Investigation is the first major step in overpayment work. An investigation follows the detection of a possible overpayment, and the purpose is to ascertain the facts of the case, analyse the evidence and determine whether an overpayment has occurred.
Note:It should be noted that all of the above causes of income support overpayments may be caused as a result of fraudulent activity with the exception of administrative error or delay.
Note:It should be noted that all of the above causes of Disability Compensation Payment overpayments may be caused as a result of fraudulent activity with the exception of administrative error or delay.
Note:For full details of the various types of overpayments and the legislative authority for raising overpayments (i.e. the relevant sections of the VEA), refer to this manual's Chapter 2 What is an Overpayment?. The methods by which a possible overpayment may be discovered are contained in this manual's Chapter 3 Detection.
5.3.1.1 — Always ensure that the current assessment is correct before commencing investigation into an overpayment to determine an effective cessation date for the overpayment. The effect is to minimise the portion of the debt caused by administrative delay. This may be achieved by updating the current rate of payment based on information already available, or may necessitate reviewing income/assets details by requesting that the client complete a Statement of Circumstances or Income and Assets Statement Form.
5.3.1.2 — In certain circumstances it will be appropriate for the examiner to ensure sufficient information is gathered before updating an assessment. For example the Department may receive a denunciation from a member of the public, alerting the Department to a special rate recipient who is working above the stipulated hours. In this case further investigation of the case will be required before an assessment may be amended.
5.3.2.1 — At the same time a letter should be sent to the pensioner(s) advising that an overpayment may have occurred. The Advice – INVESTIGATION - client - advise investigation - DVA or age client.dot standard letter may be obtained from the departmental Y: Drive at Y:\97 Templates\IS ROOLS Letter Templates (Non MetaFrame users), or Y:\Application (MetaFrame users). However, the letter should be used cautiously so as not to concern a pensioner unnecessarily about an overpaid amount. There may however, be cases where a significant period of investigation is required. Where this is the case, the pensioner should be notified that a possible overpayment may have occurred. The aim is to alleviate any unnecessary confusion or distress caused to the pensioner if an overpayment were to arise after the prolonged investigation period.
5.3.3.1 — The first step in commencing the investigation of a possible overpayment is to gain a sound knowledge of the facts of the case. Sometimes the overpayment information will be contained on more than one file (for example other parts of the pension file, or the medical file). In most instances this will require reading the whole file from back to front in order to establish the circumstances that led to the possible overpayment, and will assist in the preparation of the case summary.
5.3.3.2 — Where assessment history is not available on the system, investigation should only be undertaken with regard to those factors which have lead or contributed to the possible overpayment (unless further factors become evident during the overpayment investigation and calculation). It is unnecessary and time consuming to investigate all financial/marital/residential aspects of the case if these have no bearing on the overpayment. However, if assessment history is available on the system, the pension rate should be re-assessed based on what was actually the case at the time, as opposed to what we were led to believe was the case. VIEW may be used to obtain historical assessment information via the Pension Assessment Tab. The assessment details for a particular period may be determined by nominating the effective date from the Selection Parameters.
5.3.4.1 — Once the facts of the case have been established, a decision needs to be made about whether or not an overpayment of pension has occurred and if it is recoverable. For example, recovery of manual debts less than $200 may be automatically waived by a competent authority without first being investigated or calculated. Regard must be had to the cost effectiveness of the recovery. If it is clear that a recoverable overpayment has occurred which is likely to exceed $200, investigation should be undertaken. This would apply in cases where debts are still manually processed, such as those raised by the Death Processing System (DPS). While the $200 Ministerial waiver still exists, the automatic calculation of debts under DMRS means that it is now cost effective to recover most overpayments. If the person is in payment then recovery action is automatically initiated on all debts. If the person is no longer in payment a $50 threshold applies, and debts below this amount may be waived.
5.4.1 — In many cases the information required to enable the calculation of the overpayment will not be on file and will need to be requested from a variety of sources. These are discussed later in the chapter.
Note:For further information on determining if an overpayment has occurred and the relevant sections of the VEA, refer to this manual's Chapter 2 What is an Overpayment?.
5.5.1.1 — The VEA provides the Secretary with a wide range of information gathering powers for the purposes of investigation, so that an examiner may ascertain whether a person was eligible for a particular rate of payment or benefit (such as treatment), under the Act.
