C22/2001 ENHANCEMENT TO DEATH PROCESSING RELATING TO THE LOSS OF TREATMENT TO SURVIVING VETERANS FOLLOWING DPS REASSESSMENT

Purpose

The purpose of this Departmental Instruction is to provide information about system changes impacting treatment eligibility during the bereavement period for the surviving veteran.

Start date

The changes commenced on 26 November 2001.

Issue

Reassessments of the survivor's income and assets carried out at the time of death by the Death Processing System can result in the loss of treatment entitlement during the bereavement period.  Under the Veterans' Entitlements Act 1986 (VEA), any determination by Commission to reduce entitlement as a result of death should take effect at the end of the bereavement period

Aim of change

The main aim is to stop veterans from losing their treatment from an incorrect date and also to make sure they are advised of any future loss of benefits.

Who is affected?

There are very few cases that this scenario affects.

DPS

DPS would reassess from the day of death the income and assets in the clients assessment.  Where there were joint income and assets these generally were halved and held under the survivors' ownership.  Income and Assets held under ownership of the deceased were deleted from the survivors' new assessment.

Reassessment

With the reassessment of income and assets the surviving veteran may have income or assets which would result in the loss of treatment, either TSP or TSD.  If no other entitlement to treatment exists then DPS would put up an OFF date for the client's eligibility as being the day after death.  No advice is produced that notifies the veteran of this loss.

Commencement date

The changes commence in the Production Environment on 26 November 2001.

Enhancement

Based on the low number of cases falling into this scenario, in addition to the complexities of DPS, the most cost effective option is for DPS to identify these cases and report them out for manual processing.  Manual processing will require a PIPS transaction to terminate the deceased from the assessment, as well as additional work on the surviving client's assessment and/or treatment entitlement.

Business Rules

DPS will identify those surviving veterans who will lose their treatment entitlement because of the reassessment performed by DPS.

DPS will report out for manual actioning, including creating a CMS case registration, the processing of the death of the partner.

DPS will produce on the Processing Report and also on the Daily Report a message alerting the actioning officer of the reason for manual action.  (The message will read “FOR INFO – SURVIVOR LOSING TREATMENT – PIPS CASE CREATED”)

Treatment

Because it is possible for a client to have more than one eligibility for Treatment we must be careful to only identify those clients that would actually suffer a true loss of treatment entitlement.

Eg. a client who might lose TSP and TSD but still have eligibility under TDE, TQX or TDP should NOT be identified by DPS.  If the client only had TSP, and is now reassessed to be above the limits for provision of Treatment, then he will be identified by DPS.

Manual PIPS PC Action

When the CMS case is created by DPS a PIPS PC case must be actioned to terminate the deceased client from the assessment.  This should be done as per normal bereavement procedures.

Losing TSP

Where the client has lost TSP but retains a payment of Service Pension another case should be created to make the now single assessment a manual rates case.  The correct rates of payment should be entered.  This is to prevent any $FORT's, other BAL processes or accidental PIPS PC cases being actioned during the bereavement period that creates the need to be made manual rates.

The actioning officer must also change the date on the EN.OT screen that relates to treatment OFF date to be the correct OFF date.  That being date of death + 99 days.

It is possible to use the POG facility within Manual Rates Screen to set up the TSP OFF date but care needs to be taken to have as the Effective date of the case the same date as the TSP OFF date created by the first PIPS case.  Ie. The next available payday date as used by the BELI system.

A Standard Bereavement advice should be produced and sent that includes the notification of loss of treatment at the end of bereavement period.

At the end of the Bereavement period and usually as a result of the 13 week reassessment of income and assets the client should be removed from being manual rates and treatment cancelled.

Losing TSD

Where the client has lost TSD (has lost payment of Service Pension) there is no need for another case to be created to make the single assessment a manual rates case.

The surviving client now has a method of assessment as DP Only.  Having this method of assessment should prevent any $FORT's, other BAL processes or accidental PIPs PC cases being actioned during the bereavement period that might impact on the clients assessment.

The actioning officer must change the date on the EN.OT screen that relates to treatment OFF date to be the correct OFF date.  That being date of death + 99 days.

It is advisable that States monitor these cases to ensure that treatment OFF dates are actioned properly and the correct advices produced.

Contact

Contact officer for enquiries relating to this topic is Steve Claypole on 02 6289 6792