126.96.36.199 Backdated start days - general provisions
As a general rule, an applicant's start day may be earlier than the day on which they make a claim IF the claim is made:
- after a partner's (1.1.P.85) claim
- by a transferee
- after childbirth
- by an incapacitated applicant
- after the death of a partner, and
- following a claim for AGDRP.
These are discussed in the rest of this topic.
Claim made after partner's claim
If an applicant claims a benefit or pension within 14 days of their partner claiming a benefit or pension and both claims are granted the applicant's start day is the first day they are qualified after their partner's start day.
Explanation: This is the first day they both qualify for the payment.
Note: If a couple cease to be partners after one of them has claimed and before the other claims, the former partnership is not relevant for the purpose of this provision.
Act reference: SS(Admin)Act Schedule 2 clause 8 Claim made soon after partner's claim
Claims by a transferee
The following table outlines the start day for an applicant transferring from one payment to another with NO gap in their qualification.
|If an applicant transfers …||the start day is …|
|within 14 days of the original pension or benefit ceasing to be payable||
the day after the original payment or benefit ceased to be payable.
Explanation: This is the transfer day.
|more than 14 days, but LESS than 13 weeks after the original pension ceased to be paid PROVIDED an illness or medical incapacity was the sole or principal cause of the delay||
the transfer day.
Note: The claim must be lodged either on the last day of the illness or on the day after.
||the day a claim for a second payment is lodged.|
Act reference: SS(Admin)Act Schedule 2 clause 9 Claim by transferee
Claim soon after childbirth
The start day is the first day on which the woman is qualified ON OR AFTER the day the child was born, if she claims a social security payment within 4 weeks of giving birth.
Example: Kim gave birth to her child on 11 January 2000 and lodged her PP claim 3 weeks later. Kim's start day is backdated to 11 January 2000, which is the day she qualified for PP.
Explanation 1: For PP, Schedule 2, Clause 10 applies regardless of whether the applicant is claiming after the birth of their FIRST PP child or a SUBSEQUENT PP child. This is different to the old PP rule, where backdating could only occur where the claim was lodged after the birth of the applicant's FIRST PP child.
Explanation 2: For PP, Schedule 2, Clause 10 does NOT apply to a person who obtains a child other than by childbirth (eg adoption, fostering, or the father of a child). Such applicants are covered under the provisions of Schedule 2, Clause 29. A description of the operation of Clause 29 can be found in topic 188.8.131.52.
Act reference: SS(Admin)Act Schedule 2 clause 10 Claim soon after childbirth, Schedule 2 clause 29 Parenting payment
SSAct section 23(1)-'social security payment'
Policy reference: SS Guide 184.108.40.206 Backdated start days - PP
The start day is the first day on which an applicant is qualified after the day they became incapacitated for work, if they claim a benefit or pension within 5 weeks of becoming and remaining incapacitated for work as a result of a medical condition.
If a person claims a benefit or pension MORE than 5 weeks after becoming incapacitated for work from a medical condition AND the medical condition was the sole or principal cause of the delay in claiming, the start day is the first day on which the person is qualified for the payment in the 4 weeks ending before the day the claim was made.
Applicants claiming SA must have been working before becoming incapacitated in order to be eligible. However, applicants claiming other income support payments do not have to be working before becoming incapacitated for the backdating arrangements set out here to apply.
The date of incapacity is generally shown on the medical certificate as the date of injury or the start date of the illness. The table below describes how to determine the date of incapacity.
|If …||then the date of incapacity …|
|the date on the medical certificate is BEFORE the date last worked||is the day AFTER the date last worked.|
|the date on the medical certificate is AFTER the date last worked||is the date on the certificate.|
the applicant claims that the incapacity started on a date earlier than the date on the medical certificate
Example: Glandular fever.
|can be the date claimed, provided that:
Act reference: SS(Admin)Act Schedule 2 clause 11 Incapacitated claimant
Determining the sole or principal cause of delay in claiming
If there is more than one possible cause for the delay, it is necessary to establish the SOLE OR PRINCIPAL cause. In considering whether the medical condition was the sole or principal cause the delegate must consider whether the applicant:
- was prevented from getting to an office by the medical condition, and/or
- had control of their personal affairs and was capable either of making a claim or instructing others to make a claim on their behalf.
It is the applicant's responsibility to lodge a claim in a timely manner. It is reasonable to expect an applicant to instruct a friend or relative to inquire about possible entitlements or to lodge a claim unless their incapacity prevents them from doing so.
Care should be taken in situations where the illness or incapacity is traumatic. If evidence clearly shows that the applicant's ability to deal with their everyday affairs is substantially limited by a traumatic illness, it is unreasonable to expect the person to have thought of:
- making their own inquiries about possible social security entitlements, or
- asking others to make inquiries or to lodge a claim on their behalf.
Act reference: SSAct section 23(1)-'social security entitlement'
Claim after the death of a partner
An applicant's start day is the first day they are qualified on or after the day their partner died, if they claim a social security payment within 4 weeks after the death of their partner.
If an applicant claims more than 4 weeks after the death of their partner, the start day is the date the claim is made unless some other backdating provision applies.
Act reference: SS(Admin)Act Schedule 2 clause 12 Claim after death of partner
Claim for social security payment following claim for the AGDRP
An applicant's start day for another social security payment is the day they became qualified for AGDRP, if they:
- are qualified for and claim AGDRP, and
- then claim another payment within 14 days.
If an applicant claims more than 14 days after their claim for AGDRP, the start day is the date the claim is made unless some other backdating provision applies.
Act reference: SS(Admin)Act Schedule 2 clause 13 Claim for social security payment following claim for AGDRP