining excess

2

6.

Partnered (partner getting pension) partner has additional amounts for dependent children

remaining excess

2

Note 1: for member of a couple, partnered (partner getting neither pension nor benefit), partnered (partner getting benefit) and partnered (partner getting pension) see section 4.

Note 2: for additional amounts for dependent children see subsection 23 (1).

Note 3: for maintenance income excess see point 1066A-G13 below.

Note 4: for DC excess and remaining excess see point 1066A-G14 below.

Note 5: for background information on the special treatment given to people covered by items 5 and 6 of Table F-2 see points 1066A-A4 and 1066A-A5 above.

Maintenance income excess

1066A-G13. A persons maintenance income excess is the persons maintenance income less the persons maintenance income free area.

Working out DC excess and remaining excess

1066A-G14. For the purposes of Table G-2, if a member of a couple (in this point called the DC partner) has additional amounts for dependent children:

(a) the additional amounts for dependent children total (the DC total) is the sum of the amounts the DC partner has by way of additional amounts for dependent children; and

(b) if the DC partners ordinary income excess (see point 1066A-F10 above) plus the DC partners maintenance income excess


(see point 1066A-G13 above) are less than or equal to the DC total:

(i) the DC excess is the DC partners maintenance income excess; and

(ii) the remaining excess is nil; and

(c) if:

(i) the DC partners ordinary income excess (see point 1066A-F10 above) plus the DC partners maintenance income excess (see point 1066A-G13 above) is greater than the DC total; and

(ii) the DC partners ordinary income excess is greater than or equal to the DC total;

then:

(iii) the DC excess is nil; and

(iv) the remaining excess is the DC partners maintenance income excess; and

(d) if:

(i) the DC partners ordinary income excess (see point 1066A-F10 above) plus the DC partners maintenance income excess (see point 1066A-G13 above) is greater than the DC total; and

(ii) the DC partners ordinary income excess is less than the DC total; then:

(iii) the DC excess is the DC total less the DC partners ordinary income excess; and

(iv) the remaining excess is the DC partners maintenance income excess less the DC excess.

Note: for additional amount for dependent children see subsection 23 (1).

MODULE H—ASSETS TEST

Effect of assets on maximum payment rate

1066A-H1. This is how to work out the effect of a persons assets on the persons maximum payment rate:


Method statement

Step 1.

Work out the value of the persons assets.

 

Note 1: for the treatment of the assets of members of a couple see point 1066A-H2.

 

Note 2: for the assets that are to be disregarded in valuing a persons assets see section 1118.

 

Note 3: for the valuation of an asset that is subject to a charge or encumbrance see section 1121.

Step 2.

Work out the persons assets value limit (see point 1066A-H3 below).

 

Note: a persons assets value limit is the maximum value of assets the person can have without affecting the persons pension rate.

Step 3.

Work out whether the value of the persons assets exceeds the persons assets value limit.

Step 4.

If the value of the persons assets does not exceed the persons assets value limit, the persons assets excess is nil.

Step 5.

If the value of the persons assets exceeds the persons assets value limit, the persons assets excess is the value of the persons assets less the persons assets value limit.

Step 6.

Use the persons assets excess to work out the persons reduction for assets using points 1066A-H4 to 1066A-H7 below.

Note 1: see point 1066A-A1 Steps 10 and 11 for the significance of the persons reduction for assets.

Note 2: the application of the assets test is affected by provisions concerning:

   disposal of assets (sections 1123 to 1128);

   retirement villages (sections 1145 to 1157):

   financial hardship (sections 1129 and 1130);

   the pensions loans scheme (sections 1133 to 1144).

Value of assets of members of couples

1066A-H2. For the purposes of this Module:

(a) the value of the assets of a member of a couple is to be taken to be 50% of the sum of:

(i) the value of the persons assets; and

(ii) the value of the persons partners assets; and

(b) the value of the assets of a particular kind of a member of a couple is to be taken to be 50% of the sum of:

(i) the value of the persons assets of that kind; and

(ii) the value of the persons partners assets of that kind.


Assets value limit

1066A-H3. A persons assets value limit is worked out using Table H-1. Work out the persons family situation and home ownership situation. The assets value limit is the corresponding amount in column 3.

TABLE H-1

ASSETS VALUE LIMIT

column 1

column 2

column 3

assets value limit

 

 

column 3A

column 3B

item

persons family situation

either person or partner homeowner

neither person nor partner homeowner

1.

Not member of a couple

$110,750

$190,250

2.

Partnered (partner getting neither pension nor benefit)

$78.750

$118,500

3.

Partnered (partner getting pension or benefit)

578,750

$118,500

Note 1: for member of a couple, partnered (partner getting neither pension nor benefit) and partnered (partner getting pension or benefit) see section 4.

Note 2: for homeowner see section 11.

Note 3: items 2 and 3 apply to members of illness separated couples.

Note 4: the assets value limits are indexed or adjusted annually in line with CPI increases (see sections 1191 to 1194 and 1203).

Pension reduction for assets in excess of assets value limit

1066A-H4. A persons reduction for assets is worked out using Table H-2. Work out which family situation applies to the person. The reduction for assets is the amount per year worked out using the corresponding calculation in column 3.


 

TABLE H-2

REDUCTION FOR ASSETS

col. 1

column 2

persons family

column 3

item

situation

reduction

1.

Not member of a couple

[assets excess] × 26

250

2.

Partnered (partner getting neither pension nor benefit)

[assets excess] × 26

250

3.

Partnered (partner getting benefit)

[assets excess] × 26

250

4.

Partnered (partner getting pension) neither person nor partner has additional amounts for dependent children

[assets excess] × 26

250

5.

Partnered (partner getting pension) person has additional amounts for dependent children

[DC excess] × 52 + [remaining excess] × 26

250 250

6.

Partnered (partner getting pension) partner has additional amounts for dependent children

[remaining excess] × 26

250

Note 1: for member of a couple, partnered (partner getting neither pension nor benefit), partnered (partner getting benefit) and partnered (partner getting pension) see section 4.

Note 2: for additional amount for dependent children see subsection 23 (1).

Note 3: for assets excess see point 1066A-H5 below.

Note 4: for DC excess and remaining excess see point 1066A-H6 below.

Note 5: for background information on the special treatment given to people covered by items 5 and 6 of Table H-2 see points 1066A-A3 and 1066A-A4 above.

Assets excess

1066A-H5. A persons assets excess is the value of the persons assets less the persons assets value limit.

Working out DC excess and remaining excess

1066A-H6. For the purposes of Table H-2, if a member of a pensioner couple (in this point called the DC partner) has additional amounts for dependent children:


(a)     the additional amounts for dependent children total (the DC total) is the sum of the amounts that the DC partner has by way of additional amounts for dependent children; and

(b)     the assets equivalent of the DC total (the DC assets total) is:

; and

(c) if the DC partners assets excess (see point 1066A-H5 above) is less than or equal to the DC assets total:

(i) the DC excess is the assets excess; and

(ii) the remaining excess is nil; and

(d) if the DC partners assets excess (see point 1066A-H5 above) is greater than the DC assets total:

(i) the DC excess is the DC assets total; and

(ii) the remaining excess is the assets excess less the DC assets total.

Note: for additional amount for dependent children see subsection 23 (1).

1066A-H7. In calculating a persons assets excess under point 1066A-H5 disregard any part of the excess that is not a multiple of $250.

MODULE 1—REMOTE AREA ALLOWANCE

Remote area allowance

1066A-I1. An amount by way of remote area allowance is to be added to a persons rate of pension if:

(a)     the persons usual place of residence is situated in the remote area; and

(b)     the person is physically present in the remote area.

Note: for remote area and physically present in the remote area see section 14.

Rate of remote area allowance

1066A-I2. The rate of remote area allowance payable to a person is worked out using Table I. Work out which family situation in the Table applies to the person. The rate of remote area allowance is the corresponding amount in column 3 plus an additional corresponding amount in column 5 for each pension or benefit increase child of the person.


TABLE I

REMOTE AREA ALLOWANCE

column 1

column 2

column 3

column 4

column 5

Column 6

item

persons family

situation

basic allowance per year

basic allowance per fortnight

additional allowance per year

additional allowance per fortnight

1.

Not member of a couple

$364.00

$14.00

$182.00

$7.00

2.

Partnered—partner receiving remote area allowance

$312.00

$12.00

$182.00

$7.00

3.

Partnered—partner not receiving remote area allowance

$364.00

$14.00

$182.00

$7.00

4.

Member of an illness separated or respite care couple

$364.00

$14.00

$182.00

$7.00

Note 1: for member of a couple and partnered see section 4.

Note 2: for dependent child see section 5.

Note 3: for pension increase child see subsection 5 (15).

Note 4: for benefit increase child see subsection 5 (16).

Dependent children must be physically present in Australia

1066A-I3. Additional allowance is not payable for a pension or benefit increase child unless the child is physically present in Australia.

Additional remote area allowance for dependent children not available to both members of a pensioner couple

1066A-I4. Additional allowance is not to be included in a persons pension rate for a pension increase child if:

(a)     the persons partners pension rate includes additional allowance for the child; and

(b)     the persons partner has a dependent child add-on for the child.

PART 3.4B—PENSION RATE CALCULATOR E

Rate of disability support pension (people under 21 who are blind)

1066B. (1) The rate of disability support pension of a person who has not turned 21 and is permanently blind is to be calculated in accordance with the Rate Calculator at the end of this section.

Note: Module A of the Rate Calculator establishes the overall rate calculation process and the remaining Modules provide for the calculation of the component amounts used in the overall rate calculation.


(2) A persons pension rate is not to exceed the rate at which a pension would be payable to that person if the persons rate were calculated using Pension Rate Calculator B at the end of section 1065.

(3) If:

(a)     a person who is permanently blind is a member of a couple; and

(b)     the persons partner:

(i) is not receiving a social security or service pension; and

(ii) is not receiving a social security benefit;

the rate of pension payable to the person who is permanently blind is not to exceed twice the rate at which a disability support pension would be payable to the person if the persons partner were receiving a pension or benefit of that kind.

(4) Where:

(a)     a person who is permanently blind is living with another person as the spouse of that other person on a genuine domestic basis although not legally married to that other person; and

(b)     the other person is of the opposite sex; and

(c)     that other person is under the age of consent applicable in the State or Territory in which the person is living;

the rate of pension payable to the person who is permanently blind is not to exceed the rate at which it would be payable to the person if the other person were the persons partner.

PENSION RATE CALCULATOR E

MODULE A—OVERALL RATE CALCULATION PROCESS

Method of calculating rate

1066B-A1. The rate of pension is an annual rate (fortnightly amounts are provided for information only).


Method statement

Step 1.

Work out the persons maximum basic rate using MODULE B below.

Step 2.

Work out the amount per year for youth disability supplement using MODULE C below.

Step 3.

Work out the amount per year (if any) for dependent children using MODULE D below.

Step 4.

Work out the amount per year (if any) for rent using MODULE EA below for persons under 18 and MODULE EB below for persons who have turned 18.

Step 5.

Add up the amounts obtained in Steps 1, 2, 3 and 4: the result is called the maximum payment rate.

Step 6.

Add to the maximum payment rate any amount per year payable by way of remote area allowance (see MODULE F below).

Income test, maintenance income test and assets test generally not to apply

1066B-A2. The pension is not subject to an income test (compare Module F of Pension Rate Calculator D), a maintenance income test (compare Module G of Pension rate Calculator D) or an assets test (compare Module H of Pension Rate Calculator D).

MODULE B—MAXIMUM BASIC RATE

Maximum basic rate

1066B-B1. A persons maximum basic rate is to be worked out using Table B. Work out the family situation and whether the person has a dependent child. The maximum basic rate is the corresponding amount in column 3 of the Table.


TABLE B

MAXIMUM BASIC RATES

column 1

column 2

column 3

column 4

 

 

rate per year

rate per fortnight

 

persons family situation

column 3A

person with dependent child

column 3B

person without dependent child

column 4A

person with dependent child

column 4B

person without dependent child

1.

Not member of a couple and: person:

$7,841.60

$3,226.60

$301.60

$124.10

 

(a) has not turned 18; and

 

 

 

 

 

(b) is not a homeless person; and

 

 

 

 

 

(c) is not an independent young person; and

 

 

 

 

 

(d) is not living away from the persons parental home because of medical condition

 

 

 

 

2.

Not member of a couple and person:

$7,841.60

$5,324.80

$301.60

$204.80

 

(a) has not turned 18; and

 

 

 

 

 

(b) is:

 

 

 

 

 

(i) a homeless person; or

 

 

 

 

 

(ii) an independent young person; or

 

 

 

 

 

(iii) is living away from the persons parental home because of medical condition

 

 

 

 

3.

Not member of a couple and person:

$7,841.60

$3,876.60

$301.60

$149.10

 

(a) has turned 18; and

 

 

 

 

 

(b) is living at a home of parent or parents

 

 

 

 

4.

Not member of a couple and person:

$7,841.60

$5,889.00

$301.60

$226.50

 

(a) has turned 18; and

 

 

 

 

 

(b) is not living at a home of parent or parents

 

 

 

 

5.

Partnered (partner getting neither pension nor benefit) and person has not turned 18

$6,539.00

$5,324.80

$251.50

$204.80

6.

Partnered (partner getting neither pension nor benefit) and person has turned 18

$6,539.00

$5,889.00

$251.50

$226.50

7.

Partnered (partner getting pension or benefit) and person has not turned 18

$6,539.00

$5,324.80

$251.50

$204.80

8.

Partnered (partner getting pension or benefit) and person has turned 18

$6,539.00

$5,889.00

$251.50

$226.50

9.

Member of illness separated couple and person has not turned 18

$7,841.60

$5,324.80

$301.60

$204.80

10.

Member of illness separated couple and person has turned 18

$7,841.60

$5,889.00

$301.60

$226.50


Note 1: for member of a couple, partnered (partner getting neither pension nor benefit), partnered (partner getting pension or benefit) and illness separated couple see section 4.

Note 2: for dependent child, homeless person and independent young person see section 5.

Note 3: for living away from the persons parental homesee subsection 23 (4d).

Note 4: the rates in column 3a are adjusted 6 monthlv in line with CPI changes (see section 1198a).

Note 5: the rates in column 3b are adjusted annuallv in line with CPI changes (see section 1198b).

MODULE C—YOUTH DISABILITY SUPPLEMENT

Youth disability supplement

1066B-C1. An amount by way of youth disability supplement is to be added to a persons rate. The rate of youth disability supplement is $1,557.40 per year ($59.90 per fortnight).

Note: the rate of youth disability supplement is adjusted annually in line with CPI increases (see section 1198C).

MODULE D—ADDITIONAL AMOUNTS FOR DEPENDENT CHILDREN

Children of a couple

1066B-D1. If either or both members of a couple have dependent children, this is how the children are taken into account for the purposes of this Module:

(a) a dependent child of the man is to be taken into account as a dependent child of the woman and not of the man unless:

(i) the woman is not receiving a social security pension; or (ii) the couple is an illness separated couple because of the illness or infirmity of the woman; and

(b) a dependent child of the woman is to be taken into account as a dependent child of the man and not of the woman if:

(i) the woman is not receiving a social security pension; or (ii) the couple is an illness separated couple because of the illness or infirmity of the woman.

Note 1: the following Table summarises the rules established by this point: work out which column applies to the mans payment entitlements (if any); work out the item that applies to the womans payment entitlements (if any); find the box in that column that corresponds to that item: if the box contains the word woman the dependent children are allocated to the woman; if the box contains the word man, the dependent children are allocated to the man:


 

ALLOCATION OF DEPENDENT CHILDREN TABLE

column 1

column 2

 

column 3

man

 

 

 

column 3A

column 3B

column 3C

item

woman

social security pension

social security pension (illness separation)

nothing

1.

social security pension

woman

woman

woman

2.

social security pension (illness separation)

man

woman

3.

nothing

man

man

 

social security pension

= the person is receiving a social security pension and the couple is not an illness separated couple because of the persons illness or infirmity

social security pension (illness separation)

= the person is receiving a social security pension and the couple is an illness separated couple because of the persons illness or infirmity.

nothing

= the person is not receiving a social security pension (but may be receiving a social security benefit or a service pension).

Note 2: if the woman is receiving a social security pension and the man is receiving an age service pension or an invalid service pension, the Veterans Entitlements Act will allocate the dependent children to the man; the woman, although allocated the dependent children under point 1066B-D1, will not receive additional amounts for the children because of point 1066B-D5.

Note 3: if one partner is receiving a social security pension and the other is receiving a social security benefit, the Benefit Rate Calculators operate to deny the social security benefit recipient from receiving anything for the dependent children (see point 1067-E3 of Benefit Rate Calculator A and point 1068-E3 of Benefit Rate Calculator B).

Additional amounts for dependent children

1066B-D2. This is how to work out the amount per year to be added to a persons maximum basic rate for dependent children:


Method statement

Step 1.

Work out which one of the amounts applicable to the person under point 1066B-D3 is the highest: the result is called the provisional add-on.

Step 2.

Work out the amount that the person would receive under MODULE D of Pension Rate Calculator D if that Rate Calculator applied to the person: the result is called the notional income/assets tested add-on.

 

Note: this requires the application of the income and assets tests in Pension Rate Calculator D (Modules F, G and H) and of section 1207 (order of reduction against components of the maximum payment rate: first against MBR, then against rent, then against dependent child amount).

Step 3.

Compare the provisional add-on and the notional income/assets tested add-on: the amount to be added to the persons maximum basic rate is:

 

(a) the provisional add-on if the provisional add-on is greater than or equal to the notional income/assets tested add-on; or

 

(b) the notional income/assets tested add-on if that add-on is greater than the provisional add-on.

Applicable amounts

1066B-D3. If a person has a dependent child or dependent children, the amounts (if any) applicable to the person under this point are, subject to points 1066B-D4 to 1066B-D7, worked out using Table D.


