Types of claims - pensions

There are several types of claims, which can be lodged. These claim types are:

• Qualifying service    More → [31]
• Age service pension    More → [32]
• Invalidity service pension    More → [33]
• Partner service pension    More → [34]
• Income support supplement    More → [35]
• Disability Compensation Payment  More → [36]
• Application for increase in Disability Compensation Payment  More → [37]
• War widow's/widower's pension    More → [38]
• Orphan's pension    More → [39]

Types of claims – allowances and benefits

Claims for a broad range of income support and veterans' compensation allowances and benefits can also be lodged.    

VEA→

Who can lodge a claim?

VEA→

A claim for Disability Compensation Payment may be lodged by:

• a veteran, or
• another person on behalf of, and with the approval of, the veteran, or
• a person approved by Commission where the veteran is unable to approve a person to act on their behalf due to physical or mental incapacity.    More → [96]

Proof of identity

In order to identify a claimant a proof of identity check must be made on all new claims.    

Requirements of a claim for Disability Compensation Payment

A claim for Disability Compensation Payment requires investigation of the claimant's medical condition and service record. The claimant is required to do the following:

• complete an application form,
• state, on the application form, the reasons why they think their condition is related to service, and
• seek diagnosis of the condition being claimed from a GP or specialist.

The claimant may also be required to provide other evidence to support the claim on request such as:

• employment history,
• details of injuries or accidents,
• other personal details relating to the claim.    More → [98]

VEA→

Why apply for an increase in Disability Compensation Payment

VEA→

A veteran who is receiving a Disability Compensation Payment as compensation for an incapacity may apply for an increase in the rate of pension on the grounds that the incapacity has increased since the rate of pension was assessed, or last assessed.    

Who can lodge and application for an increase in Disability Conpensation Payment?

VEA→

An application for an increase in Disability Compensation Payment may be lodged by:

• a veteran, or
• another person on behalf of, and with the approval of, the veteran, or
• a person approved by Commission where the veteran is unable to approve a person to act on their behalf due to physical or mental incapacity.

Requirements of an application for increase in Disability Compensation Payment

An applicant for an increase in Disability Compensation Payment must provide the following information with their claim:

• information about the treatment the veteran has received for their accepted condition,
• the reasons why the applicant believes their accepted disabilities have worsened,
• a completed Lifestyle Rating options form.    More → [105]

Last amended: June 2022

Who can lodge a claim?

A claim for war widow(er)'s pension or orphan's pension can be made by a:

•  widow, or
•  widower,
• an other dependant, or
• another person on behalf of, and with the approval of, the widow(er) or dependant, or
• a person approved by Commission where the widower or dependant is unable to approve a person to act on their behalf due to physical or mental incapacity.

Who can lodge a claim for a child under 18 years?

A claim for orphan's pension for a child under 18 years of age must be made by:

• the child's parent or guardian, or by another person authorised by the parent or guardian, or
• a person approved by Commission if there is not a parent or guardian alive, willing or able to make the claim or approve a person to make the claim.    

Multiple dependant relationships

A veteran may have more than one person as a ‘widow’ or dependent spouse for the purposes of a war widow's/widower's pension. This is due to the operation of sections 11 and 11A. The Report of the Review on Veterans’ Entitlements 2003 [109] (Clarke report) acknowledged that multiple dependent relationships may exist where a person is married to but separated from a veteran, and that veteran was living in another marriage-like relationship at the time of their death. This has also been considered in Tribunals, but again, these cases only considered a separated married partner and another relationship (see Wharton and Repatriation Commission [110] (4 March 1997), and in particular at [11] where the Tribunal found that s11 clearly ‘makes provisions for more than one person being entitled to a pension’ ).

Generally, while a veteran may form multiple partnered relationships that meet the definition of dependency under s11 of the VEA, careful consideration would need to be given in situations where a veteran’s relationships include multiple defacto partners. The nature of defacto relationships is set out in s11A and requires a level of dependency, commitment and cohabitation that would be hard to be established in more than one relationship. In the same vein, where an applicant to the war widow's/widower's pension is found to be residing in Australia on a temporary basis (such as those on tourist visas) then Delegates must carefully consider whether the criteria of dependency can be adequately satisfied given the transient and provisional nature of the applicant’s living arrangements in Australia.

Proof of relationship to a deceased veteran

Claimants for war widow(er)'s pension or orphan's pension may have to provide proof of their relationship with the deceased veteran.    

Requirements of a claim for war widow(er)'s or orphan's pension

A claim for war widow(er)'s or orphan's pension will require investigation of the veteran's medical condition prior to death and their service record. The claim should include the following information:

• the deceased veterans' name,
• details of the veteran's service,
• the names of any doctors and hospitals who treated the veteran,
• reasons why the claimant believes the veteran's service caused or contributed to their death,
• information about other dependants.

Death Certificates

Generally, in order for a determination to be made regarding a bereaved family’s eligibility for compensation, there must be sufficient evidence to:

• prove that the veteran has died and 
• establish a cause of death. 

In most cases, a death certificate must be supplied to satisfy these requirements.

However, in some very specific circumstances involving significant delays in the availablility of a death certificate, a claim may be determined using alternative evidence.  These circumstances are set out here [113].

Automatic grant of pension for certain dependants exempt from requirement to lodge a claim

A war widow(er) or orphan will be automatically granted pension if:

• they were dependant on the deceased veteran, and
• the veteran was:

• a former prisoner of war, or
• receiving the Extreme Disablement Adjustment, or    More [114]
• receiving a Disability Compensation Payment at the Intermediate rate, or
• receiving a Disability Compensation Payment at an increased rate due to being a double amputee, or blinded or    More  [115]
• receiving a Disability Compensation Payment at the Temporary Special Rate, or
• receiving a Disability Compensation Payment at the Special Rate (T&PI).    More  [116]

In such a situation, war widow(er)'s or orphan's pension will be granted without an application being lodged or a determination being madeand the pension is payable from and including the day after the veteran died. Where a veteran has died as a result of a disability already accepted as being caused by war or eligible defence service, the death will be determined to be war or defence caused. In these circumstances a claim for pension still needs to be lodged with the Department.    

If a person makes a claim for a service pension, income support supplement, disability compensation payment or dependant’s pension that is not a proper claim it can be regarded as an Initial (or informal) claim.

• written application for pension on other than an approved form,
• written advice of their intention to apply for pension,
• telephone advice of their intention to apply for service pension or ISS.

How is a claim lodged

A claim is considered to be lodged with the Department if it is lodged:

• at an office of the Department in Australia,
• electronically via:
  • MyService,
  • the Department's Online Claim Lodgement system, or
  • to nominated facsimile machines
• to an email address approved for this purpose by the Comission, or
• at a place approved for this purpose by the Commission, or
• with a person approved for this purpose by the Commission.

