4.2.1.10 Centrelink claim determination role

Introduction

Centrelink accepts and determines effective claims (1.1.E.10) for PLP including claims for a PPL period and claims for flexible PPL days. Generally, there is a 2-stage determination process as outlined below, to enable parents to lodge claims and make decisions about their care arrangements in advance of their child's birth or placement for adoption.

Initial eligibility determination

An initial eligibility determination may be made if Centrelink is satisfied that a claimant has provided sufficient information to enable a determination about their initial eligibility to be made in relation to the claim.

To determine that a claimant is initially eligible to receive PLP in relation to the maximum PPL period for a child, Centrelink must be satisfied the person meets the work test (1.1.W.30), the income test (i.e. has income equal to or below the relevant PPL income limit (1.1.R.30)), and the Australian residency test (1.1.A.110).

To determine that a claimant is initially eligible to receive PLP on one or more flexible PPL days, Centrelink must be satisfied that, if an initial eligibility determination is not already in force for the person, the person meets the work test and the income test. If the claimant is a primary claimant, they must also meet the Australian residency test.

An initial eligibility determination is made on the assumption that the state of affairs known at the time of making the determination will remain unchanged. In addition, a claimant who has an initial eligibility determination must notify Centrelink of anything that causes or is likely to cause the claimant to cease to be eligible for PLP.

Employer determination

If Centrelink makes an initial eligibility determination in relation to the maximum PPL period for the child, and the conditions for making an employer determination (1.1.E.60) are satisfied, then Centrelink must make an employer determination for the person and the person's employer that the person's employer is to provide PLP.

If Centrelink has not made an initial eligibility determination for a person in relation to the maximum PPL period for the child, and Centrelink determines the person is payable in relation to that period, Centrelink must make an employer determination for the person and the person's employer if the conditions for making an employer determination are satisfied.

Centrelink is required to make an employer determination (that the person's employer is required to pay instalments) if the following conditions are met:

• a payability determination or an initial eligibility determination for the person is in force in relation to the maximum PPL period for the child, and
• that instalments are likely to be payable by the employer for at least 40 consecutive days that are week days (including PPL days (1.1.P.170) and flexible PPL days), and
• the person has, or will have been, employed by the employer for at least 12 months immediately before the expected DOB (where the claim is made prior to birth) or the later of the expected DOB and the day the child was born (where the claim is made after the birth), or
• the person's employer has made an election to provide PLP to that employee, or to a class of employees that includes that employee, and
• the person is likely to be an Australian-based employee of the employer for the duration of the person's continuous flexible period (1.1.C.145) if they have a continuous PPL period (1.1.C.147) or their PPL period or expected PPL period (1.1.E.110), and
• the employer has an ABN.

If an employer determination is made for the person and their employer and if PLP is payable to the person, the employer will be funded for instalments payable by the employer under the employer notice (1.1.E.85) relating to the employer determination, and PLP will be provided to the person by their employer for those instalments in their usual pay cycle. Centrelink will provide PLP to the person for flexible PPL days that are payable to the person that do not fall within a continuous flexible period for the person.

If an employer determination will not be made for a person, and PLP is payable to the person, Centrelink will provide all PLP instalments directly to the person.

Payability determination

Centrelink must make a payability determination if a person has made an effective claim. Centrelink must be satisfied the person was or will be eligible for the relevant period. In addition, Centrelink must not determine that PLP is payable to a claimant until the claimant has verified the child's birth and declared that action has been taken to register the child's birth if the person is required to do so, or has provided proof of the child's entry into the person's care. Centrelink must also determine a particular claimant as the child's primary carer if there are 2 or more claimants providing a near equivalent level of care for a child.

Changes to determinations

If Centrelink revokes an employer determination for a person and employer, Centrelink must give them a written notice advising of the decision. The notice must contain any information that may be prescribed in the PPL Rules.

Where Centrelink has made an employer determination for a person and their employer and Centrelink then varies, sets aside or revokes a person's payability determination, Centrelink must notify the employer in writing about the effect of the decision. If the effect is to change the person's PPL period (1.1.P.200) or their continuous flexible period, the Centrelink notice must advise the different period and any other information prescribed by the PPL Rules. However, Centrelink is not required to give such a notice if the employer determination has previously been revoked.