TABLE D

APPLICABLE AMOUNT FOR DEPENDENT CHILDREN

column 1

column 2

column 3

column 4

item

additional amount

rate per

year

rate per

fortnight

1.

amount applicable if person has a dependent child who has not turned 13

$1,378.00

$53.00

2.

amount applicable if person has a dependent child who has turned 13 but has not turned 16

$2,009.80

$77.30

3.

amount applicable if person has a dependent child who has turned 16 (over 16 child add-on)

$884.00

$34.00

4.

amount applicable if the person has a dependent child or dependent children and either is not a member of a couple or is a member of an illness separated couple

$722.80

$27.80

Note 1: the item 1 rate is adjusted annually so that the combined family allowance and additional pension amounts for children covered by this item do not fall below 15% of the combined pensioner couple maximum basic rate (see subsections 1200 (1) and (2)).

Note 2: the item 2 rate is adjusted annually so that the combined family allowance and additional pension amounts for children covered by this item do not fall below 20% of the combined pensioner couple maximum basic rate (see subsections 1200 (3) and (4)).

Note 3: the item 3 rate is not adjusted.

Note 4: the item 4 rate is indexed annually in line with CPI increases (see sections 1191 to 1194).

Failure to reasonably pursue maintenance claim 1066B-D4. If:

(a)     a person is entitled to claim maintenance from someone else for a dependent child of the person; and

(b)     the Secretary considers that it is reasonable that the person should have taken action to obtain the maintenance; and

(c)     the person has not taken action that the Secretary considers reasonable to obtain the maintenance;

items 1, 2 and 3 of Table D in point 1066B-D3 do not apply to the dependent child.


No additional amounts for children covered by Veterans Entitlements Act

1066B-D5. Items 1, 2 and 3 of Table D do not apply to a child if the maximum rate of someones service pension is increased because of the child under the following provisions of the VEA:

(a)     Service Pension Rate Calculator Where There Are Dependent Children (point 42-C3);

(b)     Service Pension Rate Calculator For Blinded Veterans (point 43-C3).

No additional amount for prescribed student children

1066B-D6. Once a dependent child of a person turns 16, the child is not to be taken into account for the purposes of item 3 of Table D if the child is a prescribed student child.

Note 1: for prescribed student child and dependent child see section 5.

Note 2: even though a young person does not attract an additional amount under items 1, 2 and 3 of Table D in point 1066B-D3, the young person may attract guardian allowance under item 4 of the Table.

No guardian allowance for dependent children who have turned 18

1066B-D7. Once a dependent child of a person turns 18, the child is not to be taken into account for the purposes of item 4 of Table D unless:

(a)     the child is a student child but not a prescribed student child; or

(b)     the person receives child disability allowance in respect of the child.

MODULE EA—RENT ASSISTANCE (UNDER 18)

Application

1066B-EA1. This Module applies to the disability support pension of a person who has not turned 18 and is permanently blind.

Rent assistance

1066B-EA2. Subject to points 1066B-EA3 and 1066B-EA4, an amount to help cover the cost of rent is to be added to the maximum basic rate of:

(a)     a member of a couple; or

(b)     a person who has a pension increase child; or

(c) a person who is in disability accommodation; or

a person if:

(d) the person is not an ineligible homeowner; and

(e) the person pays, or is liable to pay, rent (other than Government rent); and


(f)     the rent is payable at a rate of more than $1,300 per year; and

(g)    the person is in Australia.

Note 1: for pension increase child see subsection 5 (15).

Note 2: for in disability accommodation see subsection 23 (4c).

Note 3: for rent. Government rent and ineligible homeowner see section 13.

No rent assistance if partner getting incentive allowance

1066B-EA3. If the person is a member of a couple and the persons partner is living with the person in their home, an amount is not to be added to the persons maximum basic rate under point 1066B-EA2 if the persons partner is receiving incentive allowance.

Note: for incentive allowance see Module J of Pension Rate Calculator A and Module F of Pension Rate Calculator B.

Rent assistance waiting period

1066B-EA4. Subject to point 1066B-EA5, no amount is to be added to a persons maximum basic rate under point 1066B-EA2 unless the person has a current accumulated rent assistance waiting period credit of at least 26 weeks.

Note: for current accumulated rent assistance waiting period credit see points 1066B-EA7 and 1066B-EA8 below.

Some people do not have to serve rent assistance waiting period

1066B-EA5. A person does not have to satisfy point 1066B-EA4 if:

(a)     the person has a benefit increase child; or

(b)    the person is in disability accommodation and paying rent; or

(c)     the person was, immediately before becoming qualified for the disability support pension, receiving:

(i) a social security or service pension or a social security benefit; and

(ii) an amount by way of:

(a) rent assistance; or

(b) incentive allowance.

Note 1: for pension increase child see subsection 5 (15).

Note 2: for in disability accommodation see subsection 23 (4c).

Serving the rent assistance waiting period

1066B-EA6. A person acquires an accumulated rent assistance waiting period credit by accumulating 26 weeks of eligible rent assistance waiting periods.


Accumulated eligible rent assistance waiting periods

1066B-EA7. For the purposes of point 1066B-EA4, a person is to be taken to have accumulated 26 weeks of eligible rent assistance waiting periods if:

(a)     the person has an eligible waiting period that is a continuous period of 26 weeks; or

(b)     the person has eligible waiting periods that together form a continuous period of 26 weeks; or

(c)     the person has eligible waiting periods that add up to 26 weeks and none of the eligible waiting periods start more than 4 weeks after the end of the immediately preceding waiting period.

Eligible rent assistance waiting period

1066B-EA8. A period is an eligible waiting period for a person if during the whole of the period the person:

(a)     is receiving a social security or service pension or a social security benefit; or

(b)     would, but for the application of an ordinary income test or maintenance income test or assets test, be receiving a social security benefit; or

(c)     is receiving payments as a trainee in full-time training under a program included in the programs known as Labour Force Programs; or

(d)     is in continuous full-time training under a program included in the programs known as Labour Force Programs and is receiving payments by way of remuneration in respect of that training; or

(e)     is receiving payments under the Adult Migrant Education Program; or

(f)      is in gaol.

Note: for in gaol see subsection 23 (5).

Credit ceases to be current in some circumstances

1066B-EA9. A persons accumulated rent assistance credit ceases to be current at a particular time if the persons last eligible rent assistance waiting period ended more than 4 weeks before that time.

Rate of rent assistance

1066B-EA10. The rate of rent assistance is the rate at which rent assistance would be payable to the person if Pension Rate Calculator D applied to the person.

Note 1: if Pension Rate Calculator D (see section 1066a) applied to the person, the person would be subject to an ordinary income test (Module F), a maintenance income test (Module G) and an assets test (Module H).


Note 2: if Pension Rate Calculator D applied to a person and there was to be a reduction in pension rate because of the application of the ordinary income test, the maintenance income test or the assets test, section 1207 would govern the order in which the reduction would be made against the components of the maximum payment rate (first against MBR and YDS, then against the rent, then against dependent child amount).

MODULE EB—RENT ASSISTANCE (18 AND OVER)

Application

1066B-EB1. This Module applies to the disability support pension of a person who has turned 18 and who is permanently blind.

Rent assistance

1066B-EB2. Subject to points 1066B-EB4 and 1066B-EB5, an amount to help cover the cost of rent is to be added to the maximum basic rate of:

(a)     a member of a couple; or

(b)     a person who has a pension increase child; or

(c)     a person who is living permanently or indefinitely away from the persons parental home; or

(d)     a person in disability accommodation; or a person if:

(e)     the person is not an ineligible homeowner; and

(f) the person pays, or is liable to pay, rent (other than Government rent); and

(g) the rent is payable at a rate of more than $1,300 per year; and

(h) the person is in Australia.

Note 1: for pension increase child see subsection 5 (15).

Note 2: for rent, Government rent and ineligible homeowner see section 13.

Note 3: for living away from parental home see subsection 23 (4d).

Note 4: for in disability accommodation see subsection 23 (4c).

Parent

1066B-EB3. For the purposes of point 1066B-EB2, a step-parent or guardian is to be taken to be a parent.

Note: parent, when used in this Act, does not normally include a step-parent or guardian (see subsection 5 (1)).

No rent assistance if partner getting incentive allowance

1066B-EB4. If the person is a member of a couple and the persons partner is living with the person in their home, an amount is not to be added to the persons maximum basic rate under point 1066B-EB2 if the persons partner is receiving incentive allowance.


Rent assistance waiting period

1066B-EB5. Subject to point 1066B-EB6, no amount is to be added to a persons maximum basic rate under point 1066B-EB2 unless the person has a current accumulated rent assistance waiting period credit of at least 26 weeks.

Some people do not have to serve rent assistance waiting period

1066B-EB6. A person does not have to satisfy point 1066B-EB5 if:

(a)     the person has a benefit increase child; or

(b)     the person is in disability accommodation and paying rent; or

(c)     the person was, immediately before becoming qualified for the disability support pension receiving:

(i) a social security or service pension or a social security benefit; and

(ii) an amount by way of:

(a) rent assistance; or

(b) incentive allowance; or

(d) the person was previously receiving a social security benefit whose rate included an amount by way of rent assistance and:

(i) the person ceased to receive that other social security benefit; and

(ii) the person ceased to receive that other social security benefit otherwise than because of the operation of an ordinary income, maintenance income or assets test; and

(iii) the person ceased to receive that other social security benefit not more than 4 weeks before commencing to receive the disability support pension whose rate is being worked out.

Serving the rent assistance waiting period

1066B-EB7. A person acquires an accumulated rent assistance waiting period credit by accumulating 26 weeks of eligible rent assistance waiting periods.

Accumulated eligible rent assistance waiting periods

1066B-EB8. For the purposes of point 1066B-EB5, a person is to be taken to have accumulated 26 weeks of eligible rent assistance waiting periods if:

(a)     the person has an eligible waiting period that is a continuous period of 26 weeks; or

(b)     the person has eligible waiting periods that together form a continuous period of 26 weeks; or

(c)     the person has eligible waiting periods that add up to 26 weeks


and none of the eligible waiting periods start more than 4 weeks after the end of the immediately preceding waiting period.

Eligible rent assistance waiting period

1066B-EB9. A period is an eligible waiting period for a person if during the whole of the period the person:

(a)     is receiving a social security or service pension or a social security benefit; or

(b)     would, but for the application of an ordinary income, maintenance income, or assets test, be receiving a social security benefit; or

(c)     is receiving payments as a trainee in full-time training under a program included in the programs known as Labour Force Programs; or

(d)     is in continuous full-time training under a program included in the programs known as Labour Force Programs and is receiving payments by way of remuneration in respect of that training; or

(e)     is receiving payments under the Adult Migrant Education Program; or

(f) is in gaol.

Credit ceases to be current in some circumstances

1066B-EB10. A persons accumulated rent assistance credit ceases to be current at a particular time if the persons last eligible rent assistance waiting period ended more than 4 weeks before that time.

Rate of rent assistance

1066B-EB11. The rate of rent assistance is the rate at which rent assistance would be payable to the person if Pension Rate Calculator D applied to the person.

Note 1: if Pension Rate Calculator D (sec section 1066a) applied to the person, the person would be subject to an ordinary income test (Module F). a maintenance income test (Module G) and an assets test (Module H).

Note 2: if Pension Rate Calculator D applied to a person and there was to be a reduction in pension rate because of the application of the ordinary income test, the maintenance income test or the assets test, section 1207 would govern the order in which the reduction would be made against the components of the maximum payment rate (first against MBR and YDS. then against the rent, then against dependent child amount).

MODULE F—REMOTE AREA ALLOWANCE

Remote area allowance

1066B-F1. An amount by way of remote area allowance is to be added to a persons rate of pension if:

(a) the persons usual place of residence is situated in the remote area; and


(b) the person is physically present in the remote area.

Note: for remote area and physically present in the remote area see section 14.

Rate of remote area allowance

1066B-F2. The rate of remote area allowance payable to a person is worked out using Table F. Work out which family situation in the Table applies to the person. The rate of remote area allowance is the corresponding amount in column 3 plus an additional corresponding amount in column 5 for each pension or benefit increase child of the person.

TABLE F

REMOTE AREA ALLOWANCE

column 1

column 2

column 3

column 4

column 5

column 6

item

persons family situation

basic allowance per year

basic allowance per fortnight

additional allowance per year

additional allowance per fortnight

1.

Not member of a couple

$364.00

$14.00

$182.00

$7.00

2.

Partnered—partner eligible to receive remote area allowance

$312.00

$12.00

$182.00

$7.00

3.

Partnered—partner not eligible to receive remote area allowance

$364.00

$14.00

$182.00

$7.00

4.

Member of an illness separated or respite care couple

$364.00

$14.00

$182.00

$7.00

Note 1: for member of a couple and partnered see section 4.

Note 2: for dependent child see section 5.

Note 3: for pension increase child see subsection 5 (15).

Note 4: for benefit increase child see subsection 5 (16).

Dependent children must be physically present in Australia

1066B-F3. Additional allowance is not payable for a pension or benefit increase child unless the child is physically present in Australia.

Additional remote area allowance for dependent children not available to both members of a pensioner couple

1066B-F4. Additional allowance is not to be included in a persons pension rate for a pension increase child if:

(a)     the persons partners pension rate includes additional allowance for the child; and

(b)     the persons partner has a child add-on for the child..


21. Before section 1199 of the Principal Act the following sections are inserted in Division 4 of Part 3.16 of Chapter 3:

Adjustment of disability support pension (under 21 and child) MBRs

1198a. This Act (and any other Act that refers to this Act) has effect as if, on 20 March and 20 September each year, the amount worked out in accordance with applying the formula:

benefit MBR (ordinary) × 26

to an amount identified in column 2 of an item in the following Table were substituted for the amount identified in column 3 of the item.


ADJUSTMENT OF DSP (UNDER 21 AND CHILD) MBR TABLE

column 1

column 2

column 3

item

benefit MBR (ordinary) amount

corresponding DSP (under 21 and child) MBR amount

 

Benefit Rate Calculator A —point 1067-B1—Table B

Pension Rate Calculator D— point 1066A-B1—Table B

1.

column 3a—item 1

column 3a—item 1

2.

column 3a—item 2

column 3a—item 2

3.

column 3a—item 3

column 3a—item 5

4.

column 3a—item 4

column 3a—item 7

5.

column 3a—item 5

column 3a—item 9

 

Benefit Rate Calculator B—point 1068-B1—Table B

 

6.

column 3a—item 4

column 3a—item 4

7.

column 3a—item 2

column 3a—item 3

8.

column 3a—item 6

column 3a—item 6

9.

column 3a—item 8

column 3a—item 8

10.

column 3a—item 10

column 3a—item 10

 

Benefit Rate Calculator A—point 1067-B1—Table B

Pension Rate Calculator E—point 1066B-B1—Table B

11.

column 3a—item 1

column 3a—item 1

12.

column 3a—item 2

column 3a—item 2

13.

column 3a—item 3

column 3a—item 5

14.

column 3a—item 4

column 3a—item 7

15.

column 3a—item 5

column 3a—item 9

 

Benefit Rate Calculator B—point 1068-B1—Table B

 

16.

column 3a—item 1

column 3a—item 4

17.

column 3a—item 2

column 3a—item 3

18.

column 3a—item 6

column 3a—item 6

19.

column 3a—item 8

column 3a—item 8

20.

column 3a—item 10

column 3a—item 10

Adjustment of disability support pension (under 21 and no child) MBRs

1198b. This Act (and any other Act that refers to this Act) has effect as if, on 1 January each year, the amount worked out by applying the formula:

benefit MBR (junior or intermediate) × 26

to an amount identified in column 2 of item in the following Table were substituted for the amount identified in column 3 of the item.


ADJUSTMENT OF DSP (UNDER 21 AND NO CHILD) MBR TABLE

column 1

column 2

column 3

item

benefit MBR (junior or intermediate) amount

corresponding DSP (under 21 and no child) MBR amount

 

Benefit Rate Calculator A— point 1067-B1—Table B

Pension Rate Calculator D— point 1066A-B1—Table B

1.

column 3b—item 1

column 3B—item 1

2.

column 3B—item 2

column 3B—item 2

3.

column 3B—item 3

column 3B—item 5

4.

column 3B—item 4

column 3B—item 7

5.

column 3B—item 5

column 3B—item 9

 

Benefit Rate Calculator B— point 1068-B1—Table B

 

6.

column 3B—item 1

column 3B—item 4

7.

column 3B—item 2

column 3B—item 3

8.

column 3B—item 6

column 3B—item 6

9.

column 3B—item 8

column 3B—item 8

10.

column 3B—item 10

column 3B—item 10

 

Benefit Rate Calculator A— point 1067-B1—Table B

Pension Rate Calculator E—point 1066B-B1—Table B

11.

column 3B—item 1

column 3B—item 1

12.

column 3B—item 2

column 3B—item 2

13.

column 3B—item 3

column 3B—item 5

14.

column 3B—item 4

column 3B—item 7

15.

column 3B—item 5

column 3B—item 9

 

Benefit Rate Calculator B—point 1068-B1—Table B

 

16.

column 3B—item 1

column 3B—item 4

17.

column 3B—item 2

column 3B—item 3

18.

column 3B—item 6

column 3B—item 6

19.

column 3B—item 8

column 3B—item 8

20.

column 3B—item 10

column 3B—item 10

Adjustment of youth disability supplement

1198c. This Act (and any other Act that refers to this Act) has effect as if, on 1 January each year, the amount worked out using the following formula was substituted for the amount of the rate of the youth disability supplement:

where:

CDA rate is the current figure, as at that 1 January, for the CDA rate..

Note: for current figure see subsection 20 (1).


