3.6.4.150 Continuation, Variation or Termination of CP

Summary

This topic explains a range of circumstances in which CP is varied, cancelled or suspended.

Act reference: SS(Admin)Act section 123 Continuing effect of determinations

Variation or cancellation

The following is a list of the circumstances in which payment of CP may be changed or stopped.

  • If the carer (1.1.C.40):
    • ceases providing constant care for more than 25 hours per week, to undertake training, education, employment or voluntary work, and has depleted their working credit (3.6.4.70), AND/OR
    • has exceeded the 63 days temporary cessation of care provisions (3.6.4.40), OR
    • ceases to have a qualifying child (1.1.Q.17) in their care in an exchanged care situation (3.6.4.37), OR
    • ceases to participate in the care of a care receiver who is in hospital (3.6.4.50), OR
    • ceases to be qualified during a temporary overseas trip (a temporary overseas absence must not exceed 6 weeks) (3.6.4.80), OR
    • fails to meet the 20 hours per week minimum level of personal care when applying for CA under section 954A - this indicates they are not providing constant care for CP purposes (3.6.7.45).
  • If the care receiver (1.1.C.20):
    • or any other person to whom the care receiver income test applies underestimated their income for the care receiver income test and the actual income is above the income ceiling (4.2.5), OR
    • is temporarily admitted to an institution for a period longer than allowed under the temporary cessation of care provisions (this topic), OR
    • is permanently admitted to an institution or hospital which provides personal care (this topic), OR
    • has their social security or DVA payment stopped (this topic), OR
    • is a child with a profound disability who no longer meets the definition of a 'profoundly disabled child' (1.1.C.146), OR
    • is a child and no longer requires a level of care that attains a qualifying rating of intense under the DCLA, OR
    • recovers, OR
    • dies (3.1.5.130).

Assessment against the ADAT (3.6.9)

An assessment against the ADAT is current for 2 years. However, if the condition is permanent and non-improving and an ADAT score of 40 or more is achieved the care receiver is not required to undergo another assessment for CA or CP purposes. If a new carer applies for CP for the care receiver, a new assessment is required unless the care receiver's medical information can be used under the re-use provisions.

DCLA (Child) (3.6.12)

An assessment under the DCLA remains current providing the delegate remains satisfied it is an accurate reflection of the functional ability, behaviour and special care needs of the child.

If a carer reapplies for CP (child) for the same child or children a new ACL questionnaire and professional questionnaire are NOT required UNLESS the delegate has reason to believe that they do not reflect the functional ability, behaviour and special care needs of the child or children at the time of the reclaim.

If a NEW carer applies for CP (child) for a child or children with severe disability, severe medical condition, disability or medical condition, an ACL questionnaire for each child or children for whom they are applying for CP (child) is required. A new professional questionnaire is not required unless the delegate has reason to believe that the existing professional questionnaire is no longer an accurate reflection of the functional ability, behaviour and special care needs of the child or children.

Note: Special consideration must be given by the delegate that the assessment is an accurate reflection of the functional ability, behaviour and special care needs of a child where the child has reached a new developmental milestone used in the DCLA (1.1.D.170), or the claim is made within 6 months of the next medical review of entitlement, or there is a reason to believe the care receiver's medical condition has changed.

Care receiver's temporary admittance to an institution becomes permanent

Often a care receiver is admitted temporarily to an institution, with the admission subsequently becoming permanent. In such cases, the temporary cessation of care provisions may apply up to the date of permanent admission (as long as it does not exceed the number of days available). The 14 week continuation of CP for the adjustment period would then start on the date of permanent admission.

If the temporary admission in an institution exceeds the number of days allowable under temporary cessation of care provisions in that calendar year before the date of permanent institutionalisation, the carer ceases to qualify for CP when the 63 days are exhausted. In this case CP would be cancelled and the 14 week continuation would NOT occur because the carer did not qualify for CP at the time the care receiver was permanently institutionalised.

Care receiver is permanently admitted to an institution

For the purposes of CP, permanent admission to an institution means that in light of available evidence, the admission is likely to continue for the foreseeable future. A care receiver admitted to hospital or palliative care and expected to return home at some future time, would not meet this definition.

If a care receiver is admitted PERMANENTLY to an institution, which provides care, the carer remains qualified for CP for 14 weeks starting from the day the carer did not provide care. In most cases, it will be the day after the person enters the institution.