A claim is considered to be lodged on the day it is received at one of the above places.

Electronic lodgement of claims

Claims and applications forwarded to the Department through the DVA website, facsimile and email address approved by Commission may be acceptable as being valid claims.

The claims and applications lodged electronically are outlined in the Veterans' Entitlements (Electronic Lodgment Approval) Instrument 2018.pdf (dva.gov.au) [126]

This Instrument covers the approved method, and addresses, for electronic lodgement.

Where an original form is lodged and is incomplete or unsigned, the original claim form should be returned to the claimant via certified/registered mail. This should be accompanied by a request that missing information or signatures be provided, and the form returned to the Department. Full copies should be retained by the Department in case the form is misplaced or lost and to allow comparison once the completed original is received.

Staff should not alter lodged and signed original claim forms in any way.

When can a claim be withdrawn

If a claim has not already been determined, a claimant or person on behalf of the claimant may withdraw the claim. Any claim that is withdrawn is taken to have not been made.

How to withdraw a claim

The following table demonstrates how to withdraw a claim.

Note: only claims for service pension or ISS can be withdrawn orally. Claims for disability compensation payment, war widow's/widower's pension and orphan's pension must be withdrawn in writing.

Acknowledgment of an oral withdrawal of a claim

When a claim for service pension or ISS is withdrawn orally, the claimant must be provided with a written acknowledgment, that:

• confirms the withdrawal, and
• advises the claimant, or person on behalf of the claimant, that they may reactivate the claim.

Reactivating a withdrawn claim

An oral withdrawal of a claim for service pension or ISS may be treated as if it had not been made, if the request is made:

• by the claimant or a person on behalf of the claimant, and
• within 28 days of the withdrawal.

When a claim is reactivated, the commencement day of the claim remains the same as that of the original claim.    

Last amended: 7 November 2012

What is the purpose of investigation?

Investigation of a claim is a significant part of the determination process because it establishes the basis on which a decision is made. As service pension and income support supplement are income support (welfare) payments, it is the duty of the officer processing the claim, to ensure that claimants receive the full benefits permitted by the VEA, and that these are made available with the minimum of delay.

Investigation of a proper claim

If a person makes a proper claim an investigation is to be made into the matters to which the claim relates. In investigating a claim, it is necessary to gather sufficient evidence or documents to enable the decision-maker to determine the claim. The information gathering process need not be exhaustive.

Where there are barriers to a person being able to provide original documents or certified copies to support a claim, a delegate may decide that uncertified copies can be submitted. This is consistent with the department's corporate plan which states that we assess the risk of non-compliance and differentiate our response by taking individual circumstances into account. The delegate must be reasonably satisfied that, on the balance of probabilities, the copies are true copies of an original, that they have not been altered, and that they accurately reflect a pensioner's circumstances.

Once a proper claim is lodged, the Secretary will investigate the claim and submit the claim to the Commission for investigation and determination.    

Investigation of a Disability Compensation Payment application

VEA→

Investigation and processing of Disability Compensation Payment, increase in Disability Compensation Payment, war widow(er)'s or orphan's pension claims can take up to three months or longer. This time is required to:

• get service documents from the Department of Defence if it is a first time claim,
• allow the department to gather further information about the veteran's personal and medical histories if necessary, and
• conduct further medical examinations, if necessary, for people claiming Disability Compensation Payment, or an increase in Disability Compensation Payment.

Delegates should refer to Commission Guidelines for Psychiatric compensation [142] claims available in the Reference Library.

The fee schedule for Psychiatrists for the preparation of reports for compensation claims is available on the internet at http://www.dva.gov.au/service_providers/Fee_schedules/Pages/psych.aspx [143]

Payment of expenses

VEA→

A person required to attend an interview or examination in connection with a claim may be paid prescribed travelling or accommodation expenses.

Refusal to undergo medical examination

VEA→

Where a claimant refuses to undergo a medical examination or provide information for the investigation of the claim, the Commission can defer consideration of the claim if they believe that the examination or information is likely to affect the determination. Consideration of the claim can be deferred until the claimant undergoes the examination or provides the information. If the claimant does not comply after six months from the date they were notified of the deferral, the claim is deemed to be refused.

Last amended: Once a claim has been investigated and submitted to the Commission, the decision-maker must:

•    consider the claim,
•    consider the evidence relating to the claim, and
•    satisfy themselves with respect to all matters relevant to the determination of the claim.

Although the decision-maker must be satisfied on all matters relevant to the claim, an investigation for an income support pension need not be exhaustive for the claim to be determined.    

Example:  A service pension claim where the investigation is not exhaustive

A person lodges a claim for age service pension, knowing that he is to be granted superannuation in the near future, but does not know when or the amount he will receive. In this situation, if his eligibility for service pension is clearly established, pension should be assessed on the known assets and income. The letter advising of his determination will include his obligation to advise of any change of circumstances, such as the grant of superannuation.    

Determination

The decision-maker must determine the claim as follows:    

• determine whether the pension is to be granted to the person, and
• if the pension is to be granted to the person, they must then:
• calculate the person's pension rate,
• determine that the pension is payable to the person at that rate, and
• determine the date from which the pension is to be paid.

Disability Compensation Payment, dependants' pensions and increase in Disability Compensation Payment determinations

Disability Compensation Payment, dependants' pensions and increase in Disability Compensation Payment determinations are made on the basis of:

• the degree of incapacity suffered by the veteran, and
• whether this incapacity can be related to their service, or
• whether their incapacity has increased since the rate of pension was assessed or last assessed, or
• if the veteran is deceased, whether the incapacity contributed to their death.

The level of incapacity and the level of Disability Compensation Payment a person is entitled to are assessed using the Guide to the Assessment of Rates of Veterans' Pensions (GARP).    

Rejection of a claim for service pension

A person who has claimed service pension but has had that claim rejected, may be eligible for a pension or benefit from Centrelink. Such people should be advised to lodge a claim with Centrelink as soon as possible.

Subsequent claims following rejection of a claim

Where a claimant meets the eligibility requirements for service pension but a nil rate of payability is determined, the claim is to be regarded as rejected. When rejected, the claimant should be advised to apply for a commonwealth seniors health card. Claim form D3056 should be sent to the client along with notification of failure to qualify for a pension. Where the veteran's circumstances change and the income/assets subsequently allow some payability, a new claim is to be made. The new claim can be substantially based on the earlier claim documentation, but with an updated statement of income/assets and a new lodgement date. The date of grant of pension for the new claim will be the date of the informal claim, being the receipt of written or telephone notification of intention to reapply following a change in income or assets (provided the revised statement is received within three months).    

