6.2 Internal Reviews

Summary

This chapter explains Centrelink's internal review process and covers:

  • initiating a review,
  • Centrelink initiated review,
  • date of effect of favourable decision for Centrelink initiated review,
  • reviews relating to the CCS activity test,
  • reviews initiated by affected persons (1.1.P.80),
  • review relating to care percentage decisions - initiated by affected persons,
  • time limit for a review initiated by affected persons,
  • date of effect of a favourable decision for a review initiated by affected persons,
  • further requirement for review request relating to an income estimate,
  • continuation of payment during a review, and
  • notification of the decision.

Initiating a review

An internal review can be initiated by:

  • Centrelink (as a delegate of the Secretary), or
  • a person affected by a Centrelink decision.

Act reference: FA(Admin)Act section 105 Secretary may review certain decisions on own initiative, section 109A Review of certain decisions may be initiated by applicant

Centrelink initiated review

Centrelink may review an FA decision where there is sufficient reason to do so. The decision maker may affirm, vary or set aside the original decision. This includes deemed refusals, where Centrelink has neither made a determination nor refused the original application for ACCS (child wellbeing) (2.8.1.50) or (temporary financial hardship) (2.8.3.40) within 28 days after the day of application. Centrelink will undertake a review on its own initiative in circumstances where an application has:

  • been made and received,
  • meets the 'form and manner' requirement, and
  • contains the required information and accompanying documentation.

Example: Reconciliation of entitlement is one example of a review initiated by Centrelink.

Act reference: FA(Admin)Act section 105 Secretary may review certain decisions on own initiative, section 104 Decisions that may be reviewed by Secretary on own initiative

Date of effect & result of favourable decision for Centrelink initiated review

Generally, where the review is initiated by Centrelink, the date of effect of a review decision that is favourable to the person affected by the decision is the date from which full effect is given to the review decision (full arrears).

FTB by instalment or SBP

However, if the review decision relates to FTB by instalment, or SBP (paid under the FTB Part A eligibility test), and the decision is made on a date later than 52 weeks after the person concerned was given notice of the original decision then the date that the review decision comes into effect is the later of:

  • the date from which full arrears are payable, or
  • 1 July of the income year before the income year in which the review decision is made.

Explanation: For decisions in all cases listed above, full arrears are payable as long as the review decision is made before the end of the income year following the income year in which the notice of the original decision was given. Otherwise, arrears can only be paid back to the beginning of the previous income year.

The limitation on the date of effect does not apply in the following circumstances:

  • Where a review of the decision was triggered by an income assessment by the ATO (including FTB by instalment cases), provided that the tax return was lodged on or before the end of the income year following the income year to which the assessment relates.
    • Explanation: For decisions relating to the individual's income, full arrears are payable where the tax return is lodged on or before the end of the next income year even if Centrelink does not make a review decision until after that income year.
  • Where the review decision is triggered by information that immunisation requirements have been met for a child for whom immunisation requirements apply during the income year to which the review relates, provided that the information is received before the end of the first income year after that income year.
  • Where the review decision is triggered by information that health check requirements have been met for a child who turned 4 years during the income year to which the review relates, provided that the information is received before the end of the first income year after that income year.
  • Where the review decision is triggered by information that the health check or immunisation requirement should not have applied for the income year to which the review relates.

CCS & ACCS

For Centrelink initiated review decisions in relation to individuals' (1.1.I.90) eligibility and entitlement (1.1.E.30) for CCS or ACCS, or an approved provider's (1.1.A.90) entitlement to be paid ACCS (wellbeing), the date of effect for beneficial changes cannot be earlier than the beginning of the previous financial year. This time limit does not apply where a decision on review:

  • changes an individual's ATI (1.1.A.20) for the relevant income year (1.1.R.23), or the individual's activity test result for a CCS fortnight due to the individual meeting the CCS reconciliation (1.1.R.10) conditions, or
  • is affected by a review conducted by the ATO.

Note: If an individual reports a change to their combined annual estimated ATI after the change occurred (whether it is favourable or unfavourable), a review of entitlement is not undertaken, as actual CCS entitlement based on actual ATI is confirmed at reconciliation.

