8.6.2 Date of Effect of Determinations Relating to Claims

Introduction

This section outlines the application of SS(Admin)Act section 107, which deals with the date of effect of determinations relating to claims.

Applying section 107

Section 107 applies to determine the date of effect of a decision to grant a claim, including situations where a decision to grant a claim has been made after the claimant has successfully sought review of an original decision to reject their claim.

Date of effect of determination granting a claim

The general rule in relation to claims is that the date of effect of a determination to grant a claim, made under SS(Admin)Act section 37, is:

  • the day on which the determination is made, or
  • an earlier or later day specified in the determination.

The date of effect of a determination to grant a claim can be the same as the claimant's start day however this is NOT necessarily the case in all circumstances.

Explanation: The claimant's start day is worked out in accordance with SS(Admin)Act Schedule 2. Once a claim has been granted, go to Schedule 2 to determine the start day of the payment (8.3).

Date of effect of determination granting a claim which was previously rejected

The following table shows the date of effect of a determination to grant a claim when the claimant seeks review of the original decision to reject the claim.

If a notice advising of the decision to reject a claim… And application to review the original decision is… Then the date of effect of the determination is… SS(Admin)Act reference
HAS been given to the claimant, lodged WITHIN 13 weeks of receiving the notice, the day the original decision took effect. subsection 107(2)
HAS been given to the claimant, lodged MORE THAN 13 weeks after receiving the notice, the day they sought the review. subsection 107(3)
HAS NOT been given to the claimant, lodged at any time, the day the original decision took effect. subsection 107(4)
HAS been given to the person, NOT lodged but the Secretary reviews the decision, the day the original decision took effect. subsection 107(5)

If notice of the decision to reject the claim is given to the claimant and the claimant does NOT appeal against the decision, BUT the delegate decides to review the decision and grant the claim at any time, the date of effect of the new determination to grant the claim is the date of effect of the original determination to reject the claim.

Explanation: There is NO time limit on when the delegate can review the original decision to grant the claim.

Example 1: A claim is rejected on 1 May 2009, the claimant was given notice of that decision and they seek review on 10 June 2009. A determination is made to grant the claim. The date of effect of that determination will be 1 May 2009.

Example 2: A claim is rejected on 4 May 2009. A review is sought on 4 August 2009. A determination is made to grant the claim. As the request for a review of the decision was made more than 13 weeks later than the original decision the claim will be granted as from 4 August 2009. Also, under SS(Admin)Act Schedule 2, the start day is 4 August 2009 and payment is payable from that date.

Example 3: A claim is rejected on 1 May 2009, but the claimant was NOT given notice of this decision. The claimant seeks review on 10 August 2009. A determination is made to grant the claim. The date of effect of that determination will be 1 May 2009.

Example 4: A claim is rejected on 1 May 2009, the claimant was given notice of that decision and the claimant does not seek review. The delegate, of his or her own accord, reviews the decision on 1 September 2009. A determination is made to grant the claim. The date of effect of that determination will be 1 May 2009.

Act reference: SS(Admin)Act section 107 General rule

Policy reference: SS Guide 8.6.6 Summary of Rules for Date of Effect - Determinations Not Involving Working Credit or Student Income Bank, 8.6.7 Summary of Rules for Date of Effect - Determinations Involving Working Credit or Student Income Bank

Last reviewed: 16 May 2016