Application of income and assets test reductions and of compensation reductions for income tax purposes

22. Section 1207 of the Principal Act is amended by inserting after the matter relating to Pension Rate Calculator C in the Table in subsection (2) the following item:

Pension

Module D

Module EA

Module F

Module G

Module H

 

Rate

 

Module EB

 

 

 

 

Calculator D

 

 

 

 

 

 

(section 1066A)

 

 

 

 

 

.

Schedule 1a—Savings and transitional provisions

23. Schedule 1a of the Principal Act is amended by inserting after clause 32 the following clauses:

Invalid pensioners (changes introduced on 12 November 1991)

33. If a determination granting a claim for:

(a)     invalid pension; or

(b)     sheltered employment allowance;

is in force immediately before 12 November 1991, the determination has effect, from 12 November 1991, as if it were a determination granting a claim for disability support pension.

Invalid pensioners (changes introduced on 12 November 1991)

34. If, on 11 November 1991, a person:

(a)     was receiving invalid pension, sheltered employment allowance or rehabilitation allowance; and

(b)     had not turned 21;

then, on and after 12 November 1991, the persons pension or allowance continues to be worked out as if Pension Rate Calculator D at the end of section 1066a and Pension Rate Calculator E at the end of section 1066b did not apply to the person.

Rehabilitation allowance (changes introduced on 12 November 1991)

35. If a determination granting a claim for rehabilitation allowance is in force in relation to a persons participation in a rehabilitation program immediately before 12 November 1991, Part 2.10 of this Act as in force immediately before 12 November 1991 continues to apply to the person so long as the person continues to participate in the rehabilitation program.

Incentive allowance (changes introduced on 12 November 1991)

36. (1) If:

(a) a person is qualified for incentive allowance immediately before 12 November 1991; and


(b) the person is receiving disability support pension on 12 November 1991 because of a determination referred to in clause 33;

the following provisions as in force immediately before 12 November 1991 continue to apply to the person:

(c)     points 1064-J1 to 1064-J3 (Pension Rate Calculator A); and

(d)     points 1065-F1 to 1065-F3 (Pension Rate Calculator B).

(2) If:

(a)     a person was receiving incentive allowance immediately before 12 November 1991; and

(b)     on or after 12 November 1991 the person ceases to be qualified for incentive allowance because the person obtains work; and

(c)     within 2 years after so ceasing to be qualified, the person undertakes an activity that would have qualified him or her for incentive allowance had it been undertaken immediately before 12 November 1991;

the following provisions as in force immediately before 12 November 1991 apply to the person:

(d)     points 1064-J1 to 1064-J3 (Pension Rate Calculator A); and

(e)     points 1065-F1 to 1065-F3 (Pension Rate Calculator B).

(3) If a persons rate of disability support pension includes an amount for incentive allowance because of subsection (1) or (2) the persons rate of disability support pension cannot include an amount for rent assistance.

(4) A person whose rate of disability support pension includes an amount for incentive allowance because of subsection (1) or (2) may elect, by written notice to the Secretary, to have the amount for incentive allowance excluded from the persons rate.

(5) If a person referred to in subsection (1) ceases to be qualified for incentive allowance on or after 12 November 1991, subsection (1) ceases to apply to the person and cannot apply to the person again.

Employment entry payments (changes introduced on 12 November 1991)

37. If:

(a) on 11 November 1991 a person is receiving:

(i) invalid pension; or

(ii) rehabilitation allowance or sheltered employment allowance in place of invalid pension; and

(b) the person commences employment on 12 November 1991;

then, for the purpose of applying subsection 664c (1) to the person, paragraph 664c (1) (b) is taken to include a reference to invalid pension


or rehabilitation allowance or sheltered employment allowance in place of invalid pension.

Sickness benefit (changes introduced on 12 November 1991)

38. (1) If a determination granting a persons claim for sickness benefit is in force immediately before 12 November 1991:

(a)     the determination has effect, from 12 November 1991, as if it were a determination granting a claim for sickness allowance; and

(b)    for the purposes of applying sections 670, 672 and 673 to the person, the person is taken to have commenced to receive sickness allowance on the date the person commenced to receive sickness benefit.

(2) The determination is taken to specify a maximum allowance period that commences on 12 November 1991 and ends:

(a)     on 12 February 1992; or

(b)     at the end of the period specified in the most recent medical certificate that the person provided before 12 November 1991 in support of the persons claim for sickness benefit;

whichever ends earlier.

Note: for the effect of the maximum allowance period, see section 669.

(3) If immediately before 12 November 1991 a person has been receiving sickness benefit continuously from 12 November 1990, then for the purposes of applying sections 670, 672 and 673 to the person:

(a)     the person is taken to have commenced to receive sickness allowance on 12 November 1990; and

(b)    the Secretary is taken to have made a determination under subsection 670 (2) in relation to the person.

(4) If subclause (1) applies to a determination granting a persons claim for sickness benefit, then for the purposes of applying sections 670, 672 and 673 to the person, a reference in those sections to sickness, allowance is taken to include a reference to sickness benefit.

Special needs invalid pensioners (changes introduced on 12 November 1991)

39. If a determination granting a claim for special needs invalid pension is in force immediately before 12 November 1991, the determination has effect, from 12 November 1991, as if it were a determination granting a claim for special needs disability support pension..

Consequential amendments

24. The Acts specified in Schedule 1 are amended as set out in the Schedule.


Insertion of Schedule of Impairment Tables

25. After Schedule 1a to the Principal Act, the Schedule set out in Schedule 2 to this Act is inserted.

PART 4—AMENDMENT OF THE HEALTH INSURANCE ACT 1973

Principal Act

26.    In this Part, Principal Act means the Health Insurance Act 19732.

27.    After section 4c of the Principal Act the following section is inserted:

Disadvantaged persons, being children attracting child disability allowance

4ca. (1) In this section, CDA child and child disability allowance have the same meaning as in the Social Security Act 1991.

(2) While a person is qualified for child disability allowance for a CDA child, the CDA child is a disadvantaged person within the meaning of this section..


SCHEDULE 1 Section 24

CONSEQUENTIAL AMENDMENTS

Social Security Act 1991

Section 3:

 

Insert in the Index the following entries:

 

continuing inability to work

94 (2)

DSP non-compliance waiting period

105

Impairment Tables

23 (1)

in disability accommodation

23 (4c)

living away from the persons parental home

23 (4d)

physical impairment

23 (1)

program of assistance

23 (1)

SA non-compliance waiting period

698

severely disabled

23 (4b).

Paragraph 7 (4) (b):

Omit invalid, substitute disability support.

Paragraph 7 (6) (b):

Omit invalid, substitute disability support.

Section 18:

Repeal the section.

Subsection 23 (1) (paragraph (c) of the definition of education leavers waiting period):

Omit the paragraph, substitute:

(c) a sickness allowance education leavers waiting period under sections 695 and 696;.

Subsection 23 (1) (paragraph (c) of the definition of ordinary waiting period):

Omit the paragraph, substitute:

(c) a sickness allowance ordinary waiting period under sections 693 and 694;.

Subsection 23 (1) (paragraph (c) of the definition of social security benefit):

Omit benefit, substitute allowance.


SCHEDULE 1—continued

Subsection 23 (1) (paragraph (b) of the definition of social security pension):

Omit an invalid, substitute a disability support.

Subsection 23 (1) (paragraphs (h) and (j) of the definition of social security pension):

Omit the paragraphs.

Subsection 23 (1) (paragraph (c) of the definition of unused annual leave waiting period):

Omit the paragraph, substitute:

(c) a sickness allowance unused annual leave waiting period under sections 689 to 691;.

Subsection 23 (1) (before paragraph (a) of the definition of waiting period):

Insert:

(aa) a DSP non-compliance waiting period under section 105; or.

Subsection 23 (1) (paragraphs (g), (h) and (j) of the definition of waiting period):

Omit the paragraphs, substitute:

(g) a sickness allowance ordinary waiting period under sections 693 and 694; or

(h) a sickness allowance unused annual leave waiting period under sections 689 to 691; or

(i) a sickness allowance education leavers waiting period under sections 695 and 696;.

Subsection 23 (1) (definition of waiting period):

Add at the end:

; or (k) an SA non-compliance waiting period under section 698;.

Subsection 23 (10):

Omit (sickness benefit), substitute (sickness allowance).

Subparagraph 82 (1) (d) (ii):

Omit an invalid, substitute a disability support.

Subparagraph 82 (1) (d) (vi):

Omit the subparagraph.

Subparagraph 82 (1) (d) (viii):

Omit invalid, substitute disability support.


SCHEDULE 1—continued

Paragraph 147 (1) (b):

Omit invalid (wherever occurring), substitute disability support.

Subparagraph 237 (1) (d) (ii):

Omit an invalid, substitute a disability support.

Subparagraph 237 (1) (d) (v):

Omit the subparagraph.

Subparagraph 237 (1) (d) (vii):

Omit invalid, substitute disability support.

Sub-subparagraph 249 (2) (b) (i) (b):

Omit an invalid, substitute a disability support.

Sub-subparagraph 249 (2) (b) (i) (d):

Omit invalid, substitute disability support.

Sub-subparagraph 262 (2) (b) (i) (b):

Omit an invalid, substitute a disability support.

Subparagraph 303 (1) (d) (ii):

Omit an invalid, substitute a disability support.

Subparagraph 303 (1) (d) (iv):

Omit the subparagraph.

Subparagraph 303 (1) (d) (vi):

Omit invalid, substitute disability support.

Sub-subparagraph 362 (2) (b) (i) (b):

Omit an invalid, substitute a disability support.

Sub-subparagraph 362 (2) (b) (i) (d):

Omit invalid, substitute disability support.

Subsection 665 (1):

Omit or 664a, substitute , 664a or 664c.

Subsection 665 (2):

Omit or 663, substitute , 663 or 664c.

Section 773:

Repeal the section, substitute:


SCHEDULE 1—continued

Qualification for special needs disability support pension

Inability to work

773. A person is qualified for a special needs disability support pension if:

(a)     the person has not resided in Australia at any time after 7 May 1973; and

(b)     the person is severely disabled; and

(c)     the person has turned 16; and

(d)     at the time when the person first satisfied paragraph (b), the person was in Australia or temporarily absent from Australia; and

(e)     the person is, in the opinion of the Secretary, in special need of financial assistance..

Paragraph 779 (1) (e):

After medical, insert , psychiatric or psychological.

Section 780:

Omit invalid, substitute disability support.

Paragraph 784 (3) (a):

Omit invalid, substitute disability support.

Section 788:

Repeal the section, substitute:

Refusal to attend interview etc.

788. (1) A special needs disability support pension is not payable to a person if:

(a)     the person is receiving, or has lodged a claim for, a special needs disability support pension; and

(b)    the Secretary is of the opinion that the person should:

(i) contact a specified officer of the Department; or

(ii) attend an interview at a specified place; or

(iii) complete a questionnaire; or

(iv) attend a medical, psychiatric or psychological examination; and

(c) the Secretary notifies the person that the person is required to:

(i) contact that officer; or

(ii) attend that interview; or

(iii) complete that questionnaire; or

(iv) attend that examination; or


SCHEDULE 1continued

(v) if the person has undergone an examination—provide to the Secretary a report on that examination in the approved form; and

(d)     the Secretary is satisfied that it is reasonable for this section to apply to the person; and

(e)     the person does not take reasonable steps to comply with the Secretarys requirements within the time specified in the notice.

Note: if this section applies to someone who is receiving disability support pension, the persons pension will be cancelled or suspended by a determination of the Secretary under section 818.

(2) A notice under paragraph (1) (c) must be in writing and must inform the person of the effect of this section..

Section 795:

Repeal the section, substitute:

Examination by medical practitioner

795. (1) The Secretary must direct that a claimant for a special needs disability support pension be examined by a medical practitioner or practitioners unless:

(a)     it is manifest that the claimant is severely disabled; or

(b)     the claimants rate of special needs disability support pension, if granted, would be nil; or

(c)     the claimant does not satisfy the requirements of paragraph 773 (1) (c) or section 791a (age requirements).

(2) If the claimant resides in a place that is remote from any medical practitioner, the Secretary may direct that:

(a.) subsection (1) does not apply to the claimant; and

(b) the claimant is to submit to the Department a written report by a medical practitioner that relates to the impairment in respect of which the claimant is claiming special needs disability support pension.

(3) The medical practitioner who has examined the claimant is to give a certificate stating the practitioners opinion as to:

(a) whether the claimant:

(i) has a physical, intellectual or psychiatric impairment; or

(ii) is permanently blind;

(as the case requires); and

(b) if the claimant does have a physical, intellectual or psychiatric impairment—the effect of the impairment on the claimants ability to work.


SCHEDULE 1—continued

(4) The medical practitioner must, if required to do so by the Secretary, include in the certificate the practitioners opinion as to the percentage of the persons impairment (if any) under the Impairment Tables.

(5) A certificate under this section must be in accordance with a form approved by the Secretary.

(6) In this section:

medical practitioner includes a person recognised as a medical practitioner by the law of the country in which the claimant resides..

Paragraph 796 (1) (b):

(a)     Omit special needs invalid pension, substitute special needs disability support pension.

(b)     Omit an invalid (wherever occurring), substitute a disability support.

Section 796 (Special Needs Proportional Rate Calculator—point 796-B5):

Omit invalid (wherever occurring), substitute disability support.

Section 796 (Special Needs Proportional Rate Calculator—point 796-B6):

Omit invalid (wherever occurring), substitute disability support.

Paragraph 811 (1) (c):

Omit invalid, substitute disability support.

Subsection 822 (1):

(a)     Omit invalid (wherever occurring), substitute disability support.

(b)     Omit an invalid, substitute a disability support.

Paragraph 1061A (1) (c):

Omit benefit, substitute allowance.

Subsection 1064 (2):

Omit invalid substitute disability support.

Subsection 1064 (2) (Note):

Omit invalid, substitute disability support.

Subsection 1064 (3) (Note):

Omit the Note.


SCHEDULE 1—continued

Subparagraph 1064 (5) (b) (ii):

Omit the subparagraph, substitute:

(ii) a disability support pension.

Section 1064 (Pension Rate Calculator A point 1064-A1—Method statement—Step 11):

Omit and any amount per year payable by way of incentive allowance (see MODULE J below).

Section 1064 (Pension Rate Calculator A point 1064-C2—Note 1):

Omit the Note.

Section 1064 (Pension Rate Calculator A point 1064-D1—paragraph (b)):

Omit the paragraph.

Section 1064 (Pension Rate Calculator A point 1064-D2):

Omit the point.

Section 1064 (Pension Rate Calculator A point 1064-D4—Note 1):

Omit the Note.

Section 1064 (Pension Rate Calculator A point 1064-E10—Note 3):

Omit the Note.

Section 1064 (Pension Rate Calculator A point 1064-F3—Note):

Omit the Note.

Section 1064 (Pension Rate Calculator A point 1064-F5—Note):

Omit the Note.

Section 1064 (Pension Rate Calculator A point 1064-F11—Note 3):

Omit the Note.

Section 1064 (Pension Rate Calculator A point 1064-G4—Note 3):

Omit the Note.

Section 1064 (Pension Rate Calculator A Module J):

Omit the Module.

Subsection 1065 (2):

Omit invalid, substitute disability support.

Subsection 1065(2) (Note):

Omit the Note.


SCHEDULE 1continued

Paragraph 1065 (4) (b):

Omit invalid, substitute disability support.

Section 1065 (Pension Rate Calculator B point 1065-A1—Method statement—Step 5):

Omit and any amount per year payable by way of incentive allowance (see MODULE F below).

Section 1065 (Pension Rate Calculator B point 1065-C1—Note 1):

Omit the Note.

Section 1065 (Pension Rate Calculator B point 1065-D1paragraph (b)):

Omit the paragraph.

Section 1065 (Pension Rate Calculator B point 1065-D2):

Omit the point.

Section 1065 (Pension Rate Calculator B Module F):

Omit the Module.

Paragraph 1067 (1) (b):

Omit benefit, substitute allowance.

Section 1067 (Benefit Rate Calculator A point 1067-F8—paragraph (b)):

Omit sickness benefit, substitute sickness allowance.

Section 1067 (Benefit Rate Calculator A point 1067-F12—paragraph (b)):

Omit sickness benefit, substitute sickness allowance.

Section 1067 (Benefit Rate Calculator A point 1067-G7—paragraph (a)):

Omit benefit or.

Section 1067 (Benefit Rate Calculator A point 1067-G18):

(a)     Omit Social Security benefit, substitute allowance.

(b)    Omit social security benefit, substitute allowance.

Section 1067 (Benefit Rate Calculator A point 1067-H4):

Omit benefit (twice occurring), substitute allowance.

Paragraph 1068 (1) (b):

Omit benefit, substitute allowance.


SCHEDULE 1—continued

Section 1068 (Benefit Rate Calculator B point 1068-F3):

Omit the point.

Section 1068 (Benefit Rate Calculator B point 1068-F7—paragraph (c)):

Omit sickness benefit, substitute sickness allowance.

Section 1068 (Benefit Rate Calculator B point 1068-F7—subparagraph (c) (ii):

Omit the subparagraph, substitute:

(ii) an amount by way of rent assistance; or.

Section 1068 (Benefit Rate Calculator B point 1068-G4):

Omit benefit (twice occurring), substitute allowance.

Subparagraphs 1133 (1) (a) (ii) and (2) (a) (ii):

Omit invalid, substitute disability support.

Subparagraph 1133 (1) (a) (vii):

Omit the subparagraph.

Subparagraph 1133 (2) (a) (vi):

Omit the subparagraph.

Division 1 of Part 3.13 (Heading):

Omit (excluding sheltered employment allowance and rehabilitation allowance).

Section 1158:

Omit invalid, substitute disability support.

Paragraph 1161 (1) (b):

Omit sickness benefit, substitute sickness allowance.

Section 1162:

Repeal the section.