Act reference: FA(Admin)Act section 67DB Determinations when adjusted taxable income is not known, section 67FB Notice of change of circumstances: individuals, section 105C Review of entitlement to be paid CCS or ACCS - taking account of changes of circumstances etc., section 105D Review of entitlement to be paid CCS or ACCS - time limit on increase, section 107 Date of effect of certain decisions made under section 105 in relation to FTB by instalment

Policy reference: FA Guide 5.2.1.40 CCS & ACCS - Change in Activity/Income, 6.4.1 Overview of Reconciliation

Reviews relating to the CCS activity test

Individuals are obliged to notify Centrelink as soon as practicable if there is a change in their activity that would cause them to move to a different step of the activity test. An individual must also notify Centrelink as soon as practicable if there is a change in their circumstances that would mean they are no longer eligible for an exemption to the activity test, or would now be eligible for an exemption to the activity test.

For Centrelink initiated review decisions relating to activity notified after the change occurred:

  • A change in activity level that is FAVOURABLE to the individual (i.e. that causes the individual to be entitled to more hours of subsidised care per fortnight), will be backdated a maximum of 28 days to the beginning of a CCS fortnight from the date of notification.
  • A change in activity level that is UNFAVOURABLE to the individual (i.e. that causes the individual to be entitled to fewer hours of subsidised care per fortnight), will be applied as far back as the date of event, from the beginning of the next CCS fortnight (even if this is in a previous financial year).

For the purpose of CCS:

  • the date of notification is the date Centrelink receives the notification regarding a change in an individual's circumstances,
  • the date of event is the date that a change in an individual's circumstances actually occurred,
  • the date of effect is the date that particular information about an individual's circumstances will be taken into account.

Example 1: On Sunday 15 July 2018, Victor, a single parent, increased his paid work hours from part time to full time, which increased his entitlement (activity test result) from 72, to 100 hours of subsidised care per fortnight. However, Victor only notified Centrelink of this change on Tuesday 16 October 2018, around 3 months after it occurred. As such, the increase in Victor's entitlement is only applied from Monday 24 September 2018, which is 28 days before he notified Centrelink of the new information about his circumstances, to the beginning of the CCS fortnight.

Example 2: On Tuesday 16 October 2018, Cecily, a single parent, notified Centrelink that on Sunday 15 July 2018 she decreased her paid work hours from full-time to part-time, which decreases her entitlement (activity test result) from 100, to 72 hours of subsidised care per fortnight. The decrease in Cecily's entitlement is applied from Monday 16 July 2018, which is the beginning of the CCS fortnight after the change occurred.

Beneficial changes in entitlement (activity related) that are taken into account back more than 28 days

In certain circumstances, if an individual is late in reporting a change in their activity level or circumstances that is beneficial in terms of increasing their entitlement to hours of subsidy per fortnight (activity test result), and the delegate believes in their circumstances they have provided the information as soon as practicable, the delegate can take the information into account back more than 28 days. The delegate can take the information into account as far back as the date the change occurred, but not further back than the beginning of the previous financial year (i.e. the review could never extend back more than 2 years).

Circumstances in which the delegate may take beneficial activity test information into account back more than 28 days where the individual notified of the change after it occurred could be for reasons such as, but not limited to, the parent, their partner (1.1.P.30) or the child experience a natural disaster, domestic violence, serious illness or medical condition including hospitalisation or significant trauma.

Example: Taylor is a single parent who is working part-time (16 hours per fortnight), which entitles her to 36 hours of subsidised care per fortnight. On Monday 9 July 2018, Taylor begins doing a training program in accounting (for 22 hours per fortnight), which brings her total hours of recognised activity to 38 hours per fortnight, increasing her activity test result to 72 hours of subsidised care per fortnight. However, Taylor does not notify Centrelink of this change until Saturday 25 August 2018 because there is major flooding in her town that affects her house on Friday 13 July 2018. As a result of the flood, Taylor has not had access to the internet or her home phone, and has not been able to visit a Centrelink office as access to roads have been cut off. Afterwards Taylor contacts Centrelink to explain her circumstances and the delegate agrees her new activity test result of 72 hours of subsidised care per fortnight will be applied from Monday 16 July 2018 (the CCS fortnight after the change occurred).

Act reference: FAAct Schedule 2 clause 12(7) Changes in the number of hours of recognised activity

FA(Admin)Act section 67FB Notice of change of circumstances: individuals, section 105C Review of entitlement to be paid CCS or ACCS-taking account of changes of circumstances etc.

Policy reference: FA Guide 5.2.1.40 CCS & ACCS - Change in Activity/Income

Reviews initiated by affected persons

Generally, a person affected by a decision made by an officer under FA law can request a review. The decision will be quality checked by a subject matter expert (SME) and if the person is not satisfied with the outcome they can request a review by an ARO.

