188.8.131.52 Assessment of CA claim
Medical evidence (1.1.M.110) about the care receiver is used to determine whether the care receiver's need for 'care and attention' (1.1.C.10) on a daily basis (1.1.D.10) because of the disability or medical condition, will qualify the applicant for CA. This information, which forms part of the ADAT/DCLA professional questionnaire, must be completed by a THP (1.1.T.170).
For CA (adult) purposes, if a person makes a claim for an adult with a terminal condition, a THP must certify the adult is in a final phase of a terminal illness and is not expected to live more than 3 months (1.1.T.86).
CA can also be shared by 2 people who are not members of a couple (184.108.40.206). The second carer has to complete a separate claim for CA. The care receiver does not have to be assessed a second time for CA (child) against the DCLA, or for CA (adult) against the ADAT (1.1.A.78).
Age of carer
There are no legislative age limits to CA, but claims from carers (1.1.C.40) under 18 years of age, or 80 years of age or older, require a referral to a social worker. This is necessary to ensure that the carer can and does provide the care receiver (1.1.C.21) with care and attention on a daily basis.
Explanation: There are 2 main reasons for this:
- to ensure that the carer has the physical and emotional capacity to provide the level of care needed, and
- a very young or elderly carer may have difficulty accessing support services and resources. A social worker can provide information and assistance in this regard.
For carers under school leaving age, the social worker should also check that the appropriate education authority has given permission for the young person to leave school, where the daily care is not provided outside of school hours.
Note: School leaving age differs depending on the state or territory in which the person resides (not the location of the school).
A social worker in all the circumstances above should assess and document the care situation.
Note: Where there are concerns about the capacity of the carer to provide the appropriate care, regardless of their age, advice from a social worker should be sought.
The income test is based on ATI for the reference tax year, and can be evidenced by the carer's and their partner's, where applicable, TNA and any other documents required to determine ATI. Tax-free income streams from long-term financial assets are included in the income test and are assessed under the deeming provisions.
Claimants of CA may be able to provide an estimate of income for the CA income test under certain conditions.
Policy reference: SS Guide 220.127.116.11 Assessment of income for CA
Social worker assistance in determining claim
Social workers can provide information to verify:
- the care receiver's personal care or supervision needs in the home
- the level of care or supervision actually being provided by the carer
- whether any other person assists with the care of the care receiver, and if so whether the CA claimant/recipient is personally providing daily care, and
- whether the carer has the physical and/or emotional capacity to deal with the care receiver's care needs, if the carer is under 18 years of age or 80 years of age or older.
Information provided by a social worker can contribute to a decision about qualification for CA, but the delegate, NOT the social worker, makes the decision about qualification. CA should not be rejected or cancelled without contacting the carer/THP to discuss conflicting information.