Paragraph 1163 (1) (a):

Omit the paragraph, substitute:

(a) so far as the person is concerned:

(i) disability support pension;

(ii) rehabilitation allowance;

(iii) social security benefit;

(iv) special needs disability support pension; and.


SCHEDULE 1—continued

Paragraph 1163 (1) (b):

Omit the paragraph, substitute:

(b) so far as the partner (if any) is concerned:

(i) disability support pension;

(ii) rehabilitation allowance;

(iii) social security benefit;

(iv) wife pension;

(v) carer pension;

(vi) special needs disability support pension; or

(vii) special needs wife pension..

Subsection 1163 (5):

Omit all words to and including employment allowance, substitute A disability support pension, social security benefit (other than sickness allowance).

Subsection 1163 (5) (Note):

Omit benefit, substitute allowance.

Paragraph 1164 (1) (a):

Omit the paragraph, substitute:

(a) a person is receiving:

(i) disability support pension; or

(ii) rehabilitation allowance; or

(iii) social security benefit; or

(iv) special needs disability support pension; and.

Paragraph 1164 (2) (a):

Omit the paragraph, substitute:

(a) the person is qualified for:

(i) disability support pension; or

(ii) rehabilitation allowance; or

(iii) social security benefit; or

(iv) special needs disability support pension; and.

Paragraph 1165 (1) (a):

Omit the paragraph, substitute:

(a) the person is qualified for:

(i) disability support pension; or

(ii) rehabilitation allowance; or

(iii) social security benefit; or


SCHEDULE 1—continued

(iv) special needs disability support pension; and.

Paragraph 1165 (2) (a):

Omit the paragraph, substitute:

(a) the person is qualified for:

(i) disability support pension; or

(ii) rehabilitation allowance; or

(iii) social security benefit; or

(iv) special needs disability support pension; and.

Paragraph 1165 (2) (d):

Omit the paragraph, substitute:

(d) none of the following is payable to the person for the lump sum preclusion period:

(i) disability support pension;

(ii) rehabilitation allowance;

(iii) social security benefit;

(iv) special needs disability support pension;.

Paragraph 1165 (2) (e):

Omit the paragraph, substitute:

(e) none of the following is payable to the persons partner for the lump sum preclusion period:

(i) disability support pension;

(ii) rehabilitation allowance;

(iii) social security benefit;

(iv) wife pension;

(v) carer pension because of caring for the person;

(vi) special needs disability support pension; or

(vii) special needs wife pension..

Section 1165 (Examples):

(a)     Omit invalid (wherever occurring), substitute disability support.

(b)     Omit Invalid (wherever occurring), substitute Disability support.

Paragraph 1166 (1) (b):

Omit the paragraph, substitute:

(b) the person receives payments of:

(i) disability support pension; or

SCHEDULE 1continued

(ii) rehabilitation allowance; or

(iii) social security benefit; or

(iv) special needs disability support pension;

for the lump sum preclusion period;”.

Section 1166 (Recoverable Amount Table):

Omit the Table, substitute:

RECOVERABLE AMOUNT TABLE

 

column 1

column 2

column 3

column 4

column 5

 

item

category of person

person qualified for

partners status

recoverable amount

 

1.

Not member of a couple

DSP

SSB

SNDSP

RHA

 

the smaller of:

CLS

PBAP

(see subsection (3))

 

2.

Partnered

DSP

SSB

SNDSP

RHA

not qualified for:

DSP

SSB

WP

CP

SNDSP

RHA

the smaller of:

CLS

PBAP

(see subsection (3))

 

3.

Partnered

DSP

SSB

SNDSP

RHA

qualified for:

DSP

SSB

WP

CP

SNDSP

RHA

the smaller of:

CLS

PBAP + PPBAP

(see subsection (4))

KEY

DSP

= disability support pension

CLS

= compensation part of lump sum

SSB

= social security benefit

PBAP

= person’s pension, benefit or allowance payments

RHA

= rehabilitation allowance payable in place of DSP

PPBAP

= partner’s pension, benefit or allowance payments.”.

WP

= wife pension

 

 

CP

carer pension because of caring for the person

 

 

SNDSP

= special needs disability support pension

 

 

Section 1166 (Examples):

Omit “invalid” (wherever occurring), substitute “disability support”.

 

SCHEDULE 1—continued

Paragraph 1168 (1) (b):

Omit the paragraph, substitute:

(b) the person is qualified for:

(i) disability support pension; or

(ii) rehabilitation allowance; or

(jii) social security benefit; or

(iv) special needs disability support pension;

for the periodic payments period.

Subsection 1168 (2):

Omit for the periodic payments period.:

Paragraph 1168(2) (c):

Omit the paragraph, substitute:

(c) the persons partner is qualified for:

(i) disability support pension; or

(ii) rehabilitation allowance; or

(iii) social security benefit; or

(iv) wife pension; or

(v) carer pension because of caring for the person; or

(vi) special needs disability support pension; or

(vii) special needs wife pension;

for the periodic payments period;.

Section 1168 (Reduction Table):

Omit the Table, substitute:


SCHEDULE 1—continued

REDUCTION TABLE

 

column 1

column 2

column 3

column 4

column 5

column 6

 

item

category of person

person qualified for

partners status

compensation recipient

reduced fortnightly rate of pension, benefit or allowance

 

1.

Not member of a couple

DSP

SSB

SNDSP

RHA

 

person

PBA - PC

 

 

not qualified for:

 

2.

Partnered

DSP

SSB

SNDSP

RHA

DSP

SSB

WP

CP

SNDSP

RHA

person

PBA - PC

 

 

not qualified for:

 

3.

Partnered

DSP

SSB

SNDSP

RHA

DSP

SSB

WP

CP

SNDSP

RHA

partner

PBA - PC

 

 

qualified for:

 

4.

Partnered

DSP

DSP

person

PBA - PC

 

 

 

SSB

SSB

WP

 

2

 

 

 

SNDSP

 

PPBA - PC

 

 

 

RHA

CP

SNDSP

RHA

 

2

 

 

qualified for:

 

5.

Partnered

DSP

DSP

partner

PBA - PC

 

 

 

SSB

SSB

 

2

 

 

 

SNDSP

WP

 

PPBA - PC

 

 

 

RHA

CP

SNDSP

RHA

 

2


SCHEDULE 1—continued

KEY

DSP

=

disability support pension

PBA

=

person’s fortnightly rate of pension, benefit or
allowance

SSB

=

= social security benefit

PC

=

fortnightly rate of periodic compensation

WP

=

= wife pension

PPBA

=

partner’s fortnightly rate

of

pension, benefit or allowance.”.

CP

=

carer pension because of caring for the person

 

 

 

SNDSP

=

special needs disability support pension

 

 

 

RHA

=

rehabilitation allowance payable in place of DSP

 

 

 

 

Section 1168 (Examples):

Omit benefit (wherever occurring), substitute allowance.

Paragraph 1170 (1) (b):

Omit the paragraph, substitute:

(b) the person receives payments of:

(i) disability support pension; or

(ii) rehabilitation allowance; or

(iii) social security benefit; or

(iv) special needs disability support pension;

for the periodic payments period; and.

Section 1170 (Recoverable Amount Table):

Omit the Table, substitute:


SCHEDULE 1—continued

RECOVERABLE AMOUNT TABLE

 

column 1

column 2

column 3

column 4

column 5

 

item

category of person

person qualified for

partners status

recoverable amount

 

1.

 

 

 

the smaller of:

 

 

Not member

DSP

 

CLS

 

 

of a couple

SSB

SNDSP

RHA

 

PBAP

(see subsection (3))

 

 

 

 

not qualified for:

the smaller of:

 

2.

Partnered

DSP

DSP

CLS

 

 

 

SSB

SSB

PBAP

 

 

 

SNDSP

RHA

WP

CP

(see subsection (3))

 

 

 

 

SNDSP

RHA

 

 

 

 

 

qualified for:

the smaller of:

 

3.

Partnered

DSP

DSP

CLS

 

 

 

SSB

SSB

PBAP + PPBAP

 

 

 

SNDSP

RHA

(see

 

 

 

RHA

WP

CP

SNDSP

RHA

subsection (4))

KEY

 

 

DSP

 

= disability support pension

SSB

= social security benefit

WP

= wife pension

CP

= carer pension because of caring for the person

SNDSP

= special needs disability support pension

RHA

= rehabilitation allowance payable in place of DSP

 

CLS

= compensation part of lump sum

PBAP

= person’s pension, benefit or allowance payments

PPBAP

= partner’s pension, benefit or allowance payments.”.

 

Section 1170 (Examples):

(a)     Omit “invalid” (wherever occurring), substitute “disability support”.

(b)     Omit “unemployment benefit” (wherever occurring), substitute “job search allowance”.

Paragraph 1172 (1) (b):

Omit the paragraph, substitute:

“(b) the person receives or claims:

SCHEDULE 1—continued

(i) a disability support pension; or

(ii) rehabilitation allowance; or

(iii) a social security benefit; or

(iv) a special needs disability support pension;

for any period in respect of which the compensation is sought;.

Paragraph 1174 (1) (b):

Omit the paragraph, substitute:

(b) the person receives or claims:

(i) a disability support pension; or

(ii) rehabilitation allowance; or

(iii) a social security benefit; or

(iv) a special needs disability support pension;

for the periodic payments period or the lump sum payment period;.

Paragraph 1174 (5) (b):

Omit the paragraph, substitute:

(b) the persons partner neither receives nor claims:

(i) a disability support pension; or

(ii) rehabilitation allowance; or

(iii) a social security benefit; or

(iv) a wife pension; or

(v) a carer pension because of caring for the person; or

(vi) a special needs disability support pension; or.

(vii) a special needs wife pension;

for the periodic payments period or the lump sum payment period;.

Paragraph 1174 (6) (b):

Omit the paragraph, substitute:

(b) the persons partner receives or claims:

(i) a disability support pension; or

(ii) rehabilitation allowance; or

(iii) a social security benefit; or

(iv) a wife pension; or

(v) a carer pension because of caring for the person; or

(vi) a special needs disability support pension; or

(vii) a special needs wife pension;


SCHEDULE 1—continued

for the periodic payments period or the lump sum payment period;.

Paragraph 1177 (1) (b):

Omit the paragraph, substitute:

(b) the person receives or claims:

(i) a disability support pension; or

(ii) rehabilitation allowance; or

(iii) a social security benefit; or

(iv) a special needs disability support pension;

for any period in respect of which the compensation is sought; and.

Paragraph 1179 (1) (b):

Omit the paragraph, substitute:

(b) the person receives or claims:

(i) a disability support pension; or

(ii) rehabilitation allowance; or

(iii) a social security benefit; or

(iv) a special needs disability support pension;

for the periodic payments period or the lump sum payments period;.

Paragraph 1179 (5) (b):

Omit the paragraph, substitute:

(b) the persons partner neither receives nor claims:

(i) a disability support pension; or

(ii) rehabilitation allowance; or

(iii) a social security benefit; or

(iv) a wife pension; or

(v) a carer pension because of caring for the person; or

(vi) a special needs disability support pension; or

(vii) a special needs wife pension;

for the periodic payments period or the lump sum payments period;.

Paragraph 1179 (6) (b):

Omit the paragraph, substitute:

(b) the persons partner receives or claims:

(i) a disability support pension; or

(ii) rehabilitation allowance; or


SCHEDULE 1—continued

(iii) a social security benefit; or

(iv) a wife pension; or

(v) a carer pension because of caring for the person; or

(vi) a special needs disability support pension; or

(vii) a special needs wife pension;

for the periodic payments period or the lump sum payments period;.

Subparagraph 1187 (1) (a) (i):

Omit invalid, substitute disability support.

Subparagraph 1187 (2) (a) (i):

Omit invalid, substitute disability support.

Subparagraph 1187 (3) (c) (iii):

Omit benefit, substitute allowance.

Subparagraph 1187 (3) (c) (v):

Omit the subparagraph.

Paragraphs 1210 (4) (a) and (b):

Omit an invalid, substitute a disability support.

Section 1210 (International Agreement Portability Rate Calculator—point 1210-B5):

Omit invalid (wherever occurring), substitute disability support.

Section 1210 (International Agreement Portability Rate Calculator—point 1210-B6):

Omit invalid (wherever occurring), substitute disability support.

Subparagraph 1187 (1a) (a) (iii):

Omit benefit, substitute allowance.

Subparagraph 1187 (1a) (a) (v):

Omit the subparagraph.

Section 1190 (Indexed and Adjusted Amounts Table—column 2 of item 1):

Add (except disability support pension payable to a person who is under 21).


SCHEDULE 1continued

Section 1190 (Indexed and Adjusted Amounts Table):

After item 1 insert the following items:

1A. Maximum basic rates for disability support pension payable to person who is under 21 and has one or more dependent children

DSP (under 21 and child) MBR

[Pension Rate Calculator D—point 1066A-B1—Table B—column 3A—all amounts]

[Pension Rate Calculator E—point 1066B-B1—Table B—column 3A—all amounts]

1B. Maximum basic rates for disability support pension payable to person who is under 21 and has no dependent children

DSP (under 21 and no child) MBR

[Pension Rate Calculator D—point 1066A-B1—Table B—column 3B—all amounts]

[Pension Rate Calculator E—point 1066B-B1—Table B—column 3B—all amounts].

Section 1190 (Indexed and Adjusted Amounts Table):

After item 4 of table insert the following item:

Youth disability supplement

 

 

4A. Youth disability supplement payable to a disability support pensioner who is under 21

youth disability supplement

[Pension Rate Calculator D—point 1066A-C1] [Pension Rate Calculator E—point 1066B-C1].

Section 1190 (Indexed and Adjusted Amounts Table—column 4 of item 7):

Add:

[Pension Rate Calculator D—point 1066A-D3—Table D—column 3—item 1]

[Pension Rate Calculator E—point 1066B-D3—Table D—column 3—item 1].


SCHEDULE 1—continued

Section 1190 (Indexed and Adjusted Amounts Table—column 4 of item 8):

Add:

[Pension Rate Calculator D—point 1066A-D3—Table D—column 3—item 2]

[Pension Rate Calculator E—point 1066B-D3—Table D—column 3—item 2].

Section 1190 (Indexed and Adjusted Amounts Table—column 4 of item 11):

Add:

[Pension Rate Calculator D—point 1066A-D9]

[Pension Rate Calculator E—point 1066B-D3—Table D—column 3—item 4].

Section 1190 (Indexed and Adjusted Amounts Table—column 4 of item 17):

Add:

[Pension Rate Calculator D—point 1066A-EA12—Table EA—column 4—all amounts].

[Pension Rate Calculator D—point 1066A-EB13—Table EB—column 4—all amounts].

Section 1190 (Indexed and Adjusted Amounts Table—column 4 of item 20):

Add:

[Pension Rate Calculator D—point 1066A-F3—Table F-1—column 3—all amounts].

Section 1190 (Indexed and Adjusted Amounts Table—column 4 of item 23A):

Add:

[Pension Rate Calculator D—point 1066A-G10—Table G-1—columns 3 and 5—all amounts].

Section 1190 (Indexed and Adjusted Amounts Table—column 4 of item 24):

Add:

[Pension Rate Calculator D—point 1066A-H3—Table H-1—column 3A—item 1].

Section 1190 (Indexed and Adjusted Amounts Table—column 4 of item 25):

Add:

[Pension Rate Calculator D—point 1066A-H3—Table H-1—column 3B—item 1].


SCHEDULE 1—continued

Section 1190 (Indexed and Adjusted Amounts Table—column 4 of item 26):

Add:

[Pension Rate Calculator D—point 1066A-H3—Table H-1—column 3A—items 2 and 3].

Section 1190 (Indexed and Adjusted Amounts Table—column 4 of item 27):

Add:

[Pension Rate Calculator D—point 1066A-H3—Table H-1—column 3B—items 2 and 3].

Section 1190 (Indexed and Adjusted Amounts Table—item 44):

Omit the item.

Subsection 1212 (2):

Omit the subsection, substitute:

(2) Subsection (1) does not apply to a carer pension or a rehabilitation allowance..

Subparagraph 1212 (3) (a) (ii):

Omit the subparagraph, substitute:

(ii) a disability support pension; or.

Subparagraph 1212 (3) (c) (ii):

Omit the subparagraph, substitute:

(ii) a disability support pension; or.

Paragraph 1218 (1) (e):

Omit an invalid, substitute a disability support.

Subparagraph 1219 (1) (a) (ii):

Omit an invalid, substitute a disability support.

Subparagraph 1219 (2) (a) (ii):

Omit an invalid, substitute a disability support.

Subparagraph 1220 (1) (d) (ii):

Omit an invalid, substitute a disability support.

Subparagraph 1220 (2) (d) (ii):

Omit an invalid, substitute a disability support.

Subparagraph 1221 (2) (a) (ii):

Omit an invalid, substitute a disability support.


SCHEDULE 1—continued

Subsection 1221 (5):

(a)     Omit an invalid, substitute a disability support.

(b)     Omit the invalid, substitute the disability support.

(c)     Omit permanently incapacitated for, substitute unable to.

Section 1221 (Pension Portability Rate Calculator—point 1221-B5):

Omit invalid (wherever occurring), substitute disability support.

Section 1221 (Pension Portability Rate Calculator—point 1221-B6):

Omit invalid (wherever occurring), substitute disability support.

Subparagraph 1223 (2) (a) (iii):

Omit benefit, substitute allowance.

Health Insurance Act 1973

Section 4c:

Repeal the section.

National Health Act 1953

Section 4 (subparagraphs (aa) (i) and (ii) of the definition of pensioner):

Omit the subparagraphs, substitute:

(i) to whom or in respect of whom sickness allowance is payable under the Social Security Act 1991: or

(ii) to whom or in respect of whom rehabilitation allowance is payable under the Social Security Act 1991 in place of sickness benefit;.