The ARO may affirm, vary or set aside the original decision.

Review relating to care percentage decisions - initiated by affected individuals

From 1 July 2010, changes to child support and FTB legislation align determinations about care between child support and FTB. This means where a care determination needs to be made in respect of a child, the determination can be made by either a delegate of the Child Support Registrar or the Secretary (CSA Act section 54K and FAAct section 35T).

Where either the Registrar or the Secretary conducts an internal review of a care decision, any new decision made on review will be used by both the Registrar and the Secretary. Where the AAT amends a decision or substitutes a new decision about a care percentage, that amended or substituted decision will be used by both the Registrar and the Secretary.

Explanation: Where a care percentage decision has been made by Centrelink, this decision is applied to the child support assessment of the payee and the payer. Both the payee and the payer can approach either Child Support or Centrelink to seek review of the decision.

Where the care percentage decision has no effect under FA law (i.e. neither party is claiming FTB) only Child Support may make or review care percentage decisions. In such a case, if the individual approaches Centrelink to request the review, Child Support, as the original decision maker must undertake the review.

Act reference: FA(Admin)Act section 109A Review of certain decisions may be initiated by applicant

Time limit for a review initiated by affected persons

Generally, an application for a review by a person in relation to FA should be lodged within 52 weeks after the individual is notified of the original decision, noting:

  • this time limit does not apply to FTB by instalment decisions, and some other decisions,
  • applications for a review in relation to CCS and ACCS, including requirements of approved providers under FA(Admin)Act Part 8A, must be made within 13 weeks after the applicant is notified of the decision.

However, there are time limits for full arrears to be payable depending upon the circumstances. (For more information, refer to 'Date of effect of a favourable decision for a review initiated by an affected individual'.)

The table below indicates decisions other than instalment decisions where a 52 week time limit may not apply.

If these circumstances apply… Then the time limit to request a review is…
special circumstances that prevented the person from making a review application, extended past 52 weeks (or 13 weeks for CCS and ACCS) to such further period as determined appropriate by Centrelink.
FTB and SIFS past period decision, the later of the end of the income year after the income year in which the past period occurred or 52 weeks after the original decision was made.
determination of entitlement or no entitlement to FTB by single payment in substitution because of the death of another person, to the end of the income year after the income year in which the death occurred.
decision that relates to a period involving 2 income years (noting limitations associated with CCS and ACCS - see the introduction to this section above or 'Date of effect of a favourable decision for a review initiated by an affected individual'), the later of the end of the income year after the income year in which the period ended or 52 weeks after the original decision was made.
decision relating to an assessment of taxable income by the ATO (including FTB by instalment cases) and the individual lodged their income tax return before the end of the income year following the income year to which the assessment relates, there is no time limit.
review of an assessment of taxable income by the ATO and the individual initially lodged their income tax return before the end of the income year following the income year to which the assessment relates, the later of 13 weeks after the individual receives notification of the review from the ATO or 52 weeks after the original decision was made.
review of child support entitlement, the later of 13 weeks after the individual receives notification of the review from Child Support or 52 weeks after the original decision was made.
determination of an individual's eligibility or entitlement for CCS or ACCS, 13 weeks after the applicant is notified of the decision.

Act reference: FA(Admin)Act section 108 Decisions that may be reviewed under section 109A, section 109D Review applications-time limits applicable to review of certain decisions, section 109DB Review of entitlement to be paid CCS or ACCS-taking account of changes of circumstances etc, section 109DC Review of entitlement to be paid CCS or ACCS-time limit on increase, section 109E Date of effect of certain decisions relating to payment of FTB by instalment

Date of effect of a favourable decision for a review initiated by an affected person

Except for CCS and ACCS decisions, provided the person requests the review within the prescribed timeframe as described above, and the outcome of the review is in their favour, the decision takes effect from the date of the previous decision if:

  • a previous decision is varied, or
  • a new decision is submitted.

Arrears payable as a result of the review are backdated to the date of effect.

However, for a review decision relating to FTB by instalment, where the request for review is made more than 52 weeks after notice was given of the original decision, then the date of effect is generally the later of:

  • the date from which full arrears are payable, or
  • 1 July of the income year before the income year in which the review decision is made.

Explanation: For FTB by instalment cases, full arrears are payable as long as the review request is made before the end of the income year following the income year in which the notice of the original decision was given. Otherwise, arrears can only be paid back to the beginning of the previous income year.