Delay in making a subsequent claim

Where the delay in a claimant providing an updated statement of income and assets exceeds twelve months, it is likely that other personal circumstances, in addition to income and assets, may also have changed during this time. Accordingly, in these cases a new claim form should be completed in full.

Right of review

A claimant may apply to the Commission for review of a determination of a claim.    

Purpose of a Centrelink clearance

Once a claim for pension is determined, it may become necessary to liaise with Centrelink. The purpose of such a liaison is to obtain a clearance from Centrelink, which enables DVA to calculate any:

• arrears payable to the claimant, or
• excess of overpayment, which is recoverable from the claimant.

As part of this process, a monetary adjustment is frequently made between the two departments.    

When is a Centrelink clearance required?

[70]VEA?

A Centrelink clearance is required, where a claimant or their partner has declared that he or she:

• is currently receiving a Social Security pension or Social Security benefit,
• was recently receiving a Social Security pension or benefit, or
• has applied or is likely to apply for a Social Security pension or benefit.

Note:  If a war widow/widower applies for ISS while he or she is receiving a Social Security pension or benefit, a request should be sent to Centrelink for that pension to be adjusted or the benefit to be cancelled.

Request for a clearance

[70]VEA?

A request for Centrelink clearance should clearly indicate the information required from Centrelink and the reason for requesting the clearance. All necessary details required by Centrelink in supplying the information should also be provided, including a record print of income and assets details.

Effect of a Centrelink clearance on fortnightly payments and arrears

The following table is a guide to the effect of a Centrelink clearance on the payment of pension and arrears:

Last amended: 6 September 2011

Effect of death on a claim

Where a formal claim for pension has been lodged before the death of a claimant this does not affect the obligation of the Commission [192] to determine the claim. The claim should be investigated as far as possible under the circumstances and a decision made in accordance with normal procedures.

Who to notify of the determination of a deceased person's claim

Upon the death of a claimant, a copy of the will should be obtained in order to:

• establish who is the legal personal representative, or
• in specific circumstances, have a person approved by the Commission as the claimant's authorised representative.

These circumstances include where no legal representative exists, or the legal personal representative is not actively pursuing the claimant's entitlements.

The executor of the claimant's estate may be regarded as their legal personal representative, as they are empowered to finalise all matters following the person's death. A personal legal representative may also be separately identified in the will.

The legal personal representative is required for the purpose of:

• notification of the decision,
• possible bereavement payment,      More ? [194]
• possible arrears payment, and      More ? [195]
• right of review.     More ? [196]

Effect of death on an initial claim

Where a person lodges an initial claim for pension and dies before the proper claim is lodged, the legal personal representative or such other person as the Commission approves, may lodge the proper claim.    

It is not sufficient that the person lodging the claim was the claimant's power of attorney while they were alive. This is because power of attorney arrangements cease on the death of the claimant. The legal personal representative must be established by obtaining a copy of the claimant's will.

Effect of imprisonment on a claim

The imprisonment of a claimant for pension does not affect the obligation of the Commission [192] to determine the claim. The claim should be investigated and a decision made in accordance with normal procedures. This applies equally, if the imprisoned person lodges a claim either:    

• before entering prison, or
• while in prison.

Effect of imprisonment on a pension or benefit

Upon assessment of a claim, an imprisoned person may be eligible for a pension or benefit to be granted. However, due to the imprisonment of that person, the pension or benefit may not be payable.    

Current policy

DVA's current categories of proof of identity documentation can be found in the CLIK Policy Library at 2.2.4 Categories of Proof of Identity [223]. 2.2.4 Categories of Proof of Identity also provides information about the number and range of documents that must be used to establish the proof of identity of a claimant, agent or trustee.  

History to whole of government approach to proof of identity

In 2001, a whole of government approach to proof of identity led to a commitment to develop a cross agency framework which outlined different categories of acceptable proof of identity documentation. This framework was fine-tuned over time through Council of Australian Government (COAG) discussions.

This culminated in the Gold Standard Enrolment Framework [224], published in 2007, and adopted as the recommended whole of government framework for establishing proof of identity.     

Cross agency framework

The cross agency framework proposed four separate categories of proof of identity documentation.

The Repatriation Commission adopted this model and modified it to include three categories of documents to better meet the needs of DVA clients.

History of Repatriation Commission decisions over time

Departmental Instruction 41/98 outlined acceptable proof of identity documentation for income support payments. At this time, category A documents were regarded as sound because of the difficulty in obtaining them. Category B documents were regarded as acceptable because of their personal nature or because of the time they needed to have been held.

In May 2003, new proof of identity requirements were approved by the Repatriation Commission. These were based on the cross agency framework for proof of identity, with some tailoring based on consultation with DVA staff. Differences included a wider range of documents in category C than the cross agency framework. The Repatriation Commission then agreed to wait for further development of the whole of government approach to proof of identity by the Attorney General's Department.

In May 2004, the Repatriation Commission agreed to adopt the cross agency framework proposed by the Attorney General's Department, with some minor modifications. The modifications included:

• revision and merging of cross agency framework document categories B and C. These were re-labelled category B documents, and
• creation of new category C, for documents providing evidence of residential address. Acceptable documents in this category were also modified to cater for the needs of people living in nursing homes.

The Repatriation Commission has maintained a consistent approach to proof of identity since 2004. DVA's proof of identity document categories are now closely aligned with the whole of government Gold Standard Enrolment Framework published by the Commonwealth Attorney General's Department.

In March 2011, the Repatriation Commission and the Military Rehabilitation and Compensation Commission agreed that, to ensure alignment with Centrelink policy, an Australian passport can be provided as either a category A or a category B document for whole of department proof of identity purposes. A document which establishes commencement of identity in Australia, such as a full Australian birth certificate is preferred to a current Australian passport as a category A document as this is more consistent with the Gold Standard Enrolment Framework. However in order to remove barriers to DVA clients, particularly younger serving members, being able to establish proof of identity, a current Australian passport can be accepted as a category A document if other category A documents are difficult to access, not available, or not submitted with a claim.

Gold Standard Enrolment Framework

The cross agency framework was refined through COAG discussions and culminated in the Gold Standard Enrolment Framework published in April 2007 by the Commonwealth Attorney General's Department. DVA's approach to proof of identity is consistent with the Principles for Identifying the Applicant (principles 4 – 6) outlined in the Gold Standard Enrolment Framework.

Current categories accepted by DVA

The current categories of proof of identity documentation accepted by DVA are described in the CLIK Policy Library at 2.2.4 Categories of proof of identity [225].   

Automatically established Proof of Identity

POI is automatically established for current and former serving members who have joined the permanent forces or commenced a period of Continuous Full-time service from 1 January 2016 and/or separated from 27 July 2016.

DVA will rely on the identification and security clearance procedures used by the ADF to satisfy DVA identity requirements.  Under this arrangement, members will not need to provide any POI documentation when making their claim.

