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20.3.2 Interim client support during incapacity investigations


Despite the urgent need many clients experience when first incapacitated, delegates may not pay a benefit unless and until the case for payment has been made. This means that medical incapacity must first be certified by a suitably qualified doctor, and the delegate satisfied that this incapacity results from an accepted condition prior to a determination that weekly payments may be made.

However this proof of incapacity may, on occasion, take some time. Consultation with a medical specialist for instance, may involve delays particularly where the client has no treating specialist familiar with his/her case, i.e. where the delegate must organise a S57 medical examination. Delegates are required to use the utmost speed and diligence in processing incapacity claims. Nevertheless there is potential for clients to experience considerable financial distress during this investigation period.

Note that there is no authority under the Act to make any payments without a proper standard of medical justification and no provision for any sort of interim or advance weekly payments. Therefore, clients whose initial incapacity claim is subject to specialist medical investigation should be advised to seek interim 'social security' payments from Centrelink over this period. Centrelink then serves DVA with a formal notice of an interest in, and claim against, any compensation which may become payable. If and when an entitlement to SRCA incapacity payments is confirmed, the SRCA delegate is obliged by the Social Security Act to reimburse Centrelink for that period, i.e. from the back-paid incapacity entitlement.