C01/1997 Guidelines for Processing Claim for Partner Service Pension When Veteran's T&PI Application Pending

DATE OF ISSUE:  4 FEBRUARY 1997

Guidelines for Processing  Claim for Partner Service Pension When Veteran's T&PI Application Pending

PURPOSE

The purpose of this Departmental Instruction is to provide procedural guide-lines for the processing of certain claims for partner service pension (PSP) where there is an outstanding disability pension (DP) action that might result in  a grant of the special rate of DP (T&PI) to the veteran.

BACKGROUND

2.Changes resulting from the 1995/96 Budget initiatives introduced an age limit for some partners of service pensioners.  From 1 October 1995, partners under the age of 50 years without dependent children cannot be granted PSP.  However, partners of T&PI rate pensioners are exempt from this age requirement (DI C05/96 refers).

3.This instruction only applies to those claims for PSP where the claimant would otherwise be eligible for PSP except for the minimum age requirement.

OUTSTANDING DISABILITY PENSION ACTION

4.There may be instances where a partner, under 50 years with no dependent children, lodges a claim for PSP at the same time as the veteran has an outstanding disability pension action that might result in a grant of the special rate of DP to the veteran .

5.In these cases, determination of the partner's claim prior to the finalisation of the disability pension action would mean the claim would have to be rejected under subsection 38(1B) of the VEA.

6.The disability pension action may retrospectively grant or increase the veteran's DP to the special rate from a date at or prior to the claim for PSP.

7.Although this date may be prior to the date at which the primary rejection decision for PSP was made, there is no power in the Veterans' Entitlements Act 1986 for the Repatriation Commission to review a primary decision unless the claimant applies for a review under section 57.

8.This means that the partner must either apply for a review to have the primary decision reversed, or be required to lodge a new claim, in which case the effective date would be the date of the second claim.

DIFFERENT SCENARIOS

9.Cases will occur in 2 possible situations:

A)Where the veteran is already receiving service pension, or is eligible for but not receiving service pension because of a disqualifying provision (for example the application of the Compensation Affected Pension (CAP) provisions), the veteran has lodged a claim for DP or review of DP and then the partner lodges a claim for PSP; or

(B)Where the veteran is not yet receiving service pension, the veteran has lodged a claim for DP or review of DP and the veteran and the partner then lodge a claim for service pension.

DEFERRAL OF PARTNER'S CLAIM FOR PSP

10.When such situations arise, it is important to apply an approach that will best meet the Department's  Client Service and Simplification objectives.

11.In such cases, the determination of the partner's claim for PSP should be deferred until such time as a decision is made concerning the outstanding DP action.  This would provide the opportunity to pay arrears from the date of the original claim.

12.By deferring determination of the claim the partner should not be disadvantaged.  They should be informed of the delay in finalising their claim and also advised to test their eligibility for a pension or benefit from DSS in the interim.  (See para 18 (3) for further details of advising the partner, and para 21 regarding DSS clearances.)

13.If the veteran is granted the special rate, the partner's claim could then be granted with arrears.  If the veteran is not granted the special rate, the partner's  PSP claim would then also be rejected.

EFFECT ON WORK-LOAD STATISTICS

14.          It is recognised that any deferral of the determination of the partner's claim for PSP may have a detrimental effect on the new claims performance targets (Times Taken To Process figures).  However, it is unlikely that there will be a large number of these cases.  Also,  significant delays in finalising the DP action within the Compensation area are not anticipated.
     

15.          Any impact on new claims processing times is outweighed by the improvement in overall client service and simplification of the process for the client.  By being pro-active, we can ensure that the partner's full entitlements for PSP and arrears are protected.  Additionally, we are providing a less intrusive service and preventing the need for the partner to lodge an appeal or to resubmit the new claim.

PROCEDURAL GUIDELINES

Income Support Section

16.When a new claim for PSP is received, from a partner who is under 50 years and has no dependent children and the veteran has not been granted the special rate of DP, the following procedure should be applied by  new claim examiners:

• check the CM.IM screen on the CMS.  This screen will indicate if there is any outstanding DP action on the system.

If outstanding DP action is indicated

17.The examiner should contact the Compensation assessor to ascertain whether the action involves a potential grant at the special rate.  If not, the PSP claim can be processed without delay as per normal work practices.

18.If the DP action may involve the grant at the special rate:

(1)Determine the veteran's claim for SP where applicable (Scenario B in para 9 above only).  The delegate should note as part of their determination that the claim for PSP is being deferred pending a decision on the outstanding DP action.

(2)Register the partner's claim as a dependant claim.  If the partner is otherwise eligible except for the minimum age requirement, place the file on review pending a decision on the outstanding DP action.

(3)The partner should be contacted, (subject to privacy compliance procedures described in paras 26 - 30), to advise them of the reasons for the delay in finalising their claim.  They should also be advised to test their eligibility for a pension or benefit from DSS in case their claim for PSP is eventually declined.  A sample standard letter is at Attachment A.  (See para 21 for details on DSS clearance procedures.)