This process acknowledges the close linkages between DVA and the Department of Defence and is designed to assist in ensuring a smoother transition between the two Departments.

Amendments for current serving members and eligible reservists

Current serving members, reservists and trainees who hold a purple or orange ADF ID card can fully satisfy DVA's POI requirements through the in-person presentation of a current, valid, purple or orange ADF ID card to a DVA staff member when making their claim

This streamlined process acknowledges the close linkages between DVA and the Department of Defence and is designed to assist in ensuring a smoother transition between the two Departments.  This is an additional POI channel available for eligible clients; it does not supplant the existing Gold Standard Enrolment Framework.

Streamlined POI for clients eligible to use MyService

Clients with a PMKeyS number are eligible to submit their claims online via MyService. Claims submitted through MyService undergo an online, streamlined POI checking process at the time an account is created. This process is Commission approved.

When a client creates an account on MyService, their POI details, such as their PMKeyS number, driver’s licence number and Medicare details, are validated online through the Department of Defence and the Attorney-General’s Department. If the details match, the account will be created. If not, the client will be notified with an error message and will not be able to proceed with their account creation until matching data is provided.

Clients will also be able to be registered in MyService through the Early Engagement Model, or as protected identity members using an approved manual upload.  These registration and identity methods have also been approved by the Commissions.

Once a client is registered in MyService, they have satisfied all POI provisions for DVA. There is no requirement to request additional documents or undertake additional POI checks for these clients. Clients who register through MyService will need to have a new notification recorded in VIEW of ‘MyService registration POI’ under ‘POI Obtained’.

Purpose of proof of identity check

The model adopted by DVA is developed in line with the Whole of Government approach adopted by Australian government agencies. A proof of identity (POI) check is made on claimants (including trustees and agents) and their dependants to ensure that payments and benefits are made to the right person and to deter the fraudulent use of identities. Mechanisms such as data matching are also in place which can detect instances of fraud, including claims based on false identity.    

Establishing proof of identity or relationship to a veteran

The model for establishing POI introduces a standardised framework across DVA. The model includes the requirement to produce documents proving birth or arrival in Australia and documents as evidence of the identity operating in the community. A dependant claiming on the basis of their relationship to a veteran or member is required to provide documentation as evidence of that relationship existing.    

Effect of proof of identity on claim

There are no specific provisions in the VEA, DRCA, MRCA or social security law requiring that the identity of the claimant must be proved when making a claim. However, a delegate needs to be satisfied in respect of all matters relating to a claim. This includes that the identity of the claimant and the claimant's relationship with the veteran or member, where appropriate, are genuine. The standard of proof is based on the standard of reasonable satisfaction. There are provisions to grant payments or benefits temporarily while awaiting for POI to be established, in emergency and hardship situations.    

Automatic POI for members who have joined the ADF from 1 January 2016 and/or separated from 27 July 2016.

POI is automatically established for current and former serving members who have joined the permanent forces or commenced a period of Continuous Full-time Service from 1 January 2016 and/or separated from 27 July 2016.

DVA will rely on the identification and security clearance procedures used by the ADF to satisfy DVA identity requirements.  Under this arrangement, members will not need to provide any POI documentation when making their claim.

Modified POI check for current serving members, reservists and trainees with a current, valid, purple or orange ADF ID card.

DVA staff are able to fully authenticate the POI of a current serving member, reservist or trainee who holds a current, valid purple (current serving members and reservists) or orange (ADF trainees) ADF ID card using just the ID card as proof of identity.

This reflects existing information sharing arrangements with Defence and allows for eligible clients to bypass the more rigorous 100 point check.

Streamlined POI for clients eligible to use MyService

Clients with a PMKeyS number are eligible to submit their claims online via MyService. Claims submitted through MyService undergo an online, streamlined POI checking process at the time an account is created. This process is Commission approved. Once a client is registered in MyService, they have satisfied all POI provisions for DVA. There is no requirement to request additional documents or undertake additional POI checks for these clients.

Delegate's discretion regarding proof of identity

The test is that the delegate is satisfied there are no doubts about the pensioner's identity. Therefore, there is discretion not to rigorously apply a full or modified POI check, where otherwise indicated in these guidelines. For example, if a person returns to payability immediately after being cancelled there is no need to obtain refreshed identity documents where the delegate has no cause to doubt the identity of the claimant.

Standard of proof of identity documentation

The POI documentation provided in respect of a DVA claim for payment or benefit is required to meet specified standards. Provisions exist for claimants who are unable to provide proof of identity documents according to the standard requirements.    

Proof of identity not provided

If the claimant or dependant do not provide satisfactory POI to enable their identity to be proven by either a standard or non-standard check, the claim must be rejected. The rejection is based on the grounds that the claimant's status cannot be proven because the decision maker cannot be reasonably satisfied as to the claimant's identity.    

Recording proof of identity details on VIEW

Once a proof of identity check has been conducted, it is important to record this action in the comments tab of VIEW. The types of POI documentation sighted and verified should also be recorded. This allows a person to prove their identity to the department once, and for this information to be used for other departmental purposes where POI may be required.

If a modified POI check is subsequently conducted, where, for example, a person has reclaimed after 12 months of cancellation and the person is not in receipt of any DVA payments, then the comment should reflect this.

Examples of recording proof of identity details on VIEW.

Types of proof of identity

There are four types of proof of identity (POI) checks which can be carried out:

• automatic POI (for current and former serving members who have joined the ADF from 1 January 2016 and/or separated from 27 July 2016);
• a standard POI check (where the claimant can provide standard documents);
• a non-standard POI check (for claimants who cannot produce standard documents); and
• streamlined POI checking processes:
  • for current serving members, reservists and trainee who hold a current, valid purple or orange ADF ID card
  • for clients with a PMKeyS number who submit their claims via MyService.

Standard proof of identity documents

There are three different categories of standard POI documents:

• documents from category A provide evidence of birth or arrival in Australia,
• documents from category B provide evidence of identity existing in the community as well as evidence of a linkage between an identity and a person, and
• documents from category C provide evidence of residential address, or residence in an aged care facility.  

Non-standard proof of identity documents

Documents not falling into categories A, B or C are classed as non-standard documents.    

Levels of proof of identity check

The levels of identity check are:

• full POI check
• modified POI check, and
• no POI check.

Degree of check required

The level of POI check required varies depending on:

• the type of claim being made
• the type of payment (if any) already being received, and
• what level of POI check (if any) has previously been carried out.

Automatic POI for members who have joined the ADF from 1 January 2016 and/or separated from 27 July 2016.

POI is automatically established for current and former serving members who have joined the permanent forces or commenced a period of Continuous Full-time Service from 1 January 2016 and/or separated from 27 July 2016.