SCHEDULE 2 Section 25

NEW SCHEDULE 1b TO THE SOCIAL SECURITY ACT 1991

SCHEDULE 1b

TABLES FOR ASSESSMENT OF IMPAIRMENT FOR DISABILITY SUPPORT PENSION


SCHEDULE 2—continued

 


SCHEDULE 2—continued

contents

Introduction

Notes

TABLES FOR ASSESSMENT OF IMPAIRMENT

1

Cardiovascular and/or respiratory function:
exercise tolerance

 

1.1 Assignment of impairment rating

 

1.2 Metabolic cost of activities

2

Respiratory function: physiological measurements

 

2.1 Assignment of impairment rating

 

2.2 Prediction nomogram - males

 

2.3 Prediction nomogram - females

3

Upper limb

4

Lower limbs

5

Musculo-skeletal function: spine

 

5.1 Cervical spine

 

5.2 Thoraco-lumbar spine

 

5.3 Normal range of joint movement

6

Other musculo-skeletal

7

Psychiatric

8

Alcohol and drug abuse

9

Neurological function: cognition

10

Neurological function: comprehension

11

Neurological function: expression

12

Intellectual

13

Gastrointestinal: stomach and duodenum

14

Gastrointestinal: small and large bowel, rectum and anus

15

Liver and biliary tract


SCHEDULE 2—continued

16

Hearing

 

16.1 Assignment of impairment rating

 

16.2 Threshold levels - 500 Hz

 

16.3 Threshold levels - 1000 Hz

 

16.4 Threshold levels - 1500 Hz

 

16.5 Threshold levels - 2000 Hz

 

16.6 Threshold levels - 3000 Hz

 

16.7 Threshold levels - 4000 Hz

17

Miscellaneous Ear, Nose and Throat

18

Visual Acuity

19

Miscellaneous Visual

20

Other Ocular

21

Lower Urinary Tract

22

Renal

23

Skin disorders

24

Endocrine

25

Miscellaneous (eg. malignancy, hypertension, HIV infection)

26

Intermittent impairment - explanation

 

26.1 Severity

 

26.2 Duration

 

26.3 Severity grading code

 

26.4 Assignment of impairment rating

COMBINED VALUES CHART


SCHEDULE 2—continued

introduction

These Tables for Assessment of Impairment for Disability Support Pension consist of system ased tables that assign impairment ratings in proportion to the severity of the condition. The impairment rating is expressed as a percentage of the whole of person functional capacity. Accordingly, a body system that is totally impaired may not necessarily produce an impairment rating of 100% — for example a person who has a total hearing loss receives an impairment rating of 40%.

2              For the purposes of these tables, impairment refers to any loss or abnormality of psychological, physiological or anatomical structure or function remaining after appropriate medical treatment and rehabilitative processes have been completed. This guide gives emphasis to the loss of functional capacity that a person experiences particularly in relation to work and associated aspects of daily living. This is measured by reference to an individuals efficiency in performing a set of defined functions in comparison with an unimpaired person.

3              For an impairment rating to be assigned the condition must be a fully documented, diagnosed condition which has been investigated, treated and stabilised. The conditions must, therefore, be considered to be permanent. A condition is accepted as being permanent if in the light of available evidence it is more likely than not that it will persist for the foreseeable future. This will be taken as lasting for more than two years.


SCHEDULE 2—continued

NOTES

1             An impairment rating is only to be assigned after a comprehensive history and examination. Where a table gives consecutive impairment ratings separated by 10% or more, and the CMO considers that the applicant falls somewhere between the range, then an appropriate impairment rating can be given using a multiple of 5% (eg. consecutive criteria given in a table for impairment percentages of 5% and 15%, the CMO can assign a rating of 10% if it is considered that the clinical findings do not satisfy the 5% or 15% criteria but lie somewhere in between).

2             A single medical condition should be assessed on all relevant tables when that medical condition is causing a separate loss of function in more than one body system. For example, Diabetes Mellitus may need to be assessed using the endocrine (24), exercise tolerance (1), lower limb impairment (4), renal impairment (22), skin disorders (23) and visual acuity (18) tables. When using more than one table for a single medical condition the possibility of double assessment of a single loss of function must be guarded against. For example, it is inappropriate to assess an isolated spinal condition under both the spine table (5) and the lower limb impairment table (4).

3               In general, pain should be assessed in terms of the underlying medical condition which causes it. However, where medical reports of the persons history consistently indicate chronic entrenched pain, and the CMO is satisfied that the pain is contributing to a persons inability to work, Table 25 can be used to assign an impairment rating. CMOs should use their clinical judgement when determining the degree to which pain is contributing to a persons inability to work.

4               Always use a table specific to the medical condition being rated unless the instructions in a section specify otherwise, and always use functionally-based tables in preference to diagnosis-based tables (for example tables 3 and 4). The system-specific tables provide appropriate criteria with which to rate a disorder. The procedure is to identify the loss of function, refer to the appropriate system table and identify the correct rating eg. a person with a CVA (stroke) could be assessed under four different tables: expression (11), cognition (9), upper and lower limbs (3 & 4). Table selection would depend on the functions affected.

5             Impairment ratings can not be assigned in excess of the maximum rating specified by each table (eg. if the maximum impairment rating for a table is 30%, the CMO can not assign a greater percentage than this figure).

6             Impairment ratings must be consistent with the impairment tables. No idiosyncratic impairment assessment systems are allowed.


SCHEDULE 2—continued

7 Where more than one impairment is present, separate scores are allotted for each. The values are not added but are combined using the Combined Values Chart. The highest two ratings are combined first. The resulting value is then combined with the next highest impairment rating, and so on. If a single disability has been given multiple impairment ratings the individual ratings are recorded but not combined until ratings from all disabilities are combined as a final step. Final combined ratings that are an odd number should be rounded up to the nearest even number, except where the odd number is a multiple of five. For example, 19 per cent should be rounded to 20 per cent, but 15 per cent would be recorded as 15 per cent.

8 Specific instructions concerning the body systems and the applicable tables are hereunder:

Cardiovascular Impairment

Cardiovascular function is measured by reference to exercise tolerance. An impairment rating is obtained from Table 1 by determining the lowest MET band in which cardiac symptoms occur. 1 MET is defined as average oxygen consumption at rest which is 3.5mL O2/kg/min.

Peripheral vascular disease is assessed under the lower limb impairment table. Varicose veins are assessed under either the lower limb or skin tables.

Hypertension is assessed under Table 25.

Where exercise intolerance is caused by a combination of cardiac and respiratory conditions, Table 1 is to be used and used only once. Episodic conditions would still be assessed under Table 26.

Respiratory Impairment

Respiratory function is measured by reference to exercise tolerance in the majority of cases and so Table 1 is used. Spirometry (FEV1 and FVC) can be used where the CMO feels it is more appropriate eg. a history of exercise tolerance is difficult to obtain and assess or the history of exercise tolerance is inconsistent with clinical findings on examination. Impairment is then assessed using Table 2.

Musculo-skeletal Impairment

All upper limb problems are assessed under the upper limb impairment table (Table 3). Each arm is assessed separately. If the dominant arm is affected, 5% is added to the impairment rating. Table 4 is used for lower limb assessment not back conditions and Table 5 is used for spinal assessment.

Table 6 is used for sciatica, amputations and other musculo-skeletal problems that do not fit into Tables 3, 4 and 5.


SCHEDULE 2—continued

Psychiatric Impairment

It is important to record a detailed psychiatric history. This will be sufficient to be able to assess impairment on Table 7. Impairment due to alcohol and drug abuse is assessed using Table 8. Intellectual impairment is assessed by using Table 12.

Cerebral Impairment

It is important to record a detailed history. Cerebral problems are assessed at Table 9 (Cognition), Table 10 (Comprehension), and Table 11 (Expression).

Gastro-intestinal Impairment

Gastro-intestinal problems are assessed at Table 13 (stomach and duodenum), Table 14 (bowel, rectum and anus) and Table 15 (Liver and Biliary Tract). Chronic pancreatitis can be scored under Table 25 or 26.

Ear, Nose and Throat Impairment

Miscellaneous ear, nose and throat disorders are assessed at Table 17. Vertigo should only be scored if a definitive diagnosis of vertigo has been made.

Visual Impairment

Visual impairment is assessed by measuring visual acuity in the better eye using Table 18. This must be corrected vision, and should only be assessed when best corrected vision is assessed by an optometrist or ophthalmologist. Miscellaneous problems with vision are assessed at Tables 19 and 20.

Gynaecological Conditions

Gynaecological conditions such as post-natal depression, pelvic inflammatory disease and endometriosis should be assessed using Table 27.

Impairment due to mastectomy should only be scored where there is associated loss of upper limb function, and Table 3 should be used.

Genito-Urinary Impairment

Lower urinary tract and renal problems are assessed at Tables 21 and 22, respectively.

The assessment of renal impairment is based upon the applicants creatinine clearance. As creatinine clearance involves a 24 hour urine collection it is often inconvenient for the applicant and may be subject to error. Consequently the following formula can be used to estimate creatinine clearance. The formula involves knowing the applicants plasma creatinine level, age and weight:


SCHEDULE 2—continued

For females, subtract 15% of the calculated value to give the creatinine clearance (ml/s).

For males, disorders of the genital system should be assessed under Tables 25 or 26.

Skin Disorders

Skin disorders are assessed at Table 23.

Endocrine Impairment

Endocrine disorders are assessed at Table 24.

Miscellaneous conditions, for example malignancy, HIV infection and hypertension

Table 25 is to be used for miscellaneous conditions. For malignancy, HIV infection and hypertension causing symptoms related to a specific system, impairment would be assessed using the table for that system as well as Table 25 and a combined impairment calculated using the Combined Values Chart.

Intermittent Impairment

Intermittent disorders are those disorders which remain asymptomatic between discrete episodes of impairment. They are rated by reference to severity, duration and frequency of episodes.

Severity and duration, are defined below.

Frequency is determined by the number of affected days in a year.

An impairment rating using the above three factors is made by first coding severity and duration into an intermittent grading. The code is then combined with frequency, using Table 26.4, to give the rating.

When episodes vary in severity, duration or frequency, an average for each factor should be estimated. Only one rating for a given disorder may be made from Table 26.4. Further, the impairment rating is not combined with any other rating for the same disorder.

Acute exacerbations of chronic disorders cannot be measured using this table unless both are significant e.g COAD plus episodes of acute bronchitis. Some intermittent disorders may be rated using system-specific tables. The system-specific table is then used in preference.


 

SCHEDULE 2—continued

TABLE 1.

LOSS OF CARDIOVASCULAR AND/OR RESPIRATORY FUNCTION: EXERCISE TOLERANCE

NOTE:

The appropriate MET level is calculated using the lists in Table 1.2

TABLE 1.1

Assignment of impairment rating

 

Impairment

Rating

Symptomatic Activity

Level (METs)

75

1-2

50

2-3

30

3-4

20

4-5

15

5-6

10

6-7

5

7-8

0

8-9

0

10+


SCHEDULE 2—continued

TABLE 1.2 Metabolic cost of activities

INSTRUCTIONS

Listed below is a more comprehensive set of activities, with their corresponding MET level. One MET represents the energy expenditure associated with the consumption of 3.5ml O2/kg body weight/minute. Please use this list to assist you in determining an appropriate symptomatic MET level for the claimant.

In determining the symptomatic activity level, greater reliance is placed on activities which involve a steady expenditure of energy (eg. walking steadily for 10 minutes) as opposed to a sporadic expenditure of energy (eg. playing one hole of golf). The former activities are more reliable indicators of exercise tolerance. Less reliance is placed on activities which can be completed in less than a few minutes, as symptoms may take longer than this to occur.

Metabolic Cost of Activities

1- 2 METs Energy expended at rest or minimal activity

 

Lying down

sitting and drinking tea

using sewing machine (electric)

sitting down

sitting and talking on telephone

travelling in a car as passenger

standing

sitting and knitting

playing cards

strolling (slowly)

light sweeping

clerical work - desk work only

2 - 3 METs Energy expended to dress, wash and perform light household duties

Walking 3.5km/hr (slowly)

playing piano/violin/organ

typing

cooking, preparing meals

playing billiards

clerical work which involves

setting table

driving power boat

moving around

washing dishes

playing golf (with power buggy)

bench assembly work (sitting)

dressing, showering

horseback riding at walk

using self-propelled mower

light tidying, dusting

lawn bowls

polishing silver

driving a car

 

 

3 - 4 METs Energy required for walking at average pace

 

Walking 5km/hr (average walking pace)

golf (pulling buggy)

machine assembly

 

cleaning car (excludes vigorous polishing)

minor car repairs

tidying house

welding

cleaning windows

table tennis

pushing light power mower

vacuuming

sedale cycling (10km/hr)

over flat suburban lawn at

shifting chairs

light gardening (weeding/watering)

slow, steady pace

hanging out washing

making bed

 

4 - 5 METs Moderate activities: encompasses more active daily activities with the exclusion of manual labour and

vigorous exercise

 

 

Mopping floors

golf (carrying bag)

light carpentry (eg. chiselling, hammering)

scrubbing floors

ballroom dancing

 

beating carpets

tennis doubles (social non- competitive)

stocking shelves with light

polishing furniture

objects

shopping/carrying groceries (10kg)

gentle swimming

painting outside of house

hoeing (soft soil)

stacking firewood

wallpapering

5 - 6 METs Heavy exercise: manual labour or vigorous sports

 

Walking 6.5km/hr (sustained brisk

walking slowly but steadily

carpentry (eg. sawing and

walk, discomfort talking at the

up stairs

planing with hand tools)

same time

swimming laps (non-competitive)

pushing a full wheelbarrow (20kg)

shovelling dirt (12 throws/minute)

digging in garden

 

6 - 7 METs

 

 

Badminton (competitive)

tennis (singles, non-competitive)

using a pick and shovel

water skiing

loading truck with bricks

to dig trenches

7 - 8 METs Very heavy exercise

 

 

Jogging (8km/hr)

horseback riding (galloping)

carrying heavy objects

sawing hardwood with hand tools

 

(10kg) on level ground

8 - 9 METs

 

 

Running (9km/hr)

skiing (cross country)

chopping hardwood

calisthenics

squash (non-competitive)

 

10 METs

 

 

Running quickly (10km/hr)

cycling quickly (25km/hr)

carrying loads (10kg) up

football (any code)

 

a gradient


SCHEDULE 2—continued

TABLE 2.

LOSS OF RESPIRATORY FUNCTION: PHYSIOLOGICAL MEASUREMENTS

NOTE:

Predictive nomograms for the forced expiratory volume over one second (FEV1) and the forced vital capacity (FVC) are at Tables 2.2 and 2.3.

 

Measurements of FEV1 and FVC should be performed with a vitalograph or equivalent instrument. Three readings should be taken and the best of these used to calculate impairment.

TABLE 2.1

Assignment of impairment rating

 

Impairment

Rating

% Predicted

FEV1 or FVC

NIL

85+

FIVE

80-84

TEN

70-79

TWENTY

60-69

THIRTY

50-59

FORTY

40-49

SIXTY

30-39

SEVENTY

less than 30


SCHEDULE 2—continued

TABLE 2.2

Prediction nomogram - males

NOTES:

From Kamburoff, Petia L., and Woitowitz, H.J. & R.H. (1972)

 

If the claimant is a non-Caucasian the predicted value should be multiplied by 0.85.


SCHEDULE 2—continued

TABLE 2.3

Prediction nomogram - females

NOTES:

From Kamburoff, Petia L., and Woitowitz, H.J. & R.H. (1972)

 

If the claimant is a non-Caucasian the predicted value should be multiplied by 0.85.


SCHEDULE 2—continued

TABLE 3.

UPPER LIMB IMPAIRMENT

NOTE:

Assess each arm separately. Add (do not use the Combined Values Chart) an additional 5% for dominant arm.

Impairment Rating

Criteria

NIL

Can use limb efficiently for feeding, dressing, writing and other daily tasks.

FIVE

Can use limb reasonably well in most circumstances, but frequent difficulties are manifested by:

minor loss of digital dexterity causing handwriting changes, or difficulty in manipulation of small or fine objects, eg, doing up shoelaces or setting a watch; or minor loss of grip strength causing difficulty in gripping moderately heavy to heavy objects such as full saucepans, buckets and watering cans; or

shoulder, elbow or wrist pain or limitation, as may be expected with epicondylitis or painful arc syndrome.

FIFTEEN

Can use limb reasonably well, but with more noticeable difficulty manifested by:

minor loss of digital dexterity and reduced grip strength causing difficulty in manipulation of larger objects such as a lawn bowl; or

major loss of digital dexterity causing marked difficulty in handwriting or manipulation of everyday objects, eg, putting on ties and belts, preparing food, or using a knife and fork.

TWENTY

Can use limb reasonably well in some circumstances. Use of limb is otherwise inefficient, with increasing difficulty for self-care activities. Poor digital co-ordination and markedly reduced grip strength in, eg, lifting light objects such as cups. Problems with dressing, feeding or writing.

THIRTY

Uses limb inefficiently in all circumstances. Use of limb subject to major limitations, with light grip only. Aids, eg, splints, required for everyday activities such as writing and eating.

FORTY

Has only some movement against gravity at elbow, shoulder or wrist.

FIFTY

Unable to use upper limb at all.


SCHEDULE 2—continued

TABLE 4

LOWER LIMB IMPAIRMENT

NOTE:

Assess both limbs together. For sciatica, use Table 6

Impairment Rating

Criteria

NIL

Walks in a manner normal for age on a variety of different terrains and at varying speeds for distances of more than 500m.

FIVE

Has intermittent pain from weight-bearing, ie, not all the time, or only after weight-bearing for some time.

TEN

Walks with intermittent difficulty, such as locking or giving way, without falling. Caution needed on steps and uneven ground, or when running.