(4)When the DP action is finalised, the file should be forwarded to the Income Support Section for finalisation of the PSP claim.

19.If the claim for PSP is rejected (veteran not granted the special rate), normal work practices apply for processing the outstanding dependant claim and advising the partner.

20.If the veteran is granted the special rate, the claim for PSP can then be granted with arrears.

21.If the partner has been receiving a pension or benefit from DSS during the period that the claim was deferred, normal clearance and adjustment procedures for retrospective grant of pension and transfer from DSS to DVA will apply (DIs B12/95 and C42/96  refer).

22.Claims for PSP should not be delayed if the veteran's DP case is awaiting a decision from the Veterans' Review Board or the Administrative Appeals Tribunal.

If no outstanding DP action is indicated

23.For those cases where the partner lodges a claim where there is no outstanding DP action on the CM.IM screen, the partner's claim for PSP should be determined without delay, as per normal work practices.

Compensation Section

Special rate DP (T&PI) granted when partner not receiving PSP

24.Where a veteran who is not in receipt of service pension is granted T&PI, it is the current accepted work practice for the Compensation area to refer the veteran's file to Income Support to initiate action to invite a claim for Invalidity Service Pension (ISP).

25.It is recommended that this current practice be extended to also cover the partner of the veteran.  When a veteran is granted the special rate of DP (T&PI) and the partner is not in receipt of service pension, the file should be referred to the Income Support Section.  The partner should then be invited to claim PSP.

PRIVACY COMPLIANCE

26.The Privacy Act restricts the Department in providing a person's personal information to another person, including the person's partner, even where that other person is affected by the matter.  Potentially, a veteran could claim a breach of privacy if the Department disclosed that he has a T&PI assessment pending.  The Department may have to pay compensation if this situation arises.  Under the privacy provisions, we cannot assume the veteran is willing for the partner to know of his financial or medical claims, including his T&PI assessment.  Proposed changes to the Crimes Act could provide that action could be taken against the staff member who signed the letter to his partner, disclosing that he has a T&PI assessment pending.

27.Advice from the Privacy Commissioner states that examiners should obtain the consent of the veteran to disclose to his partner that his eligibility for/rate of  Special (Totally and Permanently Incapacitated) Rate of Disability Pension is being assessed.  The veteran should be informed that his consent is required under the Privacy Act and that this information is required to correctly advise the partner of the reason for the delay, ie, the outcome of the DP assessment.  This consent can be obtained by phone and the file should be noted accordingly.

28.          Staff should be aware that there is no problem discussing the partner's application for PSP with the veteran.  As he has signed the application form it can reasonably be presumed that his partner would likely be aware that this information may be disclosed to the veteran.

1. If the veteran's consent is obtained, a letter should be sent to the partner informing them of the reasons for the delay. (See paragraph 18(3).)

2.  If the veteran's consent is not obtained, the letter to the partner must not be sent.  If a veteran does refuse consent to disclose his TP&I assessment to his partner, contact NO to determine future action.

ADVICES

31.There will be no impact on advices resulting from these procedures.

32.          A sample standard letter informing the partner of the reasons for the delay in processing the claim for PSP is at Attachment A.   This letter will be included in the next release of the IS Standard Letter Template System  in the New Clm Templates  directory, as:

      PSP delay
     TPI pending

ATTACHMENTS

33.                    The following attachment is included:

Attachment ASample standard letter to partner regarding deferral of determination of PSP claim.

ENQUIRIES

34.Any questions regarding this DI should be directed to Annette Smith on (06) 289 6776.

JEANETTE RICKETTS
A/G BRANCH HEAD
INCOME SUPPORT

      January 1997

ATTACHMENT A

Reference:{Partner Reference}

Contact:{Contact Name}

Telephone:{Contact Phone}

{Partner's Name}

{Partner's Street}

{City} {State} {Postcode}

Dear {Mr/Mrs}{Partner's Name}

I refer to your claim for a Partner Service Pension from this Department dated {date}.

In order to receive this pension you must be the partner, widow or widower of a veteran with qualifying service. As you have no dependent children you must also have reached a minimum age of 50 years.

From the information you provided on the application form, you do not meet this minimum age requirement and therefore you are not yet eligible to receive a Partner Service Pension.

The only exemption from this minimum age requirement for a partner service pension is if your veteran partner is in receipt of the Special (Totally and Permanently Incapacitated) Rate of Disability Pension.

Our records indicate that {Veteran's title and name} {eligibility for / rate of } disability pension is currently being assessed.  Your eligibility for partner service pension may change depending on the result of this disability pension assessment.

In order to minimise the inconvenience to you, the decision on your claim has been deferred until  {Veteran's title and name} disability pension assessment is complete.  You will be advised in writing as soon as the decision is made.

In the meantime, so that you are not disadvantaged in any way by the delay, I suggest that you test your eligibility for a pension or benefit from the Department of Social Security.  If your claim for partner service pension is eventually successful, your pension payment can then be transferred to Veterans' Affairs.

If you have any questions regarding any of the above, please contact me on the above telephone number.

Yours sincerely

{Title}