DVA will rely on the identification and security clearance procedures used by the ADF to satisfy DVA identity requirements.  Under this arrangement, members will not need to provide any POI documentation when making their claim.  This will be accepted as full POI for DVA purposes and the POI check marked as complete for that client.

Streamlined POI for current serving members, reservists and orange who hold a current, valid, purple or orange ADF ID card

Current serving members, reservists and trainees who hold a current, valid ADF ID card are able to fully satisfy DVA's POI requirements by presenting their purple (for current serving members and reservists) or orange (for trainees) ADF ID card.

The DVA staff member will then authenticate the photo ID on the card and copy the card to send along with the client's claim.  If a delegate is satisfied that the information on the card aligns with personal information obtained from their ADF PMKeyS record, then this ID card is to be accepted as full POI for DVA purposes and the POI check marked as complete for that client.

Streamlined POI for clients eligible to use MyService

Clients with a PMKeyS number are eligible to submit their claims online via MyService. Claims submitted through MyService undergo an online, streamlined POI checking process at the time an account is created. This process is Commission approved.

When a client creates an account on MyService, their POI details, such as their PMKeyS number, driver’s licence number and Medicare details, are validated online through the Department of Defence and the Attorney-General’s Department. If the details match, the account will be created. If not, the client will be notified with an error message and will not be able to proceed with their account creation until matching data is provided.

Clients will also be able to be registered in MyService through the Early Engagement Model, or as protected identity members using an approved manual upload.  These registration and identity methods have also been approved by Commissions.

Once a client is registered in MyService, they have satisfied all POI provisions for DVA. There is no requirement to request additional documents or undertake additional POI checks for these clients. Clients who register through MyService will need to have a new notification recorded in VIEW of ‘MyService registration POI’ under ‘POI Obtained’.

Proof of identity for partner new claim

When a veteran or member is already in receipt of a DVA pension or benefit and their partner applies for DVA pension or benefit, the partner is required to provide POI. The level of POI check required depends on the partner's own circumstances.    

Dependent children of claimant

When a claim for payment or benefit is made in respect of a dependent child, POI is required of the child. Proof of the relationship to the veteran or member is also required. The documentation required differs according to the type of claim being made. For a dependant over 18 years of age, a full POI check is required.    

Applications made by a trustee or agent

If a claim for payment or benefit is made as part of the process of appointment of the trustee or agent, a full POI check is required.  A full POI check of the agent or trustee must be made on all applications.

Proof of identity and change of name

In cases where the name has changed since birth, certified copies of documents verifying the name change (e.g. deed poll, marriage certificate) are required. A statutory declaration may also be sufficient in exceptional cases.    

In cases where a person's name has not changed since birth, but they would prefer to be known by a name other than their first name, then this can be actioned as long as:

• the delegate is reasonably satisfied that the preferred name is part of the person's full name
• the person's VIEW record is changed to their preferred name
• there is a note added to VIEW comments detailing the person's full name and that they prefer to be known by a name other than their first name, and
• the person's preferred name is used for all departmental purposes, including on any cards to which the person is entitled, such as a Gold Card.

A further proof of identity check is not required where there is reasonable satisfaction that the preferred name is part of the person's full name.

In some instances a person may have been known to the department for many years, but has never provided proof of identity documentation as this was not required at the time of their initial claim. In such cases, a modified proof of identity check may be required if a delegate is unable to establish a link between the person's preferred name and their full name, and is not reasonably satisfied as to the person's identity in their preferred name.

Note: When a person prefers to be known by a name other than their first name, they should be made aware that when they receive concessions from other providers (e.g. energy companies), it is likely they will be required to have an identical name on the card as they have recorded with the other providers, otherwise they may not receive a concession.  DVA does not determine what concessions are available from concession providers nor their concession policies.

Proof of identity and sex affirmation surgery

If a person has undergone sex affirmation surgery (also known as sexual re-assignment surgery) and the sex on their original birth certificate no longer corresponds to their affirmed sex, one of the following forms of evidence can be accepted as verification of their sex:

• an updated Australian birth certificate or current Australian passport indicating the affirmed sex of the person, or
• a statutory declaration or medical report verifying the sex affirmation surgery from a medical doctor registered with a medical registration board in an Australian state or territory. This verification process can cover surgery completed either in or outside Australia.

Where a transgender person has not completed their sexual reassignment, but has had a formal change of name to match their “preferred” gender, their records should be changed to reflect their new name, but their gender should not be changed until the sex affirmation surgery is completed. The exception to this is if the person's gender, as recorded on their passport, reflects their preferred gender. From September 2011, sex affirmation surgery is no longer a prerequisite to a passport being issued in a person's preferred gender. However, a person's birth certificate cannot be altered until sex affirmation surgery has been completed. Where two different genders are recorded, the person's gender should be changed to reflect that recorded on their current passport. This is because this more accurately reflects the person's identity in the community.

Where a transgender person has not completed their sexual reassignment, but has had a formal change of name to match their preferred gender, the person's title should reflect their “preferred” gender. A note should be added to VIEW to the effect that the person's salutations on any letters from the department should reflect their “preferred” gender and identity in the community.

Australian Defence Force service records do not match claim details

A veteran of the Australian Defence Force, especially during World War 2, may have enlisted under a different identity or date of birth. When lodging a claim for pension or benefit, inconsistencies between the identification details provided in a claim and those recorded in the service documents are to be accounted for by the claimant.    

Establishing proof of identity during phone contact

Security checks must be conducted when someone contacts the department to provide information about a client or enquire about a client's personal information. The client must provide at least two client-specific pieces of information, as proof of identity. Where details of investments or accepted disabilities are provided, it is not essential that a person list all details, but more than a bare minimum of information is preferred to ensure that the delegate is able to be satisfied as to the identity of the person.

Note: For more details, see CLIK Procedure Library Part 2/Chapter 2/Section 6 [245].

Full proof of identity required

A claimant for an income support payment, Commonwealth Seniors Health Card (CSHC), Gold Card, a payment under the MRCA [192] or DRCA [192] or a veterans' compensation payment or benefit, is required to satisfy the full proof of identity (POI) requirements when:

• they are not receiving a payment or allowance from DVA or Centrelink*

• a reapplication is made where payment or benefits not previously issued

• the income support payment has been cancelled for over 12 months, or

• military compensation liability has been admitted and no benefits have been paid within the previous 24 months.

*The reference to Centrelink in this policy is only relevant in the circumstances where the client is a current Centrelink customer, transferring to a DVA income support payment; see Proof of Identity Check - Income Support [249] for details.  For all other Compensation payments under the VEA, DRCA or MRCA see the summary table [250] for examples.

Whilst full POI may not be required in certain circumstances, it is likely that at least modified POI will be required. An indication of modified POI can be found below.

