The Guides to Social Policy Law is a collection of publications designed to assist decision makers administering social policy law. The information contained in this publication is intended only as a guide to relevant legislation/policy. The information is accurate as at the date listed at the bottom of the page, but may be subject to change. To discuss individual circumstances please contact Services Australia.

2.2.5.60 Determining an illness separated couple

Summary

A couple is considered to be an 'illness separated couple' where:

  • they are unable to live together in their home, and
  • the inability to live together
    • is due to illness or infirmity of either or both of them
    • results in their living expenses being greater or are likely to be greater than otherwise, and
    • is likely to continue indefinitely.

Illness separated couples are entitled to the illness separated rate of the payment for which they are eligible (this is paid the same as the single rate). However, the amount paid takes into account the combined income and assets of both member of an illness separated couple.

Illness or infirmity

It is not the intention that medical evidence is required for the majority of assessments. A couple separated due to illness or infirmity will be accepted as illness separated in situations where:

  • it is apparent that the illness or infirmity of one or both members of a couple prevents them from living together, and/or
  • there is supporting evidence of illness or infirmity, for example, where the ill or infirm member of the couple
    • has current care needs that indicate that the couple cannot live together (this could be based on information Services Australia already holds on care needs provided to assess entitlement of a carer to receive CA or CP in respect of the ill or infirm member of the couple)
    • has had an ACAT assessment that indicates care is needed on an ongoing basis
    • permanently lives in an aged care facility that provides low (hostel) or high level (nursing home) residential care
    • is residing in a psychiatric facility, or
    • is a patient in a normal hospital ward and has been classified as a nursing home type patient.

Where illness or infirmity that prevents the couple living together is not apparent and no other supporting evidence is available, the claimant/recipient may be requested to provide supporting evidence from a treating doctor or relevant health professional.

It is important to note that:

  • it is not necessary for a care situation (1.1.C.25) to exist for the illness separated rate to be paid, and
  • an illness separated couple should not be confused with former members of a couple whose relationship has ceased as a result of ill health.

Note: To establish whether there is financial difficulty resulting from a member of a couple going into residential care, it is necessary to verify the costs incurred for the residential care.

Act reference: SSAct section 4(7) Illness separated couple

Policy reference: SS Guide 2.2.5 Verifying membership of a couple

Last reviewed: