Determining Permanent Incapacity Service Pension

Date amended:

10 Dec 2014

External

Procedure

Decision is made by the delegate

A decision to grant or reject service pension on permanent incapacity grounds is made by the delegate, not by the Departmental Medical Officer (DMO). Even when the GARP assessment has been made by the DMO, or a recommendation, or opinion has been obtained from them, the delegate has the final authority whether to grant, or reject a claim. This is not to say that the expert opinion of a DMO should be discounted, or overruled.

Deciding to accept or reject claim for permanent incapacity

Follow the next five steps when finalising a decision to accept or reject a claim for permanent incapacity service pension.

Acceptance or Rejection of Permanent Incapacity Claim.
Step	Action
1	Examine the outcome of the GARP and Work Test Assessment in the Combined Impairment Assessment (CIA) report.
	If ....	Then ...
1 (a)	total impairment rating is at least 40 points & unable to work	determine the veteran is permanently incapacitated, go to step 3.
1 (b)	total impairment rating is fewer than 40 points	determine the veteran is not permanently incapacitated, go to s — tep 2.
1 (c)	total impairment rating is at least 40 points & able to work	determine the veteran is not permanently incapacitated, go to s — tep 2.
2	Advise veteran in writing of decision to reject, a — ccess Standard Letters System folder [New Claim] file [Reject – Not PI] and if total impairment rating is: fewer than 40 points, attach copy of CIA report, or at least 40 points, but veteran is able to work, do not attach copy of CIA report.
3	Finalise the case on MAGPIES. More → Magpies Flight Guide – User Manual http://sharepoint/programsandprojects/systemguides/magpiesflightguide/Pages/MAGPIES%20Flight%20Guide%20-%20FINALISE%20CASE.aspx More → (go back)
4	Complete form D0572 [Determination Sheet for Permanent Incapacity for Invalidity Service Pension] and attach to C file. More → Procedure Library – Documenting the decision 2.1.8/Documenting the Decision DVA Forms: D0572 Determination Sheet for Permanent Incapacity http://www.dva.gov.au/dvaforms/Documents/D0572.pdf More → (go back)
5	Record details of claim in PIPS and attach copy of CIA report to automatically generated PIPS grant advice . More → Procedure Library - Entering a Claim in PIPS Section 2.1.7 More → (go back)

Grant on basis of T&PI eligibility

Follow these additional four steps when a claim has been fast tracked on the basis of T&PI eligibility.

Grant on basis of T&PI Eligibility
Step	Action
1	In all cases, check [CM.IM] screen in CMS for an outstanding AAT case, indicating the department may have appealed to the AAT to overturn a VRB decision to grant T&PI, or a finalised AAT appeal, in rare cases, may indicate a Federal Court case. If none are found, end process here, otherwise, go to step 2.
2	Liaise with the [Review] section for estimated date of hearings/cases. More → OneDVA Intranet – Veterans' Compensation Review Contacts http://sharepoint/aboutus/organisationalstructure/servicedelivery/Pages/VeteransCompensationGroup.aspx More → (go back)
3	Resubmit claim for expected date above. More → OneDVA Intranet – DRS System Guide Set Review http://sharepoint/programsandprojects/systemguides/drs/Pages/Departmental%20Review%20System%20User%20Guide.aspx#prsr More → (go back) Note: Outcomes of AAT and Federal Court cases are not generally notified to income support section, even though they may impact on eligibility for invalidity service pension.
4	When review becomes due, follow up the outcome of the appeals and if T&PI has: been revoked, cancel pension, or transfer to age service pension if pension age reached, or More → Procedure Library 3.6.5/Review After Permanent Incapacity Status Granted More → (go back) not been revoked, no further action is required.