Combinations of documents for full proof of identity

The following table details the types and combinations of standard documents required in order to satisfy full proof of identity requirements.    

Current and former serving members who joined the ADF from 1 January 2016 and/or separated from 27 July 2016

Current or former serving members who have joined the permanent forces or commenced a period of continuous full time service from 1 January 2016 and/or separated from 27 July 2016, automatically satisfy DVA’s POI requirements. 

DVA will rely on the identification and security clearance procedures used by the ADF to satisfy DVA identity requirements.  Under this arrangement, members will not need to provide any POI documentation when making their claim.  This will be accepted as full POI for DVA purposes and the POI check marked as complete for that client.

There may be limited circumstances where a DVA staff member or delegate requires a full POI check as described above.

Current serving members, reservists and trainees who hold a current, valid, purple or orange ADF ID card

Current serving members, reservists and trainees who hold a current, valid ADF ID card are able to fully satisfy DVA's POI requirements by presenting their purple (for current serving members and reservists) or orange (for trainees) ADF ID card.

The DVA staff member will authenticate the photo ID on the card and photocopy the card to send to the claim delegate along with the client's claim.  If a delegate is satisfied that the information on the card aligns with personal information obtained from their ADF PMKeyS record, then this ID card is to be accepted as full POI for DVA purposes and the POI check marked as complete for that client.

This single document is all that is required for these eligible clients to fully prove their identity to DVA, unless the delegate or frontline staff member cannot be reasonably satisfied that the person claiming is the person to whom the card belongs and the claim refers.  In this case, the delegate or staff member can request that the client supply full POI by the regular method.    

Claims submitted via MyService

Clients with a PMKeyS number are eligible to submit their claims online via MyService. Claims submitted through MyService undergo an online, streamlined POI checking process at the time an account is created. This process is Commission approved.

When a client creates an account on MyService, their POI details, such as their PMKeyS number, driver’s licence number and Medicare details, are validated online through the Department of Defence and the Attorney-General’s Department. If the details match, the account will be created. If not, the client will be notified with an error message and will not be able to proceed with their account creation until matching data is provided.

Clients will also be able to be registered in MyService through the Early Engagement Model, or as protected identity members using an approved manual upload.  These registration and identity methods have also been approved by Commissions.

Once a client is registered in MyService, they have satisfied all POI provisions for DVA. There is no requirement to request additional documents or undertake additional POI checks for these clients. Clients who register through MyService will need to have a new notification recorded in VIEW of ‘MyService registration POI’ under ‘POI Obtained’.

Modified proof of identity required

A modified POI check is required for the following:

• a claimant reapplying for an income support payment within 12 months of cancellation if a delegate is not reasonably satisfied as to the person's identity
• a claimant in receipt of a pension or allowance who has not contacted DVA for a number of years or for whom a full POI check has not been carried out, if there is a reason for a delegate to not be reasonably satisfied as to the person's identity
• a claimant for service pension, or CSHC where Disability Compensation Payment or veterans supplement are in payment, but the claimant has not contacted DVA for a number of years, or a full POI check has not previously been carried out, and
• when transferring to DVA from a Centrelink payment or benefit if the claimant has not previously provided POI to DVA.

Note: No POI is required where a person's age pension is being transferred from Centrelink to DVA. This is because the person's identity was proven at the time of the initial claim for Disability Compensation Payment from DVA. The only exception to this is where a full POI has not previously been carried out, or where the person has not contacted DVA for a number of years and the delegate is not reasonably satisfied as to their identity.

Documents to satisfy modified proof of identity requirements

Modified POI requirements may be satisfied as follows:

• one document from category B which provides evidence of residential address or residence in an aged care facility, (total of 1 document), or
• one document from category B which does not provide evidence of residential address or residence in an aged care facility and one document from category C which provides evidence of residential address or residence in an aged care facility, (total of 2 documents).

No proof of identity documentation required

No POI documentation is required for the following because no payment or benefit is to be made, a claim is not required, or POI has already been established:

• client has submitted their claim via MyService and POI has been established online through the streamlined process
• claimant reapplying for an income support payment within 12 months of cancellation if a full POI check has been previously carried out and there are no doubts about the person's identity
• Bring Em Back cases (transfer of Centrelink age pension to DVA) where a person is in receipt of DVA Disability Compensation Payment (and therefore their identity has been accepted by DVA), and a full POI check was conducted by Centrelink as part of the process of applying for Centrelink age pension
• non-veteran partner of a DVA Disability Compensation Payment recipient transferring Centrelink age pension to DVA, where Centrelink has already conducted a full POI check on the partner
• pension bonus scheme [255] registration    
• a claim for a qualifying service determination
• a claim for income support supplement, if the delegate is satisfied that a full POI check has been  conducted at grant of war widow's/widower's pension
• a claim for war widow's/widower's pension where the person has already been receiving partner service pension, and
• application for increase in Disability Compensation Payment.

New claims for age pension

The Guide to Social Security Law [256] provides the proof of identity policy for cleanskin grants of age pension, excluding transfers from a Centrelink payment or benefit where only a modified POI check is required if the claimant has not already had their POI verified by DVA.    

Emergency or Hardship

For exceptional circumstances of hardship or emergency, provisions exist to permit temporary payment of pension or allowance, or access to treatment benefits. This provision applies when a person is not able to obtain sufficient POI documents to enable immediate grant of a claim and is subject to the claimant meeting all other relevant eligibility criteria.    

Summary table

The following table summarises the circumstances when a full, modified or no proof of identity (POI) check is required for claim for an income support payment.

Note: If the current Centrelink customer is a member of a couple and a full POI check has already been conducted on the non-veteran partner as part of the Centrelink claims process, then no POI is required for the partner. This is because their identity has already been established. If a full POI check was not conducted by Centrelink, then a modified POI check will be required for the non-veteran partner as part of the transfer process.

Note: POI is automatically established for current and former serving members who have joined the permanent forces or commenced a period of Continuous Full-time Service from 1 January 2016 and/or separated from 27 July 2016.  This is detailed elsewhere in the CLIK proof of identity policy library. [225]

Note: A POI check for current serving members, reservists and trainees who hold a current, valid purple or orange ADF ID card can be performed using the streamlined process available to these clients and detailed elsewhere in the CLIK proof of identity policy library [225].

Note: Eligible clients who submit their claims via MyService will have their POI verified by the system at the time of creating their account. Additional POI checks are not required.

Summary table

The following table summarises the circumstances when a full (standard), modified or no proof of identity (POI) check is required for a veterans' compensation claim:

*for a child between 5 and 18 years of age, a certified true copy of the full birth certificate showing the names of both parents, and evidence of enrolment in full time education. For a child 18 years of age or over, full POI).

