DATE OF ISSUE: 26 FEBRUARY 1997
FILE MANAGEMENT - SUPPORTING DOCUMENTATION
PURPOSE
The purpose of this Departmental Instruction is to remind Compensation staff of their responsibilities in ensuring that all documentation supporting their decisions made using the Compensation Claims Processing System (CCPS) are placed on the claimant's file.
BACKGROUND
A recent Quality Assurance exercise which examined the processing of death cases highlighted the need for staff to ensure that written records of information obtained verbally are placed on file.
Any information obtained during a phone conversation or during a face-to-face interview with a claimant or the representative of the claimant which is relevant to the processing and determination of a claim must be documented and placed on the client's file. Advice from Team Managers, Senior Claims Assessors, Review Officer, Departmental Medical Officers, etc on particular points of the case must also be documented and placed on the claimant's file.
As any decision can be subject to scrutiny by the claimant, external and internal review bodies or as part of quality assurance checks, it must be possible for anyone, with cause to look at the case, to easily identify individual items of evidence and be able to understand why a decision was made. An audit trail of the evidence must exist.
The problem of lack of documentation supporting decisions has also been raised by the Australian National Audit Office (ANAO). This has led to changes to Quality Assurance procedures whereby in future an absence or shortage of supporting documentation which results in it not being possible to establish the validity and correctness of the decision made will be classified as a “critical” error.
ACTION
CCPS Staff are to ensure that a clearly identifiable written record is made of any discussion/conversation which may have a bearing on a decision they are making, or will make, on a claim. The written record must be placed on the claimant's file and folio numbered.
DIVISION HEAD
COMPENSATION