 

Pain or claudication restricts walking to 500m or less, at a slow to moderate pace (4km/h). Can walk further after resting.

FIFTEEN

Walks at normal pace on level ground, but has constant difficulty up and down steps and over uneven ground. Need for a walking stick may be manifested by:

 

pain and/or slowness, or

constant pain from weight-bearing.

TWENTY

Can walk at moderately reduced pace on flat ground and

is unable to manage stairs or ramps without rails, or

is unable to rise from the sitting position without the assistance of one hand.

 

Pain or claudication restricts walking (4km/h) to 250m or less at a time. Can walk further after resting.

THIRTY

Walks at significantly reduced pace in comparison with peers and:

legs give way frequently, resulting in falls; can walk more efficiently with a brace or an artificial limb, or

is unable to negotiate stairs without personal assistance, or

is unable to rise to standing position without the assistance of both hands.


SCHEDULE 2—continued

 

Pain or claudication restricts walking (4km/h) to 100m or less at a time. Can walk further after resting.

FORTY

Walks at greatly reduced pace in comparison with peers, is unable to negotiate kerbs, gutters or uneven ground, and:

is restricted to walking in home and around block; probably needs a walking aid; or

finds transfer1 difficult without personal assistance.

 

Pain or claudication restricts walking (4km/h) to 50m or less at a time. Can walk further after resting.

FIFTY

Restricted to walking in and around home and:

requires quad stick, crutches or similar walking aid, or

is unable to transfer1 without personal assistance.

SIXTY

Restricted to walking in and around home. Can walk only with personal assistance, or with a walking aid such as a pickup frame.

SEVENTY

Unable to walk or stand. Mobile only in a wheelchair.

 

1 Transfer means moving from one seat to another, from sitting to standing, on and off the toilet, and in and out of bed.


SCHEDULE 2—continued

TABLE 5.            LOSS OF MUSCULO-SKELETAL FUNCTION: SPINE

TABLE 5.1          Cervical spine

Impairment Rating

        Criteria

NIL

X-ray changes only. Normal or nearly normal range of movement.

FIVE

Loss of about one quarter of normal range of movement.

TEN

Loss of about half of normal range of movement.

TWENTY

Loss of about three-quarters of normal range of movement.

THIRTY

Loss of almost all movement, or complete ankylosis in position of function.

FORTY

Ankylosis in an unfavourable position, or unstable joint

TABLE 5.2

Thoraco-lumbar spine

Impairment Rating

Criteria

NIL

X-ray changes only. Normal or nearly normal range of movement.

TEN

Loss of about one-quarter of normal range of movement.

TWENTY

Loss of about half of normal range of movement.

THIRTY

Loss of about three-quarters of normal range of movement.

FORTY

Loss of almost all movement, or complete ankylosis in position of function.

FIFTY

Ankylosis in an unfavourable position, or unstable joint.


SCHEDULE 2—continued

 

TABLE 5.3   Normal range of joint movement

NOTE:

* indicates functionally most important movements.

The numbers in brackets represent the position of function. This information is required when considering whether an ankylosis is in a favourable position or not.

 

JOINT

NORMAL RANGE OF JOINT MOVEMENT (DEGREES)

Shoulder

* Abduction

(45)

150

 

Adduction

 

30

 

* Forward elevation

(30)

150

 

Backward elevation

 

40

 

* External rotation

(20)

90

 

Internal rotation

 

40

Elbow

* Flexion

(100)

150

 

Extension

 

0

 

Supination

(0)

80

 

Pronation

 

80

Wrist

* Dorsiflexion

(30)

60

 

* Palmar flexion

 

70

 

Ulnar deviation

(0)

30

 

Radial deviation

 

20

Hip

Flexion

(25)

100

 

Extension

 

30

 

* Abduction

(0)

40

 

Adduction

 

20

 

* Internal rotation

(0)

40

 

External rotation

 

50

Knee

* Flexion

(10)

150

 

Extension

 

0

Ankle

* Dorsiflexion

(0)

20

 

* Plantar flexion

 

40

 

Inversion

(0)

30

 

Eversion

 

20

Cervical Spine

* Flexion

(0)

45

 

* Extension

 

45

 

Right lateral flexion

(0)

45

 

Left lateral flexion

 

45

 

* Right rotation

(0)

80

 

* Left rotation

 

80

Thoraco-lumbar Spine

Right lateral flexion

(0)

30

 

Left lateral flexion

 

30

 

Right rotation

(0)

30

 

Left rotation

 

30

 

* Flexion

(0)

90

 

Extension

(0)

30


SCHEDULE 2—continued

TABLE 6.      OTHER MUSCULO-SKELETAL IMPAIRMENT

NOTES:

Add (do not use the Combined Values Chart) an additional 5% for dominant upper limb.

 

Only one rating is given for joint pain regardless of the number of joints affected.

 

This table is used only if Table 3 or 4 cannot be used.

Impairment Rating

Criteria

NIL

Pes planus, hammer or claw toes, hallux valgus, calcaneal spurs, genu varum, or genu valgum causing no or minimal symptoms

 

Sciatic pain: occasional twinges but no effect on walking most of the time

 

Amputation of entire little finger

 

Amputation of single entire toe other than great toe

FIVE

Amputation of entire ring finger

 

Shortening of lower extremity by 2.5 cm or more

 

Amputation of 2 to 4 entire toes on one foot excluding great toe

 

Crush fracture of one vertebra (compression of 25%-50%

 

Recurrent dislocation of shoulder (not surgically corrected) with marked crepitus

 

Frequent pain in any joint, or combination of joints, which responds to medication

 

Sciatic pain occurring frequently: present some of the time when walking

TEN

Amputation of entire great toe

 

Amputation of entire middle finger

 

Amputation of entire index finger

 

Crush fracture of a single vertebra with more than 50% compression


SCHEDULE 2—continued

 

Crush fracture of two or more vertebrae with more than 25% compression of each

 

Sciatic pain daily - present most of the time during walking

 

Total knee replacement

 

Total hip replacement

 

Dislocation of shoulder resulting in prophylactic restriction of movement

 

Chronic pain in any joint or combination of joints

FIFTEEN

Mid-metatarsal amputation

 

Mid-tarsal amputation

TWENTY

Amputation below knee with functional stump

 

Amputation at ankle

 

Amputation of all fingers but not thumb

 

Amputation of entire thumb

 

Sciatica with abnormal neurological signs

THIRTY

Amputation above knee with functional stump

 

Disarticulation at knee

 

Amputation below knee with short stump (7.5cm or less below intercondylar notch)

FORTY

Disarticulation at hip joint

 

Amputation above knee with short stump (7.5cm or less below tuber ischii)

 

Amputation of forearm distal to biceps tendon insertion

 

Disarticulation at wrist joint

 

Mid-carpal or mid-metacarpal amputation

FIFTY

Hemipelvectomy

 

Amputation between deltoid insertion and elbow

 

Disarticulation at elbow


SCHEDULE 2—continued

 

 

Amputation of forearm proximal to biceps tendon insertion

 

Disarticulation at shoulder

 

Amputation above deltoid insertion

SIXTY

Forequarter amputation


SCHEDULE 2—continued

TABLE 7.   PSYCHIATRIC IMPAIRMENT

Impairment Rating

Criteria

NIL

Minimal symptoms may be present but no more than slight impairment in functioning, varying degrees of everyday worries and problems that sometimes get out of hand.

FIVE

Some mild symptoms (eg. depressed mood and mild insomnia) OR some difficulty in several areas of functioning, but generally functioning well, has some meaningful interpersonal relationships and most untrained people would not consider him/her sick.

TEN

Mild but regular symptoms which tend to cause subjective distress. On most occasions able to distract themselves from this distress. Minor interference with function in everyday situations. Exacerbation of symptoms may cause occasional days off work. (eg. There may be some loss of interest in activities previously enjoyed. There may be occasional friction with family, colleagues or friends. Medical therapy or some supportive treatment from treating doctor may be required, and if not commenced, may be recognised as being of use).

FIFTEEN

Moderate and regular symptoms OR generally functioning with some difficulty, (eg. As manifest by short periods of absence from work, noticeable reduction in social contacts or recreational activities, or the beginnings of permanent family conflict. Likely to have received psychiatric treatment which has stabilised their condition).

TWENTY

Any serious symptomatology OR impairment in functioning that most clinicians would think obviously requires treatment or attention (eg. suicidal preoccupation, severe obsessional rituals, frequent severe anxiety attacks, serious anti-social behaviour).

THIRTY

Serious psychiatric illness with major impairments in several areas, such as work, family relations, judgement, thinking, or mood (eg. depressed person avoids friends, neglects family unable to do housework), OR some impairment in reality testing or communication (eg. speech is at times obscure, illogical or irrelevant).


SCHEDULE 2—continued

FORTY

Major psychiatric illness with severe symptoms and overt evidence of distress. Relief from that distress is difficult to achieve even with a high level of support and reassurance. The level and frequency of symptoms is such as to cause major difficulties in everyday functioning, but not so severe as to be totally disabling, (eg. There will be marked social withdrawal and loss of interest in most recreational pursuits, with frequent family discord. There will be a continuing need for intensive specialist psychiatric treatment on an out-patient basis, including medication. In-patient hospital care for short periods may have been instituted).

FIFTY

Unable to function in almost all areas (eg. stays in bed all day), OR behaviour is considerably influenced by either delusions or hallucinations, OR serious impairment in communication (eg. sometimes incoherent or unresponsive) or judgement (eg. acts grossly inappropriately).

SIXTY

Needs some supervision to prevent injury to self or others, or to maintain minimal personal hygiene (eg. repeated suicide attempts, frequently violent, manic excitement), OR gross impairment in communication (eg. largely incoherent or mute).

SEVENTY

Needs constant supervision to prevent injury to self or others.


SCHEDULE 2—continued

TABLE 8.        ALCOHOL AND DRUG ABUSE

NOTES:

If there is end organ damage eg. peripheral neuropathy, dementia, these conditions should be assessed on the appropriate tables in conjunction with Table 8. Use the Combined Values Chart to calculate Whole Person Impairment.

Impairment Rating

Criteria

NIL

Alcohol or drug abuse with no effect on daily functioning or work capacity

TEN

Alcohol or drug abuse sufficient to cause intermittent or temporary absence from work

TWENTY

Addiction to alcohol or drugs, well established over time, which is sufficient to cause prolonged absences from work. Reversible end organ damage may be present.

THIRTY

Addiction to alcohol or drugs, well entrenched over many years, with minimal residual work capacity. Personality deterioration may be present.

FORTY-FIVE

Alcohol or drug abuse with gross functional disability and non-reversible end organ damage.


SCHEDULE 2—continued

TABLE 9.      NEUROLOGICAL FUNCTION: IMPAIRMENT OF COGNITION

Impairment Rating

Criteria

NIL

Negligible impairment: reasoning is comparable with that of peers.

 

Memory similar to that of peers: written notes, etc., used in the manner of busy people of all ages.

TEN

Mild impairment: appropriate use is made of accumulated knowledge, and reasonable judgement is shown in routine daily activities most of the time. Difficulties are apparent in new circumstances.

 

Mild impairment of memory. Can learn, although at a slower rate than previously. Impairment has little impact on everyday activity because of compensation through reliance on written notes, schedules, checklists and spouse.

TWENTY

Moderate impairment of memory: has frequent difficulty in recalling details of recent experiences; frequently misplaces objects; fails to follow through with intentions or obligations; tends to get lost more easily in unfamiliar areas. Compensation through use of aids, eg, lists or diaries is normally adequate. If restricted to familiar schedules, activities, procedures and areas, is largely independent.

 

Moderate impairment of problem-solving ability: relies on accumulated knowledge. Suffers significant disadvantage in circumstances requiring complex decision-making or non-routine activities, ie, when past decision-making is not directly relevant. Has reduced initiative, spontaneity, and capacity for abstract thinking.

FORTY

Symptoms as above, but more frequent and severe. Is partially able to compensate, but unable to function with complete independence, and needs some supervision.

SIXTY

Severe impairment: has difficulty in carrying out basic activities such as sequencing the steps needed for dressing and for preparing meals. Planning/organizational ability is reduced. Is unable to function independently in new or complex situations. Shows markedly reduced initiative and spontaneity, and perseverative thinking.


SCHEDULE 2—continued

 

Severe memory deficiency: is unable to retain any information about recent experiences. New learning is not possible after attention has been directed elsewhere. Is unable to work or live independently, needing supervision to avoid harm, eg, from fire caused by forgetting to put out cigarettes or to turn off appliances. Has extreme difficulty in keeping track of finances, scheduled activities, social relationships, etc.

SEVENTY

Gross impairment: is unable to initiate and sustain activities without supervision. Supervision and prompting are required for virtually all daily activity. Is unable to plan a course of action for the simplest activity.

 

Gross amnesic syndrome: is unable to acquire or recall new information. Constant supervision and care are required. Unable to recognize family, own reflection in mirror, etc. Is disoriented in familiar surroundings.


SCHEDULE 2—continued

TABLE 10.         NEUROLOGICAL FUNCTION: IMPAIRMENT OF COMPREHENSION

Impairment Rating

Criteria

NIL

Normal or nearly normal comprehension.

TEN

Can understand movies, radio programmes or group discussions, but with some difficulty. Comprehension is good in most situations, but understanding is difficult in large groups, or when tired and upset. Has difficulty coping with rapid changes of topic.

TWENTY

Can understand speech face-to-face, but confusion or fatigue occurs rapidly in any group. Is unable to cope with rapid change in topic, or with complex topics: is able to grasp the meaning of TV serials, but not more complex ideas.

THIRTY

Can understand only simple sentences, and follow simple sentences from context and gesture, although frequent repetition is needed.

FORTY

Can understand only single words. Shows some understanding of slowly-spoken simple sentences from context and gesture, although frequent repetition is needed.

FIFTY

Unable to understand simple instructions or yes/no questions, even with gesture.

 

Unable to read single words, labels or signs.


SCHEDULE 2—continued

TABLE 11.      NEUROLOGICAL FUNCTION: IMPAIRMENT OF EXPRESSION

Impairment Rating

Criteria

NIL

Normal or nearly normal expression

FIVE

Speech is of enough intensity and vocal quality for most everyday needs, eg:

 

normal speech, but unable to shout; or

 

needs to repeat self at times, or is unable to produce some phonetic units; or

 

speech is sustained over a 10-minute period, but with difficulty that includes hesitation and word-retrieval problems; or

 

is permanently hoarse.

TEN

Speech is of enough intensity and vocal quality for many of the needs of everyday speech, eg:

 

is adequate with low background noise, but is heard with some difficulty in vehicles or public places; or

 

has many inaccuracies, but is easily understood by strangers; or

 

is slow or discontinuous, conveying the distinct impression of difficulty.

 

Converses in simple sentences on familiar topics, although word-finding problems are frequent, and has difficulty in explaining long or complex ideas.

TWENTY

Speech is of enough intensity and vocal quality for some of the needs of everyday speech, eg:

 

is adequate under quiet conditions, but is heard with great difficulty against any background noise: voice fades rapidly; or

 

is understood by family and friends, but is difficult for strangers. Needs frequent repetition; or

 

speech is sustained for short period only; fatigues rapidly.

THIRTY

Speech is of only sufficient intensity and vocal quality for a few of the needs of everyday speech, eg:

 

is reduced to a whisper at best: inaudible over the telephone; or

 

can produce only a few phonetic units approximating some words, but these are not intelligible if the context is unknown, or

 

can produce only short phrases or single words: speech flow is not maintained, or is too slow to be useful.


SCHEDULE 2—continued

 

Is unable to initiate conversation, but, with considerable effort, is able to respond in short simple sentences or phrases.

FORTY

Has no speech production, but is able to use unspoken means of expression.

 

Is limited to single words or familiar social or stereotyped phrases requiring considerable listener inference.

FIFTY

Has no or minimal speech, and is unable to use unspoken means of communication.

 

Has no functional speech: is limited to swearing, or is fluent but unintelligible.


SCHEDULE 2—continued

 

TABLE 12. INTELLECTUAL IMPAIRMENT

NOTE:

Three key criteria are assessed and the claimant allotted a score for each. These are then added. The final figure is converted to a whole person impairment score using the table below.

CLASS OF IMPAIRMENT

Score

Intelligence

Behaviour

Capacity for Independent Living

0

Normal

Normal

Self-sufficient

3

Borderline (IQ 70-80)

Slight problem

Needs minor help

4

-

Moderate problem

Needs regular help

5

Mildly impaired or worse (IQ 50-70)

Moderate to severe problem

Needs major help

6

Moderately Impaired (IQ 30-50)

Severe problem

Totally dependent

8

Moderately to severely impaired (IQ 20-30)

-

-

10

Severely impaired (IQ<20)

-

-

Table for conversion to whole person impairment score (%WPI).

 

Score

% WPI

3

10

4

15

5

20

6

25

7

30

8

35

9

40

10

45

11

50

12

55

13

65

14

70

15

75

16

80

17

85

18 or greater

90


SCHEDULE 2—continued

TABLE 13.   GASTROINTESTINAL IMPAIRMENT: STOMACH AND DUODENUM

Impairment Rating

Criteria

NIL

Past gastric surgery - asymptomatic.

 

Nausea and vomiting: infrequent and mild.

 

Reflux, with or without oesophagitis: reasonably well controlled with treatment.

 

Past history of peptic ulcer: currently inactive and asymptomatic, with or without medication.

FIVE

Nausea and vomiting: mild to moderate, necessitating some medication on most days.

 

Peptic ulcer with intermittent symptoms necessitating ongoing prophylactic acid suppressant.

 

Oesophagitis: active disease with frequent symptoms necessitating full dose medication.

 

Past gastric surgery with mild dyspepsia and mild dumping syndrome.

TEN

Nausea and vomiting: moderate symptoms, necessitating daily full-dose medication.

