The Guides to Social Policy Law is a collection of publications designed to assist decision makers administering social policy law. The information contained in this publication is intended only as a guide to relevant legislation/policy. The information is accurate as at the date listed at the bottom of the page, but may be subject to change. To discuss individual circumstances please contact Services Australia.

4.6.1.10 CCS - making an effective claim

Summary

This topic contains information on an individual (1.1.I.90) claiming CCS for approved care (1.1.A.90) and covers:

  • when a claim (1.1.C.27) is effective
  • claims that are not effective
  • information required to make an effective claim.

When is a claim effective?

To make an effective claim for CCS by fee reduction, individuals must:

  • submit a CCS claim form with all relevant questions answered through Centrelink online, in person or over the phone, and
  • submit all relevant supporting documentation (if required).

Where an individual has provided documentary evidence or 'free text' information (for example, in relation to an application for exceptional circumstances) to support their online CCS claim, it will be manually assessed to determine if it is effective.

If the claim is effective the individual will receive an acknowledgement in writing of receipt of the claim.

Claims that are not effective

If a claim is not effective, it considered not to have been made, will not be assessed, and no CCS payments can be made. The individual will receive a notification in writing, which will include the reason it was not effective.

Claims that are not effective are also considered not to have been made for the purposes of review and appeal.

Information required when claiming CCS

Information individuals must provide to make an effective claim includes:

  • personal details for themselves and their partner (1.1.P.30), such as address and DOB
  • personal details of the child/ren for whom the claim is made, such as name and DOB
  • details required to establish whether the individual meets the CCS core eligibility requirements
    • FTB/regular care child (2.1.1.13) (through questions about the percentage of care the individual provides for that child)
    • Residency requirements (2.1.2.10)
    • Child's age and education level
    • Immunisation (2.1.3.20) status (through the child's Medicare number)
  • details of recognised activities being undertaken by the individual, and their partner if they have one (3.5.2)
  • estimated ATI (1.1.A.20) for the individual and their partner, if they have one, (1.1.I.20)
  • TFN of the individual and their partner, if they have one*
  • the individuals bank account details*
  • additional information required for claiming ACCS (grandparent) (if applicable) (2.8.2).

*Explanation: Where an individual or their partner does not have a TFN when making a claim, they may contact Centrelink in person or by phone to submit a staff assisted claim without these details. Centrelink can place the claim 'on hold' for up to 28 days. At this point, the individual has not made an effective CCS claim. If the individual provides the required TFN within the 28 day period (and the claim now meets all other requirements for an effective claim) their claim will be assessed as though it was effective from the day it was initially submitted (not the day that they provided the TFN). Eligibility for CCS can only be backdated up to a maximum of 28 days before an individual made an effective claim.

At the end of 28 days, Centrelink may decide that the TFN is not required for the claim indefinitely. It may be appropriate to make this decision if:

  • the individual is in a violent or abuse relationship and cannot obtain their partner's TFN,
  • the individual or their partner is unable to obtain a TFN due to location or technology constraints.

If Centrelink doesn't decide to remove the TFN requirement indefinitely, and the individual does not provide Centrelink with the required TFN within 28 days, their claim will lapse, meaning they will need to make a new claim if they wish to receive CCS in future.

Act reference: FAAct section 85BA Eligibility for CCS

FA(Admin)Act section 67BE When a claim is effective, section 67CC Determination of individual's eligibility for CCS by fee reduction

Last reviewed: