The reason why the assessment is being undertaken is included in the Incapacity Calculations Report. A brief explanation of each reason is set out below.
Before commencing the assessment of a new claim, it is important to ensure that:
- the client has not previously made a claim in respect of the same period; and
- there has not already been a redemption of weekly incapacity payments in respect of the client.
Enter previous compensation details
Previous compensation details are entered to enable the Summary Report to take into account previous compensation payments and previous lengths of incapacity (for calculation of first 45 weeks of incapacity).
Changes in military pay rates or allowances
The Military Pay Scales, which are contained in Defence Force Pay & Allowance Accounting Circulars (DEFSAACs), are subject to change as a result of indexation and industrial agreements.
Changes in the Military Pay Scales do NOT apply to discharged clients (excepting former employees) after 30 June 2002 as increases for that group of clients is calculated by reference to a WCI on and from 1 July 2002.
WCI changes in rates for discharged clients
Discharged clients have their NWE increased annually on each 1 July (from 1 July 2002) by a Wage Cost Index (WCI), set by a regulation authorised by s 8(9D) of the SRC Act. WCI is also the only basis upon which the rate of compensation for former employees can be increased.
AWOTEFA rates change each quarter, affecting the minimum rate of compensation under s19.
Receipt of a superannuation pension may affect weekly incapacity compensation as a result of the operation of the superannuation rules (ss 20, 21 & 21A). A recalculation of affected incapacity payments is required when superannuation pensions are increased as a result of indexation.
Until July 2001, DFRDB, MSBS, CSS and PSS pensions were increased each year on the first payday in July, with the increase taking effect from the first day of that pay period (eg. in late June). The increase was an amount based on upward movement of the Consumer Price Index for the 12 months ending on 31 March of that year.
After July 2001, the Government funded portion of all Commonwealth superannuation pensions paid by Comsuper are adjusted twice a year – in January and July each year, with the first such rise paid on 10 January 2002 effective from 28 December 2001.
There a number of statutory rates in the SRC Act, including rates relating to “minimum earnings” in s19. Statutory rates change on 1 July each year, by operation of s13 of the Act.
New period of certified incapacity
A reassessment is required if an injured client provides a certificate stating that they are once again incapacitated for work after a period back in employment.
Changes in client's ability to earn
A reassessment is required if there is any change in the client's ability to earn in suitable employment.
Changes to actual hours worked
A reassessment is required if there is any change to the client's actual hours of employment in a week.
Changes in superannuation classifications
A reassessment is required if the client's superannuation pension class is changed (resulting in an increase or a decrease in the rate of pension). See the discussion of DFRDB pension class or MSBS pension class.
A reassessment is required when a change occurs in a client's entitlement to certain allowances. This may occur, for example, when entitlement to Seagoing Allowance ceases because the time when the client would have been on a sea posting has ended. See the discussion of Allowances.
Section 23(1) provides that weekly incapacity compensation is not payable under ss 19, 20, 21, 21A or 22 to a person who has reached 65 years of age. Other forms of compensation (eg. medical expenses, permanent impairment, household care) continue to be payable after 65.
Note that former employees may continue to receive incapacity compensation after age 65, at a reduced rate calculated under s 134.
Note also that compensation may continue past age 65 where an employee was injured after reaching age 63. In this case, s 23(1A) provides that incapacity compensation may be paid for a maximum of 104 weeks (whether consecutive or not) after injury.
Changes in the number of prescribed persons
Changes in the number of “prescribed persons” can affect weekly incapacity compensation in two ways:
- a change in the minimum earnings amount in respect of compensation for incapacity (s 19);
- a bar to the operation of s 22, which provides for reduction in weekly incapacity payments where a client is maintained as a patient in a hospital.
Changes in the number of prescribed children
Changes in the number of “prescribed children” can affect weekly incapacity compensation in two ways:
- a change in the minimum earnings amount in respect of compensation for incapacity (s 19);
- a bar to the operation of s 22, which provides for reduction in weekly incapacity payments where a client is maintained as a patient in a hospital.
Section 23(2) provides that a client is not entitled to weekly incapacity compensation under ss 19, 20, 21 or 21A during any period in which the client is “imprisoned in connection with his or her conviction of an offence”. See the discussion of “Imprisonment”.
Hospitalisation (invoking s 22)
Section 22 of the SRC Act provides that weekly compensation for incapacity may be paid at a reduced rate where:
- a client is receiving compensation under s 19 (but not ss 20, 21 or 21A);
- as a result of an injury, the client is maintained as a patient in a hospital, nursing home or similar place for a continuous period of not less than one year; and
- there are no prescribed persons or prescribed children who are dependent on the client.
Change to or completion of a work trial or RTW period
When a client completes a work trial or Return to Work program, a new assessment could be required for one of several reasons:
- the client's actual hours of employment may have changed;
- consideration is being given to deeming an ability to earn in suitable employment.
Resumption of weekly payments after redemption
A “redemption” occurs when Defence's ongoing liability for weekly payments is terminated in return for a lump-sum payment under s 30 of the SRC Act. In certain circumstances, weekly incapacity payments may be resumed after redemption by application of s 31 of the SRC Act.
Note that a redemption under s 137 (for a former employee) is final and payment cannot be resumed.
A “redemption” occurs when the Commonwealth's ongoing liability for weekly payments is terminated in return for a lump-sum payment. A redemption is made under s 30 of the SRC Act (or s 137 for former employees).
If the assessment is being undertaken for a reason which is not listed in the drop box, select “Other” and the reason for the assessment will be collected in a text box later in the investigation.
See the discussion of “Other Reason for Assessment”.