 

Peptic ulcer: continuing frequent symptoms despite full-dose ulcer-healing medication.

 

Oesophagitis: active disease proven endoscopically with complications eg. ulceration, blood loss, aspiration or stricture.

 

Past gastric surgery with moderate dyspepsia and dumping syndrome.

TWENTY

Constant dysphagia requiring regular dilatation.

 

Vomiting: severe, not controlled despite medication, and causing significant weight loss.

 

Peptic ulcer: troublesome symptoms daily despite full-dose ulcer-healing medication, and complications, eg, bleeding or outlet obstruction.

THIRTY

Diet limited to liquid or to pureed food.

 

Past gastric surgery with severe dyspepsia and dumping syndrome on most days.

 

Oesophagostomy or gastrostomy.


SCHEDULE 2—continued

 

TABLE 14.     GASTROINTESTINAL IMPAIRMENT: SMALL AND LARGE BOWEL, RECTUM AND ANUS

Impairment

Criteria

NIL

Anal disorder: infrequent and minor symptoms, eg, haemorrhoids, anal fissures, controlled by medication.

 

Bowel disorder, eg, irritable bowel, diverticulosis: infrequent and minor symptoms such as constipation, or intermittent diarrhoea and abdominal cramps which respond to dietary treatment.

 

Inguinal hernia easily reducible or surgically repaired.

FIVE

Anal disorder: moderate symptoms on most days, necessitating regular medication for control.

 

Bowel disorder: frequent moderate symptoms necessitating regular medication.

 

Inguinal hernia not easily reduced and resulting in mild symptoms.

TEN

Minor faecal incontinence associated with occasional soiling.

 

Anal disorder: marked to severe symptoms despite regular treatment.

 

Colostomy, ileostomy - well controlled.

TWENTY

Faecal soiling necessitating frequent changes of underwear, or a precautionary incontinence pad.

 

Bowel disorder: marked symptoms, such as regular diarrhoea and frequent abdominal pain, partially controlled by full-dose medication.

 

Colostomy, ileostomy - poorly controlled.

 

Large inguinal or ventral hernia resulting in frequent symptoms.

THIRTY

Bowel disorder: diarrhoea and abdominal pain on most days, with no response to medication and considerable interference with daily routine.

 

Jejunostomy

FIFTY

Complete faecal incontinence.


SCHEDULE 2—continued

 

TABLE 15.       LIVER AND BILIARY TRACT IMPAIRMENT

Impairment Rating

Criteria

NIL

Mildly abnormal liver function tests but good nutrition and strength and no other signs of disease.

FIVE

Signs or stigmata of liver disease BUT no history of jaundice, ascites or bleeding oesophageal varices within the last 5 years. Liver function tests normal or mildly abnormal.

TEN

Signs or stigmata of liver disease with jaundice, ascites or bleeding oesophageal varices 1 to 5 years ago BUT normal or mildly abnormal liver function tests.

TWENTY

Signs or stigmata of liver disease with jaundice, ascites or bleeding oesophageal varices 1 to 5 years ago AND markedly abnormal liver function tests.

FORTY

Signs or stigmata of liver disease with jaundice, ascites or bleeding oesophageal varices in the past year OR objective signs of progressive liver disease.

FIFTY

Permanent, irreparable biliary tract obstruction.

SIXTY

Objective signs of progressive liver disease with ONE of the following:

persistent jaundice

frequent, recurrent bleeding episodes

central nervous system manifestations of hepatic insufficiency.

SEVENTY

Objective signs of progressive liver disease with TWO of the following:

persistent jaundice

frequent, recurrent bleeding episodes

central nervous system manifestations of hepatic insufficiency.

EIGHTY

Objective signs of liver disease with ALL of the following:

persistent jaundice

frequent, recurrent bleeding episodes

central nervous system manifestations of hepatic insufficiency.

NINETY-FIVE

Hepatic coma


SCHEDULE 2—continued

TABLE 16. HEARING IMPAIRMENT

NOTE:

Testing to be carried out without a hearing aid

TABLE 16.1  Assignment of impairment rating

 

Percentage Loss of Binaural Hearing

Impairment Rating

0-4.9

0

5-14.9

5

25-34.9

10

35-44.9

15

45-54.9

20

55-64.9

25

65-74.9

30

75-84.9

30

85-94.9

35

95-100

40


Social Security (Disability and Sickness Support) Amendment

No. 141, 1991

SCHEDULE 2—continued


TABLE 16.2 500 Hz

VALUES OF PERCENTAGE LOSS OF HEARING CORRESPONDING TO GIVEN HEARING THRESHOLD LEVELS IN THE BETTER AND WORSE EARS AT 500Hz

HTL-BETTER EAR

 

15

20

25

30

35

40

45

50

55

60

65

70

75

80

85

90

95

HTL-WORSE EAR

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

15

0.0

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

20

0.4

0.6

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

25

0.6

1.0

1.4

 

 

 

 

 

 

 

 

 

 

 

 

 

 

30

1.0

1.4

2.0

2.8

 

 

 

 

 

 

 

 

 

 

 

 

 

35

1.3

1.6

2.5

3.4

4.5

 

 

 

 

 

 

 

 

 

 

 

 

40

1.7

2.2

3.0

3.9

5.1

6.4

 

 

 

 

 

 

 

 

 

 

 

45

2.0

2.6

3.4

4.3

5.5

6.8

8.1

 

 

 

 

 

 

 

 

 

 

50

2.3

2.9

3.7

4.7

5.8

7.1

8.4

9.7

 

 

 

 

 

 

 

 

 

55

2.5

3.2

4.0

5.0

6.1

7.3

8.6

9.9

11.2

 

 

 

 

 

 

 

 

60

2.7

3.4

4.2

5.2

6.3

7.5

8.8

10.0

11.3

12.6

 

 

 

 

 

 

 

65

2.8

3.5

4.4

5.4

6.5

7.7

8.9

10.2

11.5

12.7

14.0

 

 

 

 

 

 

70

2.9

3.7

4.5

5.5

6.6

7.8

9.1

10.3

11.6.

12.9

14.2

15.5

 

 

 

 

 

75

3.0

3.8

4.7

5.7

6.8

8.0

9.2

10.5

11.8

13.1

14.5

15.7

16.9

 

 

 

 

80

3.1

3.9

4.8

5.8

6.9

8.1

9.3

10.6

12.0

13.3

14.7

16.0

17.2

18.2

 

 

 

85

3.2

4.0

4.9

5.9

7.0

8.2

9.4

10.7

12.1

13.5

14.9

16.2

17.4

18.4

19.1

 

 

90

3.4

4.1

5.0

6.0

7.1

8.1

9.5

10.8

12.2

13.6

15.0

16.3

17.6

18.5

19.2

19.7

 

95

1.4

4.2

5.1

6.1

7.1

8.1

9.5

10.8

12.2

13.6

15.0

16.4

17.6

18.6

19.3

19.7

20.0

 


TABLE 16.3 1000 Hz


Social Security (Disability and Sickness Support) Amendment

No. 141, 1991

SCHEDULE 2—continued


VALUES OF PERCENTAGE LOSS OF HEARING CORRESPONDING TO GIVEN HEARING THRESHOLD LEVELS IN THE BETTER AND WORSE EARS AT 1000HZ

HTL - BETTER EAR

 

15

20

25

30

35

40

45

50

55

60

65

70

75

80

85

90

95

HTL - WORSE EAR

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

15

0.0

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

20

0.5

0.8

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

25

0.8

1.2

1.8

 

 

 

 

 

 

 

 

 

 

 

 

 

 

30

1.2

1.7

2.5

3.5

 

 

 

 

 

 

 

 

 

 

 

 

 

35

1.7

2.3

3.1

4.3

5.7

 

 

 

 

 

 

 

 

 

 

 

 

40

2.1

2.8

3.7

4.9

6.3

8.0

 

 

 

 

 

 

 

 

 

 

 

45

2.5

3.3

4.2

5.4

6.9

8.5

10.2

 

 

 

 

 

 

 

 

 

 

50

2.8

3.6

4.7

5.9

7.3

8.8

10.5

12.1

 

 

 

 

 

 

 

 

 

55

3.1

3.9

5.0

6.2

7.6

9.1

10.7

12.4

14.0

 

 

 

 

 

 

 

 

60

3.3

4.2

5.3

6.5

7.9

9.4

11.0

12.6

14.2

15.7

 

 

 

 

 

 

 

65

3.5

4.4

5.5

6.7

8.1

9.6

11.2

12.8

14.4

15.9

17.5

 

 

 

 

 

 

70

3.7

4.6

5.7

6.9

8.3

9.8

11.3

12.9

14.6

16.2

17.8

19.4

 

 

 

 

 

75

3.8

4.7

5.8

7.1

8.5

10.0

11.5

13.1

14.8

16.4

18.1

19.7

21.1

 

 

 

 

80

3.9

4.9

6.0

7.3

8.6

10.1

11.7

13.3

15.0

16.7

18.4

20.0

21.5

22.7

 

 

 

85

4.1

5.0

6.2

7.4

8.8

10.3

11.8

13.4

15.1

16.9

18.6

20.3

21.7

23.0

23.9

 

 

90

4.2

5.2

6.3

7.5

8.9

10.3

11.9

13.5

15.2

17.0

18.7

20.4

21.9

23.2

24.1

24.6

 

95

4.3

5.3

6.4

7.6

8.9

10.3

11.9

13.5

15.2

17.0

18.7

20.5

22.0

23.3

24.2

24.7

25.0

 


TABLE 16.4 1500 Hz


Social Security (Disability and Sickness Support) Amendment

No. 141, 1991

SCHEDULE 2—continued


VALUES OF PERCENTAGE LOSS OF HEARING CORRESPONDING TO GIVEN HEARING THRESHOLD LEVELS IN THE BETTER AND WORSE EARS AT 1500HZ

HTL - BETTER EAR

 

15

20

25

30

35

40

45

50

55

60

65

70

75

80

85

90

95

HTL - WORSE EAR

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

15

0.0

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

20

0.4

0.6

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

25

0.6

1.0

1.4

 

 

 

 

 

 

 

 

 

 

 

 

 

 

30

1.0

1.4

2.0

2.8

 

 

 

 

 

 

 

 

 

 

 

 

 

35

1.3

1.8

2.5

3.4

4.5

 

 

 

 

 

 

 

 

 

 

 

 

40

1.7

2.2

3.0

3.9

5.1

6.4

 

 

 

 

 

 

 

 

 

 

 

45

2.0

2.6

3.4

4.3

5.5

6.8

8.1

 

 

 

 

 

 

 

 

 

 

50

2.3

2.9

3.7

4.7

5.8

7.1

8.4

9.7

 

 

 

 

 

 

 

 

 

55

2.5

3.2

4.0

5.0

6.1

7.3

8.6

9.9

11.2

 

 

 

 

 

 

 

 

60

2.7

3.4

4.2

5.2

6.3

7.5

8.8

10.0

11.3

12.6

 

 

 

 

 

 

 

65

2.8

3.5

4.4

5.4

6.5

7.7

8.9

10.2

11.5

12.7

14.0

 

 

 

 

 

 

70

2.9

3.7

4.5

5.5

6.6

7.8

9.1

10.3

11.6

12.9

14.2

15.5

 

 

 

 

 

75

3.0

3.8

4.7

5.7

6.8

8.0

9.2

10.5

11.8

13.1

14.5

15.7

16.9

 

 

 

 

80

3.1

3.9

4.8

5.8

6.9

8.1

9.3

10.6

12.0

13.3

14.7

16.0

17.2

18.2

 

 

 

85

3.2

4.0

4.9

5.9

7.0

8.2

9.4

10.7

12.1

13.5

14.9

16.2

17.4

18.4

19.1

 

 

90

3.4

4.1

5.0

6.0

7.1

8.3

9.5

10.8

12.2

13.6

15.0

16.3

17.6

18.5

19.2

19.7

 

95

3.4

4.2

5.1

6.1

7.1

8.3

9.5

10.8

12.2

13.6

15.0

16.4

17.6

18.6

19.3

19.7

20.0

 


TABLE 16.5 2000 Hz


Social Security (Disability and Sickness Support) Amendment

No. 141, 1991

SCHEDULE 2—continued


VALUES OF PERCENTAGE LOSS OF HEARING CORRESPONDING TO GIVEN HEARING THRESHOLD LEVELS IN THE BETTER AND WORSE EARS AT 2000HZ

HTL - BETTER EAR

 

15

20

25

30

35

40

45

50

55

60

65

70

75

80

85

90

95

HTL-WORSE EAR

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

15

0.0

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

20

0.3

0.5

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

25

0.5

0.7

1.1

 

 

 

 

 

 

 

 

 

 

 

 

 

 

30

0.7

1.0

1.5

2.1

 

 

 

 

 

 

 

 

 

 

 

 

 

35

1.0

1.4

1.9

2.5

3.4

 

 

 

 

 

 

 

 

 

 

 

 

40

1.3

1.7

2.2

2.9

3.8

4.8

 

 

 

 

 

 

 

 

 

 

 

45

1.5

1.9

2.5

3.3

4.1

5.1

6.1

 

 

 

 

 

 

 

 

 

 

50

1.7

2.2

2.8

3.5

4.4

5.3

6.3

7.3

 

 

 

 

 

 

 

 

 

55

1.9

2.4

3.0

3.7

4.6

5.5

6.4

7.4

8.4

 

 

 

 

 

 

 

 

60

2.0

2.5

3.1

3.9

4.7

5.6

6.6

7.5

8.5

9.4

 

 

 

 

 

 

 

65

2.1

2.6

3.3

4.0

4.9

5.7

6.7

7.6

8.6

9.6

10.5

 

 

 

 

 

 

70

2.2

2.7

3.4

4.1

5.0

5.9

6.8

7.8

8.7

9.7

10.7

11.6

 

 

 

 

 

75

2.3

2.8

3.5

4.3

5.1

6.0

6.9

7.9

8.9

9.9

10.8

11.8

12.7

 

 

 

 

80

2.4

2.9

3.6

4.4

5.2

6.1

7.0

8.0

9.0

10.0

11.0

12.0

12.9

13.6

 

 

 

85

2.4

3.0

3.7

4.4

5.3

6.1

7.1

8.1

9.1

10.1

11.1

12.1

13.0

13.8

14.3

 

 

90

2.5

3.1

3.8

4.5

5.3

6.2

7.1

8.1

9.1

10.2

11.2

12.2

13.2

13.9

14.4

14.8

 

95

2.6

3.2

3.8

4.6

5.4

6.2

7.1

8.1

9.1

10.2

11.3

12.3

13.2

14.0

14.5

14.8

15.0

 


TABLE 16.6 3000 Hz


Social Security (Disability and Sickness Support) Amendment

No. 141, 1991

SCHEDULE 2—continued


VALUES OF PERCENTAGE LOSS OF HEARING CORRESPONDING TO GIVEN HEARING THRESHOLD LEVELS IN THE BETTER AND WORSE EARS AT 3000HZ

HTL-BETTER EAR

 

15

20

25

30

35

40

45

50

55

60

65

70

75

80

85

90

95

HTL - WORSE EAR

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

15

0.0

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

20

0.2

0.3

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

25

0.3

0.5

0.7

 

 

 

 

 

 

 

 

 

 

 

 

 

 

30

0.5

0.7

1.0

1.4

 

 

 

 

 

 

 

 

 

 

 

 

 

35

0.7

0.9

1.2

1.7

2.3

 

 

 

 

 

 

 

 

 

 

 

 

40

0.8

1.1

1.5

2.0

2.5

3.2

 

 

 

 

 

 

 

 

 

 

 

45

1.0

1.3

1.7

2.2

2.7

3.4

4.1

 

 

 

 

 

 

 

 

 

 

50

1.1

1.4

1.9

2.3

2.9

3.5

4.2

4.8

 

 

 

 

 

 

 

 

 

55

1.2

1.6

2.0

2.5

3.0

3.6

4.3

4.9

5.6

 

 

 

 

 

 

 

 

60

1.3

1.7

2.1

2.6

3.1

3.7

4.4

5.0

5.6

6.3

 

 

 

 

 

 

 

65

1.4

1.8

2.2

2.7

3.2

3.8

4.4

5.1

5.7

6.4

7.0

 

 

 

 

 

 

70

1.5

1.8

2.3

2.8

3.3

3.9

4.5

5.2

5.8

6.5

7.1

7.7

 

 

 

 

 

75

1.5

1.9

2.3

2.8

3.4

4.0

4.6

5.2

5.9

6.6

7.2

7.8

8.4

 

 

 

 

80

1.6

2.0

2.4

2.9

3.4

4.0

4.7

5.3

6.0

6.6

7.3

8.0

8.6

9.1

 

 

 

85

1.6

2.0

2.5

3.0

3.5

4.1

4.7

5.4

6.0

6.7

7.4

8.1

8.7

9.2

9.5

 

 

90

1.7

2.1

2.5

3.0

3.5

4.1

4.7

5.4

6.1

6.8

7.5

8.2

8.8

9.2

9.6

9.8

 

95

1.7

2.1

2.6

3.0

3.6

4.1

4.7

5.4

6.1

6.8

7.5

8.2

8.8

9.3

9.6

9.8

10.0

 


TABLE 16.7 4000 Hz


Social Security (Disability and Sickness Support) Amendment

No. 141, 1991

SCHEDULE 2—continued


VALUES OF PERCENTAGE LOSS OF HEARING CORRESPONDING TO GIVEN HEARING THRESHOLD LEVELS IN THE BETTER AND WORSE EARS AT 4000HZ

HTL - BETTER EAR

 

20

25

30

35

40

45

50

55

60

65

70

75

80

85

90

95

HTL - WORSE EAR

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

20

0.0

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

25

0.2

0.3

 

 

 

 

 

 

 

 

 

 

 

 

 

 

30

0.3

0.5

0.8

 

 

 

 

 

 

 

 

 

 

 

 

 

35

0.5

0.7

1.0

1.5

 

 

 

 

 

 

 

 

 

 

 

 

40

0.6

0.9

1.3

1.8

2.5

 

 

 

 

 

 

 

 

 

 

 

45

0.8

1.1

1.5

2.1

2.7

3.5

 

 

 

 

 

 

 

 

 

 

50

0.9

1.3

1.7

2.3

2.9

3.6

4.4

 

 

 

 

 

 

 

 

 

55

1.0

1.4

1.9

2.4

3.1

3.8

4.5

5.2

 

 

 

 

 

 

 

 

60

1.2

1.5

2.0

2.6

3.2

3.9

4.6

5.3

6.0

 

 

 

 

 

 

 

65

1.2

1.6

2.1

2.7

3.3

3.9

4.6

5.3

6.0

6.7

 

 

 

 

 

 

70

1.3

1.7

2.2

2.7

3.4

4.0

4.7

5.4

6.1

6.8

7.5

 

 

 

 

 

75

1.4

1.8

2.3

2.8

3.4

4.1

4.8

5.5

6.2

6.9

7.6

8.2

 

 

 

 

80

1.4

1.9

2.3

2.9

3.5

4.2

4.9

5.6

6.3

7.0

7.7

8.4

8.9

 

 

 

85

1.5

1.9

2.4

3.0

3.6

4.2

4.9

5.7

6.4

7.1

7.8

8.5

9.0

9.5

 

 

90

1.6

2.0

2.5

3.0

3.6

4.3

5.0

5.7

6.5

7.2

7.9

8.6

9.1

9.5

9.8

 

95

1.6

2.0

2.5

3.1

3.7

4.3

5.0

5.7

6.5

7.2

8.0

8.7

9.2

9.6

9.8

10.0

 

SCHEDULE 2—continued

TABLE 17.       MISCELLANEOUS EAR, NOSE AND THROAT DISORDERS

Impairment Rating

Criteria

NIL

Intermittent otorrhoea.

