188.8.131.52 Internal Review of a Claimant Decision
A person whose interests are affected by a claimant decision (1.1.C.110) may apply for an internal review of the decision. A person who can apply for a review of a claimant decision may include a primary or secondary or tertiary claimant, or a DAPP claimant, or other affected person, but not an employer.
Exception: A person may NOT apply for an internal review of a claimant decision that was made personally by a PPL agency representative (1.1.P.160). In this case they may apply for a review to the AAT.
A claimant decision is a decision of an officer made under the PPLAct, but not including decisions:
- which deal with the payment of instalments by employers, or
- which deal with employer determinations, or
- which deal with compliance, or
- which are made under the PPL Rules, if the rules state section 206 does not apply to the decision, or
- which are made under the regulations, if the regulations state section 206 does not apply to the decision.
Any affected party may seek a review of a decision to transfer, or a decision not to transfer PLP.
If Centrelink makes a determination as to who is the primary carer (1.1.P.230) for PLP, each person who sought to be the primary carer may seek review of that decision.
If a claim is not effective, the claimant can seek review only of the decision that the claim is not effective. The claimant also may claim again for PLP or DAPP.
Review of a decision that PLP or DAPP is not payable to a person would result in the person not being paid PLP or DAPP until the review is finalised. If the outcome of the review is that the claimant is eligible and PLP or DAPP is payable, Centrelink may commence payments to the claimant. The payments can be in accordance with the claimant's initial claim.
A claimant can seek review of a decision to stop payment of PLP or DAPP. This may occur, for example, if Centrelink believes that a claimant has returned to work (1.1.R.50), or that the claimant is no longer the primary carer. If a claimant seeks review of a decision to stop payments, payments should not re-commence until the review is completed.
Form of application for internal review of a claimant decision
An application for review of a claimant decision may be made orally or in writing to Centrelink.
Timing of application for internal review of a claimant decision
Applications for review of claimant decisions may only be made within 28 days of the day the decision in contention was made, unless Centrelink is satisfied that a longer period is appropriate.
Example: A woman makes a claim for PLP. She meets all eligibility criteria and estimates her ATI (for the reference income year) to be $160,000. She is advised that she is not eligible for PLP as her income is too high. Eight months later, when preparing her tax return for the reference income year, the woman's accountant asks her if she has claimed PLP. He calculates her ATI (for the reference income year) to be less than the relevant PPL income limit and she realises that she had incorrectly estimated her ATI. Although the 28 day time limit has passed the woman can still seek review on the basis that her actual ATI is below the relevant PPL income limit because she did not become aware of this until 8 months later.
Notice of decision on review of a claimant decision
Written notice is required when a decision is made on an internal review of a claimant decision. See 8.1.5 for the requirements of this notice.
Act reference: PPLAct section 206 Internal review-application for review of claimant decision, section 211 Internal review-notice of decision on review of claimant decision, section 216 AAT first review of claimant decision-application for review