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Ch 20 Investigating Entitlement To Payment

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Claims for incapacity payments involve delegates in a dual investigation i.e.

  • whether the client qualifies (i.e. is entitled to any weekly payment at all), and
  • if so, what amount is payable.

In practice Delegates should first check whether the client is or is not prohibited from receiving weekly payments, or alternatively whether he/she has met all of the qualifying conditions (for instance adequate medical certification of incapacity) before attempting to determine an amount payable.

Of course, these entitlement/amount categories interact. It is possible for example for a client to meet all the qualifying tests listed at 20.1 below, but the subsequent calculation of the amount payable result in 'nil payment'.

Reflecting this investigation hierarchy, chapter 20 is a guide as to whether weekly compensation may be paid at all, and chapter 30 is a guide to how entitlements are to be calculated, i.e. for those who qualify.