Section 54 of the SRCA specifies several requirements of an application for compensation. As a matter of policy, these requirements also apply to new claims made under former Acts. In general, claims are not acceptable and are not formally recognised as a 'claim' unless these requirements have been met. However, there are several exceptions provided, both under S54 itself, and through Policy on the interpretation of S54.
In short, Delegates are required to:
1.record the receipt of the attempted claim before any other action
2.test the attempted claim for compliance with the standard of completeness required by S54 and by policy
3.actively assist the client to bring the claim to the specified level of compliance.
Section 54(2) of the DRCA requires a claim to be in writing.
A claim for compensation under section 54 and the legislative provision stipulating the requirement for a claim to be made in writing is satisfied during the initial liability claim by the claimant i.e. lodgment of the D2020 claim form. Therefore any ancillary benefits i.e. incapacity or permanent impairment compensation can be claimed by a person without a further claim form or written request.
Subsequent claims for benefits
The request for, investigation, and payment of subsequent compensation benefits (such as incapacity or permanent impairment) can proceed without requiring further written requests from a claimant where the liability claim has substantially satisfied the requirements under section 54. In practice, this will mean a DRCA client can make a claim for compensation either verbally or in writing following an initial liability claim.
If a claim for liability and compensation under the DRCA is made in writing it must be substantially compliant with a form approved by Commission. The Electronic Transactions Act 1999 (ETA) provisions apply to the DRCA and requirements for a valid claim can be satisfied where it is lodged by means of electronic communication. The receipt of electronic DRCA claims is not required to be the subject of an instrument (as is the case under the MRCA and VEA) but, as a matter of Commission policy, mirrors that of electronic MRCA claims.
The manner of electronically lodging claims is detailed below and includes;
Transmission by fax – the MRCA instrument provides a list of fax numbers.
Transmission via the internet (i.e. MyAccount), and
Transmission via email – the MRCA instrument provides a list of email addresses
Any supporting material that is required by the DRCA to be lodged in respect of a claim or other document, may be lodged in the same manner as approved by the MRCA instrument for the claim or other document to which it relates. If proof of identity (POI) documents are requested to be lodged in respect of a claim under DRCA, they may be lodged in the same manner as approved by the MRCA instrument for the kind of claim to which they relate. This allows clients to scan certified copies of POI and other documents and provide them as electronic attachments as they do currently thorough MyAccount. The delegate will continue to be required to be satisfied with the authenticity and validity of any e-mail claim they receive, supporting documents and including the POI requirements.
If a claimant is unable to complete the claim form because of blindness or a disability such as mental incapacity, it is appropriate to accept a claim form certified by a person acting in the interests of that person.
In such cases, the name, address and relevant relationship of the person to the client must be provided on or with the claim form.
If a claimant is not actually prevented from completing and signing the claim form by reason of impairment, a representative's signature should not be accepted. For example, where a person physically capable of completing a claim form has engaged a lawyer who subsequently submits a claim form signed only by that lawyer as representative, the claim form should be returned to the lawyer for endorsement with the claimant's signature.
Where an unsigned claim form is received, a Delegate should register the claim and take a photocopy for file, but then return the original claim form to the claimant with a covering letter asking for the claim form to be signed and returned without delay.
The Delegate may in the interim begin what limited investigation of factual and medical circumstances is covered by documents accompanying the claim form.
However, the Delegate should progress the matter no further, and especially should refrain from approaching agencies and medical personnel for further information until the claim form is returned with the claimant's authority to proceed.
In certain circumstances, claims may be lodged under one Act, but the client is subsequently found to be eligible under one of the other Acts.
The three compensation claim forms listed below have been updated to provide a Cross-Act Authority to enable delegates to make investigations under all three Acts, without seeking further approval to do so from the client.
D2020 – Claim for Rehabilitation and Compensation;
D2051 – Claim for Liability and/or Reassessment of Compensation; and
D2582 – Claim for Disability Pension and/or Application for Increase in Disability Pension.
Previous versions of the claim forms required the delegate to contact the client and request a new completed claim form under the correct Act or a completed Release Authority Form.
It is important to identify which claim form has been used to determine whether you need to obtain a completed Release Authority Form from the client or if the consent given in the latest form is sufficient. The checklist below will assist you to identify which version of the claim form has been used:
Latest D2020 SRCA form:
Old D2020 SRCA form:
Once you have identified which version of a claim form the claimant has lodged, go to the following page to determine what actions need to be taken next:
6.3.6.1 [9] – Cross-Act Authority Form
6.3.6.2 [10] – Use of old versions of SRCA, VEA, and MRCA claim forms
The latest version of the claim forms allow the client to give their consent for the delegate to consider their claim under one or more of the Acts. For example, where the client has submitted a D2020 SRCA claim for compensation, using the latest version of the form which includes the Cross-Act Authority, but the injury or disease should be determined under the VEA or MRCA, then the claim can be accepted under the VEA or MRCA.
Please note that if a claim is submitted on the incorrect claim form and it is missing some of the information needed to make a full assessment, then you should investigate and obtain the required information from the client.
A Release Authority form is not required in circumstances where the claim is lodged on the latest version of a claim form.
A Release Authority form is not sufficient in cases where an old version of the MRCA or a SRCA claim form has been lodged for a VEA condition, that claim can be accepted as an informal claim under the VEA. However, a formal VEA claim on a D2582 must be lodged subsequently. The rules on page 6.3.6.2 [10] are not applicable when the client has lodged the latest form which provides the Cross-Act Authority, but be aware the rules applicable to denying the claim lodged under the incorrect Act still apply.