Note 1: A POI check for current serving members, reservists and trainees who hold a current, valid purple or orange ADF ID card can be performed using the streamlined process available to these clients and detailed elsewhere in the CLIK proof of identity policy library [225].

Note 2: Eligible clients who submit their claims via MyService will have their POI verified by the system at the time of creating their account. Additional POI checks are not required.

Note 3: POI is automatically established for current and former serving members who have joined the permanent forces or commenced a period of Continuous Full-time Service from 1 January 2016 and/or separated from 27 July 2016.  This is detailed elsewhere in the CLIK proof of identity policy library. [225]

Circumstances that warrant non-standard POI consideration are detailed in the CLIK proof of identity policy library at Chapter 2.2.4 [223].

Establishing proof of relationship to a deceased veteran or member

Evidence of a dependent partner's relationship to a deceased veteran or member is required to support a claim for payments or benefits if this has not been established by previous claims.

Documents required in respect of a widow/widower or de facto spouse

A widow, widower or de facto spouse claiming pension is required to provide the following documentation:

• certified copies of their own identification documents, and
• their marriage certificate, or
• evidence of their marriage-like relationship with the deceased veteran or member (de facto relationships only).    More ? [280]

Documents required in respect of a child

For each child named in the claim, the following documents are required:

• a certified true copy of the full birth certificate showing the names of both parents, or
• an adoption order, and
• for a child between 5 and 18 years of age, evidence of enrolment in full time education, or
• for a child over 18 years of age, a full proof of identity (POI) check is required.    More ? [281]

Natural or adopted or dependent child of the veteran, member or claimant

The following table shows when the child of a veteran or other person is required to be related to and/or wholly or substantially dependent on the veteran or member to be eligible (subject to other eligibility criteria also being met), for Veterans' Children Education Scheme (VCES) or orphan's pension or income support benefits.    

Establishing authorisation to contact on behalf of a pensioner

When contact is made on behalf of a pensioner it is important to check the client record to see whether the person is authorised to act on behalf of the pensioner and the extent or limits of the authority. Once a delegate is satisfied that the person is authorised, a security check must be conducted to check the identity of the caller.

In some circumstances, where written authorisation of the third party does not already exist, it may still be possible for a notified event to be recorded and actioned, subject to authorisation subsequently being obtained from the client. A security check must be conducted in these circumstances, so that the delegate may be satisfied that the caller does have a relationship to the veteran.

Note: For more details, see CLIK Procedure Library - 2.2.6 [245].

The following table provides a list of acceptable standard proof of identity (POI) documents

by category.    

In most cases, at least three different documents are needed to establish POI – one document from category A and two documents from category B.

If the documents produced to satisfy category A or B do not provide evidence of the current residential address, then a document from category C must also be produced (i.e. four different documents).

The above list is instructive rather than exhaustive. For POI documents not listed above, the Delegate may need to determine whether the POI documents provided are considered as non-standard, which will require approval at the EL1 level or above. See CLIK Policy Library Non-Standard Proof of Identity [297] for further information.
 

* Use of the Australian passport as a POI document

A full birth certificate is preferred to a current Australian passport as a category A document. This would then allow the passport to be used as a category B document.

However, a current Australian passport can be accepted as a category A document if other category A documents are not available, or are difficult for the person to access. Not available can be taken to mean that the person does not have the other category A documents with them, or that they were not provided with the claim.

An Australian passport may only be used as a category A OR a category B document.  It cannot be used for proof of identity purposes in both categories concurrently.

** Use of the ADF ID card as a POI document

As well as its use as a category B document, current serving members, reservists and trainees who hold a current, valid ADF ID card are able to fully satisfy DVA's POI requirements by presenting their purple (for current serving members and reservists) or orange (for trainees) ADF ID card.

The DVA staff member will then authenticate the photo ID on the card and copy the card to send along with the client's claim.  If a delegate is satisfied that the information on the card aligns with personal information obtained from their ADF PMKEYS record, then this ID card is to be accepted as full POI for DVA purposes and the POI check marked as complete for that client.

This single document is all that is required for these eligible clients to fully prove their identity to DVA, unless the delegate or frontline staff member cannot be reasonably satisfied that the person claiming is the person to whom the card belongs and the claim refers.  In this case, the delegate or staff member can request that the client supply full POI by the regular method.

 Proof of Identity (POI) and Australian Defence Force (ADF) Identification Cards

 TRIM Ref: 14316822E (accessible to DVA staff)

History of use of identity

Non-standard proof of identity (POI) is where the claimant cannot provide the standard POI documents as required but can collectively demonstrate a continued history of the exclusive use of an identity over a reasonable period of time, generally considered to be 2 years. An example of this is a veteran or war widow/widower who is living overseas and cannot satisfy the category A documents.

Acceptable non-standard proof of identity documents

Non-standard POI should be considered in cases where a claimant is unable to produce sufficient categorised documents. The claimant is required to provide details such as name, address, next of kin, to enable verification of their identity. Any combination or number of documents listed in the category A, category B and category C lists and other documents not listed, may serve to identify the claimant and confirm their current residential address. The non-standard POI provided should demonstrate the exclusive use of the claimant's stated identity during the preceding two years. The delegation for approval or refusal of non-standard POI checks is at the EL1 level or above.    

Veterans of the forces of the Republic of Vietnam

There are various documents that may be used to identify these veterans, such as a visa for travel to Australia, Selection and Interview Report and Application for Resettlement in Australia issued by the Department of Immigration and Multicultural Affairs. These documents relate to people who came to Australia from Vietnam via a refugee camp and as such they may also have documentation relating to refugee status. Vietnamese veterans may not have any documents relating to their military service. If they were interned by the new regime in a 're-education' camp, they may have retained the related documents. They will also have, or have access to, civilian documentation such as birth and marriage certificates or driver's licences.    

Original documents

It is preferable that the claimant provides original documents. Certified and true copies of documents are acceptable as proof of identity (POI).    

Verification of original documents

Verification of POI documentation is needed to protect claimants and the department from fraud. Therefore, it is preferable that an employee of DVA sights and copies an original POI document. Original documents may be forwarded to the department to be photocopied and immediately returned to the claimant by certified mail.

Document copies

If original documents are unavailable, true and certified copies of these documents may be accepted. A true and certified copy must be signed by a person before whom a statutory declaration may be made. Australian, State or Local Government officials with 5 years continuous service, or with a separately listed authorisation are able to certify copies of POI documents as a public service, at no cost to the claimant. For this reason clients should be encouraged to have their copies of POI documents certified by a government official in preference to people with other accepted qualifications.

