3.6.5.40 Payability of SA

Summary

Payment of SA is subject to an MAP which is detailed in the rest of this topic.

SA MAY NOT be payable to the recipient in the circumstances listed in the following table. Where more detail about the circumstance is required, the second column indicates where you will find this.

Circumstances More Detail

Specific provisions

When payments are received from sickness, accident or other insurance policies. Part 4 Income & Assets
When payments are received from an employer. 3.6.5.50 Payability of SA - Payments from an Employer
When the recipient has not taken reasonable steps to obtain compensation. 3.1.9 Compensation Provisions
The recipient is subject to a NARWP, unless he or she has a QRE. 1.1.N.70 Newly arrived resident's waiting period (NARWP)

1.1.Q.35 Qualifying residence exemption (QRE)

When the recipient is serving a compensation preclusion period. 3.1.9 Compensation Provisions

4.13.2 Lump Sum Compensation

Common provisions

Allowance is not payable before the start day. 8.3 Start Days
Other common payability provisions. 3.1.6 General Payability Provisions

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

Policy reference: SS Guide 3.6.5.70 Waiting Periods for SA

Maximum allowance period

Payment of SA is restricted to the MAP. The MAP is:

  • the period decided by a delegate that a recipient is incapacitated for work, which is the lesser of the period specified by the treating doctor (1.1.T.160) on the medical certificate or 13 weeks, OR
  • the duration of a vocational rehabilitation program as long as the total period on SA does not exceed 208 weeks.

The delegate sets the MAP and is not necessarily restricted to the period recommended by the treating doctor.

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

Policy reference: SS Guide 3.6.5.120 Expiry & Extension of the MAP for SA, Part 4 Income & Assets

Employment income nil rate period

An SA recipient on a graduated return to work who loses payment because of ordinary income (1.1.O.30), made up entirely or partly of employment income (1.1.E.102), may qualify for an employment income nil rate period. The recipient must be covered by a medical certificate for the entire period while on an employment income nil rate period. To assess qualification for an employment income nil rate period see 3.1.12 Employment Income Nil Rate Period.

During the employment income nil rate period an SA recipient can:

  • be paid certain supplementary benefits (3.1.12), and
  • retain their HCC or PCC, and
  • have their payment resumed if they report a fall in income sufficient for SA to be payable again.

Act reference: SSAct section 23(4A) Despite subsection (4)…, section 23(4AA) For the purposes of subsection (4A)…, section 1061ZEA Further extended qualification rule: loss of payment because of employment income, section 1061ZMA Further extended qualification rule: loss of payment because of employment income

Policy reference: SS Guide 3.9.1.10 Qualification for HCC - Automatic Issue, 3.9.2.30 PCC due to Employment

Last reviewed: 20 March 2015