Where the client has submitted a claim using the old form and the conditions are to be considered under one or more of the Acts, then the below steps must be followed:
If lodged on an old version SRCA form:
MRCA - accept the claim and obtain a completed Release Authority form. Please see 2.1.7.4 [8] in the MRCA Manual for further information,
VEA - accept the claim as an informal claim under the VEA, but a formal VEA claim will still need to be lodged;
If lodged on an old version VEA form:
MRCA - accept the claim and obtain a completed Release Authority form,
SRCA - accept the claim and obtain a completed Release Authority form;
If lodged on an old version MRCA form:
SRCA - accept the claim and obtain a completed Release Authority form,
VEA - accept the claim as an informal claim under the VEA, but a formal VEA claim will still need to be lodged.
Sections 54 and 147 require a claim to be on a form approved by the MRCC, but also give some latitude where a written claim is not on the correct form. The correct form i.e. the 'form approved by the MRCC' means, for SRCA purposes, DVA Form D2020 (SRCA), D2051 (MRCA), or D2582 (VEA).
Prior to the inclusion of the Cross-Act Authority on these claim forms, the MRCC approved the use of the D2051 (MRCA) and D2582 (VEA) for SRCA claims where a Release Authority Form is completed by the client. This also applies for MRCA purposes, when a client lodges a claim under D2582 (VEA) and D2020 (SRCA), the claim can be accepted under MRCA once a Release Authority Form is completed. Note this does not include a medical certificate as specified in s54 as no such medical certificate is part of the SRCA DVA claim form. However, naturally, medical evidence will be required during the investigation to determine a nexus between the claimed condition and the claimant's ADF service.
Claims lodged on a D2051 (MRCA) or D2020 (SRCA) form for a VEA condition, can be accepted as an informal VEA claim, however a formal VEA claim will still need to be lodged.
These forms must also be used for claims under the 1971 Act and the 1930 Act. There are no separate forms required in respect to claims for injuries under these earlier Acts, and the older superseded forms are not satisfactory.
However, please note, the latest version of all claim forms allow the client to give their consent for the delegate to consider their claim under one or more of the Acts.
Old Defence claim forms, Comcare (civilian) claim forms and general correspondence are not to be accepted as a valid claim. This is because forms D2582 (VEA), D2020 (SRCA), and D2051 (MRCA) require the claimant to sign a very specific and necessary authority. This authority allows delegates to access personal or medical information and to also make inquiries of other Government agencies. No claim investigation should proceed until the claimant has signed this form. If a claim is submitted on a form other than a D2582 (VEA), D2020 (SRCA), or D2051 (MRCA) the delegate should forward a D2020 (SRCA) form to the claimant for completion and signature. A letter explaining the need to get the appropriate signed authorities should accompany the claim form.
The Act requires only 'substantial compliance' with respect to the claim form, accordingly trivial omissions can be excused. For client service reasons this provision is to be interpreted liberally. Nevertheless, no claim form may be accepted as 'substantially' compliant unless it contains the following minimum entries:
If this minimum form of application is not complied with, the Delegate ultimately has the power to refuse to deal with the claim. Should the Delegate choose to take this line, the claimant must of course be informed in writing, i.e. as a Determination.
However, such a formal rejection on the basis of non-compliance should be rare indeed. For most non-compliant claims, applicants should not be served with a formal refusal to deal with the claim in the first instance. The form should instead be returned with an explanation of what information is required and the significance of the signatures required. The client must be told that the claim can not be registered until this information has been received. Only if there is, subsequently, a refusal to conform with this direction should the Delegate then formally 'refuse to deal' with the claim as non-compliant with S54. A copy of the document should be retained for audit purposes.
For lesser omissions on the claim form, the claim should be registered and the investigation begun prior to the request to the claimant for more information. The intent of this strategy is to minimise the delay in processing the claim.
Links
[1] https://clik.dva.gov.au/user/login?destination=node/20294%23comment-form
[2] https://clik.dva.gov.au/user/login?destination=node/20336%23comment-form
[3] https://clik.dva.gov.au/user/login?destination=node/20092%23comment-form
[4] https://clik.dva.gov.au/user/login?destination=node/20360%23comment-form
[5] https://clik.dva.gov.au/user/login?destination=node/20177%23comment-form
[6] https://clik.dva.gov.au/user/login?destination=node/20188%23comment-form
[7] https://clik.dva.gov.au/user/login?destination=node/20346%23comment-form
[8] https://clik.dva.gov.au/military-compensation-mrca-manuals-and-resources-library/policy-manual/ch-2-claims/21-making-claim/217-some-claims-must-be-made-particular-form
[9] https://clik.dva.gov.au/military-compensation-srca-manuals-and-resources-library/liability-handbook/ch-6-claims-compensation/63-claim-format/636-claims-lodged-under-one-act-incorrectly-and-subsequently-determined-under-another-act/6361-cross-act-authority-form
[10] https://clik.dva.gov.au/military-compensation-srca-manuals-and-resources-library/liability-handbook/ch-6-claims-compensation/63-claim-format/636-claims-lodged-under-one-act-incorrectly-and-subsequently-determined-under-another-act/6362-use-old-versions-srca-vea-and-mrca-claim
[11] https://clik.dva.gov.au/user/login?destination=node/20143%23comment-form
[12] https://clik.dva.gov.au/user/login?destination=node/20266%23comment-form