 

Intermittent otalgia and tinnitus.

 

Post nasal discharge, rhinorrhoea and sneezing.

 

Vertigo which does not interfere with any activities.

 

Other conditions which are controlled by medication or for which no medication is required.

FIVE

Chronic otorrhoea.

 

Complete loss of olfaction or taste.

TEN

Chronic otalgia.

 

Constant tinnitus.

 

Vertigo which interferes only with activities involving personal or public safety (eg: driving a car, operating machinery).

TWENTY

Vertigo which interferes with some normal daily activities.

TWENTY-FIVE

Permanent tracheostomy or stoma.

FORTY

Vertigo which interferes with all normal daily activities except household duties and self-care.

SIXTY

Vertigo which interferes with all activities to the extent that only self-care can be managed but all other activities are impossible.

EIGHTY

Vertigo such that the sufferer is confined to home and requires assistance with all activities including self-care.


SCHEDULE 2—continued

TABLE 18. IMPAIRMENT OF VISION - VISUAL ACUITY IN THE BETTER EYE

NOTE:

This is assessed by measuring visual acuity in the better eye after correction.

 

Visual Acuity

Impairment Rating

6/6

0

6/9

0

6/12

5

6/18

15

6/24

20

6/30

30

6/36

40

6/48

50

6/60

75

3/60 or worse

85


SCHEDULE 2—continued

TABLE 19. MISCELLANEOUS VISUAL IMPAIRMENTS

THE VISUAL SYSTEM1

Disorders such as nystagmus, conjunctivitis, colour blindness, night blindness and glaucoma (without visual loss) are usually binocular and cause minimal impairment. An assessment of 0-5% is appropriate.

 

Visual Disturbance

Impairment Rating

Heterotropia with diplopia

 

all directions of gaze

25

all directions of downward gaze

15

all directions of upward gaze

10

one quadrant of downward gaze

10

one quadrant of upward gaze

5

one direction of sideways gaze

10

both directions of sideways gaze

15

all range of near vision

15

Heterophoria

0

Nystagmus without diplopia

0

Unilateral aphakia

10

Bilateral aphakia

5

Unilateral intraocular lens

5

Heterotropia without diplopia

 

all directions of gaze

10

near vision only

5

Loss of stereopsis in absence of heterotropia

5

Gaze defects

 

vertical

15

horizontal

10

vertical and horizontal

25

Homonymous Hemianopia

50

1 Visual Fields based on Ophthalmologists advice.


SCHEDULE 2—continued

TABLE 20. OTHER OCULAR IMPAIRMENTS

 

Impairment Rating

Criteria

NIL

Glaucoma, with or without medication and no evidence of field loss

 

Intermittent conjunctivitis

 

Disorders resulting in dry eyes necessitating regular, daily use of eye drops

FIVE

Constant but mild irritation of eyes resulting in symptoms and signs, eg, chronic conjunctivitis or blepharoconjunctivitis, persistent photophobia, epiphora

Uncorrected ectropion or entropion

 

Ptosis or tarsorrhaphy resulting in continuous but partial closure of the eye

TEN

Symptoms and signs of severe eye irritation, present all of the time.


SCHEDULE 2—continued

TABLE 21. LOWER URINARY TRACT IMPAIRMENT

 

Impairment Rating

Criteria

NIL

Occasional stress incontinence: infrequent and small amounts of urine lost, and incontinence pad not needed.

 

Mild symptoms of bladder outlet or urethral obstruction, eg, hesitancy, or poor stream.

TEN

Minor stress incontinence, needing use of 1-2 incontinence pads a day, and/or mild urge incontinence, but rarely unable to find a toilet in time.

 

Bladder outlet or urethral obstruction as above, but with more severe symptoms such as urge frequency, nocturia, or recurrent urinary tract infections.

 

Urethral stricture, necessitating passage of sounds at intervals of 3 months or less.

FIFTEEN

Loss of voluntary control of bladder, but satisfactory emptying achieved by triggering of reflex activity, suprapubic pressure or Valsalva manoeuvre. No incontinence aid needed.

 

Urinary diversion, eg, ileal conduit, sigmoid conduit, ureterosigmoidostomy.

TWENTY

Loss of voluntary control of bladder necessitating intermittent catheterization.

THIRTY-FIVE

Dribbling incontinence needing frequent change of incontinence pads, or a collection device, eg, condom catheter.

FIFTY

Incontinence needing a permanent indwelling catheter.


SCHEDULE 2—continued

TABLE 22 RENAL IMPAIRMENT

Impairment Rating

Criteria

NIL

Impairment of renal function corresponding to a creatinine clearance of 90 1/day (1.05ml/s) or better AND/OR intermittent symptoms or signs of upper urinary tract dysfunction are present that do not require continuous treatment or surveillance.

TEN

Impairment of renal function corresponding to a creatinine clearance of 75 to 89 1/day (0.87-1.05ml/s) AND/OR renal transplant.

FIFTEEN

Creatinine clearance is 75 to 89 1/day (0.87-1.05ml/s) AND symptoms and signs of urinary tract dysfunction OR disease necessitates continuous medical treatment.

THIRTY

Impairment of renal function corresponding to a creatinine clearance of 60 to 74 1/day (0.70-0.87ml/s).

FORTY

Impairment of renal function corresponding to a creatinine clearance of 50 to 59 1/day (0.58-0.70ml/s).

FORTY-FIVE

Impairment of renal function corresponding to a creatinine clearance of 50 to 59 1/day (0.58-0.70ml/s) and symptoms and signs of disease or dysfunction are incompletely controlled by surgical or continuous medical treatment.

SIXTY

Impairment of renal function corresponding to a creatinine clearance of 40 to 49 1/day (0.46-0.58ml/s).

SIXTY-FIVE

Impairment of renal function corresponding to a creatinine clearance of 40 to 49 1/day (0.46-0.58ml/s) and symptoms and signs of disease or dysfunction are incompletely controlled by surgical or continuous medical treatment.

SEVENTY

Impairment of renal function corresponding to a creatinine clearance of less than 40 1/day (0.46ml/s).


SCHEDULE 2—continued

 

SEVENTY-FIVE

Impairment of renal function corresponding to a creatinine clearance of less than 40 1/day (0.46ml/8) and symptoms and signs of disease or dysfunction are incompletely controlled by surgical or continuous medical treatment.

EIGHTY-FIVE

Deterioration of renal function requiring either peritoneal or haemodialysis.

 


SCHEDULE 2continued

TABLE 23.      SKIN DISORDERS

NOTE:

In the evaluation of impairment resulting from a skin disorder, the actual functional loss is the prime consideration, rather than the extent of cosmetic or cutaneous involvement.

 

Impairment Rating

Criteria

NIL

Signs and symptoms of skin disorder present and with treatment there is NO limitation in the performance of normal daily activities.

FIVE

Signs and symptoms of skin disorder present and with treatment there is MINIMAL limitation in the performance of normal daily activities.

TEN

Signs and symptoms of skin disorder present despite intermittent treatment and result in some interference with normal daily activities.

FIFTEEN

Signs and symptoms of skin disorder present despite continuous treatment and results in some interference with normal daily activities.

TWENTY

Signs and symptoms of skin disorder present despite continuous treatment and needs some assistance with normal daily activities.

FORTY

Signs and symptoms of skin disorder present despite continuous treatment and needs considerable assistance with normal daily activities.

SIXTY

Very severe symptoms requiring continuous treatment which may include periodic confinement to home or hospital and needs considerable assistance with normal daily activities.


SCHEDULE 2—continued

TABLE 24.    ENDOCRINE IMPAIRMENTS

 

NOTE:

The effects of diabetes mellitus on other body systems eg. the vascular and visual systems should be assessed from the appropriate tables and combined with values from this table using the Combined Values Chart.

 

Impairment Rating

Criteria

NIL

Thyroid disease adequately controlled with thyoxine replacement.

 

Primary hyperparathyroidism; parathyroid adenoma removed; replacement therapy not indicated.

 

Asymptomatic Pagets disease.

 

Asymptomatic osteoporosis or other bone disease WITH OR WITHOUT treatment.

 

Diabetes mellitus satisfactorily controlled by diet and/or tablets.

TEN

Thyroid disease which cannot be adequately treated.

 

Symptomatic Pagets disease, osteoporosis or other bone disease WITH pain not completely controlled by continuous therapy.

 

Diabetes mellitus requiring insulin.

TWENTY

Diabetes mellitus not satisfactorily controlled despite vigorous therapy.


SCHEDULE 2—continued

TABLE 25. MISCELLANEOUS IMPAIRMENTS, FOR EXAMPLE MALIGNANCY, HYPERTENSION AND HIV INFECTION

 

NOTE:

Persons with Group III and IV HIV infection are usually manifestly incapacitated for work.

 

Impairment Rating

Criteria

NIL

Controlled hypertension.

 

Minor symptoms which are easily tolerated.

TEN

Mild to moderate symptoms which are irritating or unpleasant but which rarely prevent completion of any activity. Symptoms may cause loss of efficiency in some activities.

 

Malignancy with a fair prognosis (75% 5-year survival rate) or malignancy in remission.

 

Hypertension that is difficult to control despite intensive therapy but without end-organ damage.

 

Potentially life-threatening condition which is currently not interfering with daily activities.

FIFTEEN

More severe symptoms which are more distressing but prevent few everyday activities. Loss of efficiency is discernible elsewhere. Self-care is unaffected and independence is retained.

TWENTY

Marked loss of energy leads to avoidance of many daily tasks, most of which can be completed but rapidly cause fatigue (eg. malignancy).

THIRTY

Loss of efficiency discernible in many everyday activities. Some elements of self-care are restricted but in most respects independence is retained.

 

Malignant hypertension - severe, uncontrolled.

 

Inoperable, asymptomatic but potentially life-threatening aneurysm or malignancy.

FIFTY

Major restrictions in many everyday activities. Capacity for self-care is increasingly restricted, leading to partial dependence on others.

SIXTY-FIVE

Most everyday activities are prevented. Dependent on others for many kinds of self-care. Able to be maintained at home with considerable assistance and frequent medical care.


SCHEDULE 2—continued

TABLE 26. INTERMITTENT IMPAIRMENT

Intermittent disorders are those that remain asymptomatic between discrete episodes of impairment. They are rated by reference to severity, duration and frequency of attacks:

severity during an attack is defined in the descriptions below;

duration is defined in the descriptions below;

frequency is determined by the number of affected days in a year.

An impairment rating using the above three factors is made by first coding severity and duration into an intermittent grading. The code is then combined with frequency, using Table 26.4, to give the rating.

When attacks vary in severity, duration or frequency, an average for each factor should be estimated. Only one rating for a given disorder may be made from Table 26.4. Further, the impairment rating is not combined with any other rating for the same disorder.

Acute exacerbations of chronic disorders cannot be measured using this table unless the chronic component is completely asymptomatic.

Some intermittent disorders may be rated using system-specific tables. The system-specific table is then used in preference.


SCHEDULE 2continued

TABLE 26.2 Intermittent attack - duration

Level

Criteria

NIL

Minor symptoms which are easily tolerated.

ONE

Mild to moderate symptoms which are irritating or unpleasant but which rarely prevent completion of any activity, symptoms may cause loss of efficiency in some activities.

TWO

More severe symptoms which are distressing, but prevent few everyday activities. Loss of efficiency is discernible elsewhere. Self-care is unaffected and independence is retained.

THREE

Loss of efficiency is discernible in many everyday activities. Some elements of self-care are restricted but in most respects, independence is retained. Bed-rest is often necessary during an attack.

FOUR

Major restrictions in many everyday activities. Capacity for self-care is increasingly restricted, leading to partial dependence on others.

FIVE

Most everyday activities are prevented. Dependent on others for many kinds of self-care.

Able to be maintained at home only with considerable difficulty, or hospital admission is required.

SIX

Total incapacity. Unconscious or delirious. Self-care is impossible.

 

TABLE 26.2 Intermittent attack - duration

Description

Duration

Transient Short

Lasting up to and including five minutes.

Lasting more than five minutes but less than 30 minutes.

Medium Prolonged

Lasting from 30 minutes to four hours.

lasting more than four hours.

 


SCHEDULE 2continued

TABLE 26.3  Severity – grading code

Description

Severity Level

 

0

1

2

3

4

5

6

Transient

A

A

A

B

C

C

F

Short

A

A

C

C

D

E

H

Medium

A

B

C

D

E

H

I

Prolonged

A

C

D

F

G

I

J

An impairment rating is obtained using Table 26.3 and

Table 26.4:

determine the intermittent grading code appropriate to the estimated severity and duration from Table 26.3 and

make the impairment rating appropriate to the intermittent grading code and frequency from Table 26.4.

TABLE 26.4 Assignment of impairment rating

 

Frequency (Affected days/year)

2+

5+

10+

20+

40+

100+

 

Intermittent Grading code

Impairment rating

A

-

-

-

-

-

-

B

-

-

-

-

-

5

C

-

-

-

-

5

10

D

-

-

-

5

10

20

E

-

-

-

5

10

30

F

-

-

5

5

10

30

G

-

-

5

10

20

30

H

-

-

5

10

30

50

I

-

5

10

30

50

70

J

5

10

20

40

70

90

 


SCHEDULE 2continued

TABLE 27.      GYNAECOLOGICAL CONDITIONS

Impairment Rating

Criteria

NIL

Minor symptoms which are easily tolerated. Minimal effect on daily functioning or work capacity.

FIVE

Mild symptoms frequently present which are irritating or unpleasant but there is minimal limitation in the performance of normal daily activities.

TEN

Moderate and frequent symptoms which result in some interference with normal daily activities and may cause occasional days off work. Treatment may be required or may be recognised as being of use.

FIFTEEN

More severe and frequent symptoms present despite treatment. Some interference with normal daily activities which may result in short periods of absence from work.

TWENTY

Moderate to severe symptoms frequently present despite continuous treatment, resulting in an inability to carry out some normal daily activities, particularly those requiring some exertion or extended periods of concentration.

THIRTY

More severe symptoms frequently present despite continuous treatment, resulting in discernible loss of efficiency in many everyday activities.

FORTY

Severe symptoms frequently present despite continuous treatment, resulting in need for considerable assistance with many daily activities.

FIFTY

Very severe symptoms requiring continuous treatment which may include periodic confinement to home or hospital, resulting in need for considerable assistance with normal daily activities.

 

 

 

 

 

NOTES

  1. No. 46, 1991, as amended. For previous amendments, see Nos. 68, 69, 70, 73, 74, 115 and 116, 1991.
  2. No. 42, 1974, as amended. For previous amendments, see No. 58, 1975; Nos. 59, 91, 101, 109 and 157, 1976; No. 75, 1977; Nos. 36, 89 and 133, 1978; Nos. 53 and 123, 1979; No. 132, 1980; Nos. 118 and 176, 1981; Nos. 49, 80 and 112, 1982; Nos. 54 and 139, 1983; Nos. 15, 46, 63, 120, 135 and 165, 1984; Nos. 24, 65, 70, 95 and 167, 1985; Nos. 28, 75 and 94, 1986; Nos. 44, 131, 132 and 141, 1987; Nos. 85, 87, 99 and 155, 1988; No. 95, 1989; and Nos. 3 and 119, 1990.

NOTES ABOUT SECTION HEADINGS IN SOCIAL SECURITY ACT 1991

  1. On the day on which subsections 1064 (1) and 1065 (1) are amended by the Schedule to this Act, the headings to sections 1064 and 1065 are altered by omitting “invalid” and substituting “disability support”.
  2. On the day on which paragraphs 1067 (1) (b) and 1068 (1) (b) are amended by the Schedule to this Act, the headings to sections 1067 and 1068 are altered by omitting “benefit” and substituting “allowance”.

[Minister’s second reading speech made in

House of Representatives on 31 May a.m. 1991

Senate on 5 June 1991]

 

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