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20.4.3 Client requests for payments vs. delegate-initiated payments


The payment of incapacity benefits requires no formal application. Therefore, in cases where a client self-evidently has both an entitlement and a financial need for incapacity payments but due to the effects of the condition is unable to make a request, delegates may self-initiate a determination and subsequent payment. For example, this may occur where a reservist remains comatose in hospital from the date of a serious injury on duty, or a full-time member is discharged with a very serious psychiatric condition rendering him incapable of managing his affairs.

However in less extreme circumstances, delegates should not ordinarily pay incapacity entitlements unless the client indicates that this is in accordance with his/her wishes. Normally, payment is dependant upon medical certification of incapacity and it is the client's responsibility to provide this certificate. Active provision of a certificate of course implies consent to receive the benefit. However in some cases the delegate may receive medical certification from sources other than through the client. For instance, medical reports commissioned to report on liability-for-injury issues may also volunteer information on incapacity for work. In all cases a client's personal, financial, social security, VEA and taxation issues may all be affected by receipt of an amount of compensation. These matters are within the clients' own power to manage and a delegate should not normally pay an entitlement automatically or in a compulsory fashion, but only in accordance with the client's expressed wish following contact with the client.

For example, clients involuntarily discharged for medical reasons should be advised in advance of that discharge, of the intent to pay the standard four week post-discharge incapacity benefit (i.e. on the basis of the ADF medical board opinion). The client should also be made aware, well before the determination is made, that the payment is on the basis of notional incapacity and thus is not payable after the start date of any new employment commenced during that same period.