The person certifying the copy must write on the copy CERTIFIED TRUE COPY, sign and date the copies and insert their name, address, business hours telephone number and profession or occupation group as qualification to sign, as certification, on the documents. An official stamp of the certifying person's organisation should also be affixed, if appropriate. If the certifying officer is a Justice of the Peace, they must list their registration number and state/territory of registration.    

The model adopted by DVA for the certification of copies of POI documents is in line with the Whole of Government approach adopted by Australian government agencies. The accepted qualifications for the certification of these documents are based in legislation.

It is important that each page of a document is certified, as this provides reassurance that the copy is a true copy of an original. For example, where certification appears on the back of a document (which is blank) or only on the first page of a three page document, then a delegate should request to see the original, in preference to accepting the incompletely certified copy. The test is that a delegate should be reasonably satisfied that a certified copy is a true copy of an original.

Certified copies of certified copies

In some instances, particularly where a person has paid for a document to be certified, they may not be willing to lodge the certified copy. In these circumstances, it is acceptable for a delegate to take a photocopy of the certified copy, for placement on file. The delegate should write on the copy CERTIFIED TRUE COPY OF A CERTIFIED COPY. This provides reassurance that the certified copy was sighted. The copy should be signed and dated.

Copies of certified copies, which have been certified by a person before whom a statutory declaration can be made, can also be accepted.

A copy of a certified copy can be regarded in the same way as a copy of an original. It is therefore not necessary for the original to be re-presented.

Copies of certified copies of documents can only be used for internal purposes, that is for placement on file to support a claim. A claimant may not remove the copy and use it for any other purpose.     

Translated documents

Documents in a foreign language must have their originals sighted and a copy placed on file. A written translation must be provided. The translation of any documents must be done at the claimant's expense by an authorised translation service e.g. Department of Immigration and Citizenship, an appropriate embassy or professional translation service. This is usually recognisable by the document being stamped with the translator's details.    

[70]VEA?

What is evidence

Evidence is material that tends to satisfy an inquirer that a fact exists. For evidence to be relevant, there must be a relationship between the material provided and the facts in issue.

Entitlement cannot be granted without supporting evidence

[70]VEA?

Commission cannot grant a claim or application without evidence to support it. A case must always be established on the balance of probabilities by relevant evidence for acceptance by a delegate.

Difficulties in providing information to be taken into account

[70]VEA?

The Commission is required to take into account difficulties that may inhibit, or obstruct the gathering of information or evidence of any fact, matter, cause or circumstance including:

•  the effects of the passage of time and its effects on the availability of witnesses, and
•  the lack of relevant official records.

Example of where difficulties may be taken into account

If a veteran's statement concerning an alleged encounter with hostile forces cannot be confirmed by a witness because a witness cannot be found, it does not mean that the veteran's statement should be automatically discounted.

All relevant material to be considered

When gathering evidence for a case all material that is relevant to the matter to be decided must be considered. Equally, material that is not relevant must be disregarded.

Last updated: 25 November 2008

Commission not bound by rules of evidence

[70]VEA?

The Commission does not have to act in a formal manner, nor is it bound by rules of evidence when making decisions in relation to pensions. Evidence such as hearsay evidence which would not be admissible in a court of law, may be used by a delegate to establish reasonable satisfaction in a case.

Example where rules of evidence need not apply

If a widow relates stories that her late husband told her about his experiences during his war service in an attempt to illustrate that he incurred danger, this evidence may be accepted, whereas it would be inadmissible in court.

Commission's decisions are to be made on substantial justice of cases

[70]VEA?

The Commission, when considering, hearing, determining or making a decision in relation to:

• claims,
• applications,
• reviews,
• variations,
• suspensions, and
• cancellations;

shall act according to substantial justice and the substantial merits of the case, without regard to legal form and technicalities.

Meaning of substantial justice

Substantial justice implies that the decision maker must accord the claimant procedural fairness (or natural justice) in the manner in which the decision-making process is conducted. The decision maker must:

• afford an opportunity to be heard to a person who will be adversely affected by the decision,
• be disinterested or unbiased in the matter to be decided,
• ensure that similar cases are dealt with in the same way, and
• ensure that similar outcomes occur for similar cases.

Delegate required to examine all bases

A delegate must examine all apparently valid bases before rejecting a claim. If a claimant's main argument is not substantiated by the evidence they provided, but supported by other evidence they may have omitted, a decision may still be made in their favour.

Administrative decision making

When making a determination based on a ruling in the VEA, decision makers must comply with the general principles of administrative law. Section 5(1) of the Administrative Decisions (Judicial Review) Act 1977 provides for circumstances in which an administrative decision may be judicially reviewed. The Administrative Review Council (ARC) Best Practice Guide 2 - Natural Justice explains the implications of natural justice (or procedural fairness) for decision makers and its connection with public service values and standards of conduct. .     

Natural justice

Natural justice requires that administrators adhere to a fair decision-making procedure. Although fair procedures tend to result in better decisions, the concern is not whether the decision itself is fair, it is the decision-making process that must be fair. Statutes sometimes require administrators to make a decision that could be regarded as unfair—for example, to require someone to repay an overpaid allowance. For legal purposes, however, a fair decision is one that is properly made, in accordance with the statute and the rules of natural justice.     

Rules of natural justice

There are two primary rules of natural justice. The 'hearing rule' is that people who will be affected by a proposed decision must be given an opportunity to express their views to the decision maker. The 'bias rule' is that the decision maker must be impartial and must have no personal stake in the matter to be decided.      

Legal definition of reasonable satisfaction

The term reasonable satisfaction is the civil standard of proof that applies in Australian courts on matters other than criminal proceedings. To be reasonably satisfied, a delegate must consider that a piece of evidence is more likely than not to be true. The reasonable satisfaction standard of proof is also referred to as the balance of probabilities.

Example where delegate is reasonably satisfied

If it is more likely than not that a claimant has qualifying service, the delegate can be said to be reasonably satisfied that the claimant is a veteran as defined.

Reasonable satisfaction standards apply to all decisions

VEA→

The reasonable satisfaction standard of proof applies to all decisions and matters relating to service pension and income support supplement (ISS) including:

• claims for qualifying service;
• claims for service pension or ISS;
• applications for review of a service pension or ISS matter;
• hardship applications;
• determining the rate of pension payable;
• deciding that a couple are illness-separated; and
• deciding that a person undertook a course of action for the primary purpose of obtaining a pension, an increase in pension or fringe benefits eligibility.    More → [333]

Application of balance of probabilities

If a situation arises where a delegate has doubts about a fact relating to a case, while still being reasonably satisfied about the matter as a whole, a decision can still be made on the balance of probabilities.

Making a decision where evidence is insufficient to be clear

In situations where the delegate has insufficient evidence to decide on the balance of probabilities, the claim cannot be accepted until further evidence is provided. If further evidence cannot be obtained, the delegate must reject the claim.