This limitation on the date of effect does not apply where the request for review is the result of:

  • an assessment or review of taxable income by the ATO, provided the application for review is made within 13 weeks of when the individual received notification of the ATO decision and the individual had lodged their tax return before the end of the income year after the income year to which the review relates, or
  • a review of child support entitlement, provided the person makes the application for review within 13 weeks of receiving notification of the revised child support assessment, or
  • immunisation requirements being met for a child for whom immunisation requirements apply during the income year to which the review relates, provided that the application for review is made before the end of the income year after that income year, or
  • health check requirements being met for a child who turned 4 years during the income year to which the review relates, provided that the application for review is made before the end of the income year after that income year, or
  • information that the health check or immunisation requirement should not have applied for the income year to which the review relates.

CCS & ACCS

In relation to CCS and ACCS decisions the decision takes effect from the date of the previous decision, if that date is not earlier than the previous financial year, provided the person:

  • requests the review within 13 weeks of a decision relating to eligibility and entitlements, and
  • the outcome of the review is in their favour, and
  • the individual had provided all the information required for Centrelink to determine their eligibility or entitlement to CCS and ACCS as soon as practicable.

There is no time restriction where the review is the result of the individual meeting the CCS reconciliation conditions or an ATO review.

Act reference: FA(Admin)Act section 109D Review applications-time limits applicable to review of certain decisions, section 109DB Review of entitlement to be paid CCS or ACCS-taking account of changes of circumstances etc, section 109DC Review of entitlement to be paid CCS or ACCS-time limit on increase, section 109E Date of effect of certain decisions relating to payment of FTB by instalment

Further requirement for review request relating to an income estimate

A request for a review of a decision in regard to eligibility for or entitlement to FA (other than SBP) or a CCS percentage to the extent that the decision was based on an estimate of the person's taxable income cannot be made until after the end of the income year and where the person is required to lodge a tax return, after the ATO has made an assessment of the person's taxable income for that year.

A request for a review of a decision in regard to eligibility for or entitlement to FTB to the extent that the decision was based on an estimate of maintenance income for an income year cannot be made until after the end of that income year.

Explanation: This restriction only allows a review of a decision to the extent that it is based on an income estimate to occur after actual income is available so that correct entitlement can be determined.

This restriction does not preclude the person from providing a revised estimate of income at any time during the income year. If a revised estimate is provided and considered reasonable, the rate paid can be varied from the date the revised estimate is provided.

If an FTB instalment claim is rejected due to the income estimate being too high and the income estimate subsequently decreases, the person can lodge a new claim which contains a revised estimate and, if eligible, be paid prospectively from the date of the new claim. However, the individual will need to wait until their actual income is known to be paid for the past period (i.e. period from the date the first rejected claim is lodged up to the date the new claim is lodged).

Where a claim for SBP has been rejected because of the income estimate, the person's eligibility for each payment can be reviewed if they provide a revised estimate within 52 weeks of being notified of the rejection. The revised estimate must include the person's income and, if the person was partnered on the day the claim was initially lodged, the income of the person to whom they were partnered on the day the claim was lodged. This means that if the individual has separated since lodging the claim, their former partner's income for the 6 month income test period needs to be included in the revised estimate.

Act reference: FAAct section 36 When an individual is eligible for SBP in normal circumstances

FA(Admin)Act section 31A Variation of instalment entitlement determination to reflect revised ATI estimates, section 108 Decisions that may be reviewed under section 109A, section 109A Review of certain decisions may be initiated by applicant

Policy reference: FA Guide 4.4.2.20 Change in Income Related Circumstances, 4.2.2.20 Specific Requirements for Past Period Claim

Continuation of payment during a review

If an unfavourable decision is made and the decision depends upon the exercise of discretion, the person's entitlement to FA may continue during the review process.

Act reference: FA(Admin)Act section 109G Secretary may continue payment etc. pending outcome of application for review

Notification of the decision

The reviewer must:

  • notify all parties affected by the review decision in writing or another approved manner of:
    • the review decision, and
    • the reasons for the decision, and
    • the effect of the decision, and
  • advise the affected person that they may seek further review by the AAT.

Act reference: FA(Admin)Act section 106 Notice of review decision not relating to CCS or ACCS, section 106A Notice of certain review decisions relating to CCS or ACCS, section 109B Notice to be given of decisions under section 109A, section 109H Notification of further rights of review

Last reviewed: 2 July 2018