Explanation: The extension of CP is made in recognition of the impact on the carer of no longer being in the caring role. The carer will need to make adjustments to their life and may need to seek employment or another form of income support.

Note: If the former care receiver dies during the 14 week adjustment period and the former carer and care receiver were not members of the same couple, CP will continue to be paid for the remainder of the 14 weeks. The former carer will not be entitled to a lump sum bereavement payment or to a further 14 week bereavement period.

If the former care receiver and the former carer were members of the same couple and the care receiver dies within the 14 week adjustment period of permanently entering an institution, the carer is eligible for a new 14 week bereavement period if all aspects of the SSAct section 237 are met. The carer may also be eligible for a lump sum bereavement payment.

Act reference: SSAct section 198AAA Continuation of qualification when person receiving care admitted to institution, section 235 Continuation of carer payment for bereavement period where person cared for dies, section 237 Qualification for payments under this Subdivision

Policy reference: SS Guide 3.1.5 Bereavement Payment Provisions, 3.6.4.10 Qualification for CP, 3.6.4.40 Qualification for CP during temporary cessation of care

Carer requires care or the care receiver provides care to a third party

If a carer makes a CP claim for caring for a person who is receiving CP themselves, or if a care receiver who qualifies a carer for CP makes a claim for CP for another care receiver, a social worker should assess the situation (8.1.7.20) to ensure both carers personally provide constant care (1.1.C.310).

Example 1: Jill receives CP for caring for her adult daughter, Angela. Jill is involved in an accident that results in brain injury and problems with mobility. Jill's partner, James, resigns from his job to care for Jill. James applies for CP for the care he provides to Jill and meets all the qualifying criteria. James is granted CP. However, a social worker determines that while Jill continues to provide some care to Angela, she does not personally provide constant care and Jill's CP is cancelled.

Example 2: Debbie qualifies for CP for the care she provides to her sister-in-law, Edna, who has paraplegia. Edna is employed full-time. Edna's older sister develops Alzheimer's disease and must have constant supervision (e.g. to prevent injury and ensure medication is taken etc.) and prompting to undertake personal care activities (e.g. showering, grooming, etc.) rather than needing much physical help. Edna decides to quit her job to care for her sister. She applies for CP, even though she herself needs a carer to help her to do most physical tasks. A social worker determines that Edna provides constant care and CP is granted.

Policy reference: SS Guide 8.1.7.20 Social Worker Involvement - Specific Payments

Care receiver underestimated income for the care receiver income test

CP must be cancelled or suspended if evidence is received that the income of the care receiver, and/or any other person included in the care receiver income test, was underestimated and the actual taxable income is more than the care receiver income test income ceiling. The date of effect of the suspension or cancellation is the day on which the determination to accept the estimate was made. An overpayment will result for the period when the estimated income was used, however the overpayment may not be recoverable, unless it was reasonable for the CP recipient to know of the situation that led to the debt arising.

Policy reference: SS Guide Part 4 Income & Assets, 6.3 Assessing Overpayments

Care receiver's social security or DVA income support payment stopped

If a person receives a social security or DVA income support payment, and that payment is cancelled, they may still qualify their carer for CP after a reassessment under the care receiver income and assets tests.

Example: Maurice is on Age and qualifies his daughter, Alison for CP. Maurice wins a sum of money in a lottery, which puts his assets over the assets limit and he is no longer able to receive the Age. Maurice may still qualify Alison for CP after reassessment under the care receiver income and assets tests.

Note: The Secretary has the discretion, under specific conditions, to decide that the care receiver assets test does not disqualify the carer from CP.

Act reference: SSAct section 198(5) Income and assets tests etc., section 198N Exemption from care receiver assets test, refer to (2), (3) and (4)

Policy reference: SS Guide 4.2.5 CP income & assets tests

Transfer between CP & other payments/benefits

If a person ceases to qualify for CP or becomes eligible for another income support payment, they may be able to transfer to that payment. As there are differences in their administration, a person may need guidance about the relative advantages of one payment over another. No transfers should occur without the knowledge and consent of the person.

Example: If a person receiving CP reaches age pension age, the person's payment should NOT be automatically transferred to Age.

Comparable foreign payment (1.1.C.230)

CP may be terminated if a person or their partner fails to take action to obtain a CFP.

Policy reference: SS Guide Part 7 Portability & comparable foreign payment (CFP)

Last reviewed: 11 May 2015