3.6.5.120 Expiry & Extension of the MAP for SA

Summary

This topic describes:

  • the situations which may occur at the expiry of the MAP and the impact on payment of SA, and
  • extending the MAP:
    • without medical certification, and
    • when medical certification is not on the approved form.

Act reference: SSAct section 669(2) The maximum allowance period…

Expiry of MAP

Recipients are advised 28 days before the expiry of the MAP that a further medical certificate will be necessary for payment to continue beyond the current MAP. A further reminder is issued 7 days before the MAP expires.

The following table describes the situations which may occur at the expiry of the MAP and the impact on payment of SA.

If the recipient… Then…
does not lodge a medical certificate before expiry of the MAP, SA is suspended for up to 14 days.

lodges a medical certificate that provides continuous coverage within 14 days of the MAP expiry AND still qualifies for SA,

payment is restored with full arrears.
fails to provide a new medical certificate within 14 days of MAP expiry, SA will be cancelled and the recipient must lodge a new claim to receive SA.

Act reference: SSAct section 669 Time limit on qualification for SA

Policy reference: SS Guide 3.6.5.110 Continuation, Variation or Termination of SA

Extending the MAP without medical certification

The MAP should only be extended for a period without medical certification if the delegate is satisfied that:

  • the temporary incapacity for work or study will continue after the current MAP expires, AND
  • it is unreasonable to expect the recipient to obtain another medical certificate before their current MAP expires.

The following table describes the rules for extending the MAP without a medical certificate.

If the recipient is… Then…
advised to obtain another medical certificate at least 2 weeks before the MAP expiry date, the MAP should NOT be extended without a further medical certificate.
  • given less than 2 weeks in which to obtain another certificate, OR
  • unable to be seen by their treating doctor (1.1.T.160) before expiry of the MAP,
the MAP can be extended for up to 2 weeks.
  • living in a remote area, OR
  • unable to obtain another medical certificate within 2 weeks because of their medical condition (1.1.M.90),

Examples: Severe psychiatric episode or recipient in a coma.

the MAP can be extended from the initial 2 weeks to 4 weeks.

If the MAP is extended and the recipient fails to provide another medical certificate, there is NO overpayment.

Extending the MAP - medical certification not on the approved form

If a non-standard medical certificate is provided which does not substantially comply with the approved form, the delegate can contact the treating doctor to obtain the missing information. If the delegate is satisfied that all criteria for SA are met, the MAP may be extended by the period specified on the medical certificate up to a maximum of 13 weeks. In such cases, the extension of the MAP requires a written determination by the delegate.

The MAP may also be extended for the period specified on the medical certificate up to a maximum of 13 weeks, without confirming the missing information with the doctor, if a report from the same treating doctor has been provided within the previous 4 weeks and the recipient's medical condition/s is unchanged.

Policy reference: SS Guide 3.1.3 Notification & Recipient Obligations

Last reviewed: 20 September 2017