5.5.1.2 — The Secretary (or a Delegate of the Secretary) has the power to require a person to:
5.5.2.1 — The information gathering powers relating to a service pension or income support supplement recipient or a recipient of benefits under Division 12 VEA are contained in section 54 [15] VEA through to section 54C [15] VEA. Section 128 [15] VEA provides the Department with the authority to obtain information from non-pensioner sources (such as 3rd parties, banks, employers, etc.) Prior to 1 July 1991, these powers were contained in section 127 [15] VEA and section 128 [15] VEA.
5.5.2.2 — When requesting information from either a third party or a pensioner it is important to be aware of the pensioner's right to privacy (refer to this manual's Section 10.3 Information Privacy Principles in Chapter 10 Freedom of Information and Privacy). It is also important to remember to keep questions relevant to the overpayment.
5.5.2.3 — It should also be noted that section 128 [15] VEA should not be used to request information from a person who is suspected of fraud, as this information can not be used later in any criminal prosecution.
5.5.2.4Section 128 [15] VEA may not be used to request information from an Australian Government agency specified under Schedule 3 of the Freedom of Information Act 1982, as the agency must comply with the secrecy provisions contained within their Act. Agencies include Centrelink and the ATO (refer to notes on table 7).
Note:e-mail and the Internet are unsecured environments. Therefore information should not be requested via e-mail under any circumstances. In general, the sender of an e-mail cannot be assured that:
5.7.1 — When requesting information it is vital that the sections of the Act which contain the authority to request that information, and which compel the person to comply with that request, are quoted.
5.7.2 — The tables in this manual's Section 5.8 Tables provide some suggestions for the type of information required and who to contact for that information in respect of a number of different income/assets overpayments. Please note these are suggestions only, and have been kept as general as possible. Please note that these tables do not imply that the examiner must request and verify all of the items listed under each table. In most cases, it would be unnecessary to request all of these items unless the specific overpayment required them. Each State may have more sources for gathering information than have been stated here. The Overpayment Management Unit Manager or Section Training Officer may have further information on who to contact, or where to go if experiencing difficulties with an investigation. No addresses have been provided as each State should have a list of commonly contacted paying authorities.
These tables provide some suggestions for the type of information required, and who to contact for that information, in respect of a number of different income/assets overpayments. Please note that these are suggestions only, and have been kept as general as possible.
Index of tables
This section contains the following tables:
(other than self-employment)
Type of Income |
What to Verify |
What to request |
Who to contact for Information |
Wages & Salary |
|
Signed and dated income tax returns (ITRs) and Notices of Assessment. Statements from each employer detailing the periods and wages earned, including details of any salary sacrifice payments. If not available then request the PAYE payment summaries and confirm details of any salary sacrifice payments. |
The pensioner (for ITRs), the employer for statements of earnings. If employer not known the Australian Taxation Office (ATO) may be able to supply financial year details and employer's name. Where a pensioner has a taxable income, a direct pro forma request to the ATO is effective in earnings review detected overpayments. |
Variable/Short term employment Contract work |
|
Signed and dated ITRs (plus Notice of Assessment) from the pensioner for the relevant financial year (s). Statements from each employer detailing the periods and wages earned. If not available, PAYE payment summaries. Details of contract e.g., a copy. |
The pensioner (for ITRs), the employer for statements of earnings. If employer not known the ATO can supply financial year details and employer's name. |
Fees - such as Director's, Councillor's fees |
|
For Director's fees, you may have to request signed and dated private company tax returns and other financial statements to verify the extent of the pensioner's involvement in the company. If more involved than just as director then investigate as for private company. If other type of fees, contact paying body or request ITRs. |
Initially contact the pensioners and/or their accountant for the tax returns. If that fails to bring a response then contact the ATO for the details. Contact paying authority (such as the Council) for other fees and ensure the fees are not reimbursement for out of pocket expenses. |
If using a PAYE payment summary, or copies of tax returns to assess an income amount, it is advisable to obtain a copy of the Notice of Assessment to verify that the income on the certificate or tax return was accepted by the ATO.
The ATO can only provide income summaries, so if it is necessary to check on deductions or any other details that may be on the tax return a copy of the full tax return should be requested from the accountant or pensioner.
If there is a suggestion of possible fraud, information obtained directly from the pensioner is not admissible as evidence in court proceedings as the information may be incriminating. Information may be obtained from a third party such as an employer under section 128 [15] VEA however information requested from the ATO under section 128 [15] VEA may not be admissible in court. Therefore the employer is the preferred source of information in these cases. The ATO can be a first point of call, but verification should be followed up with the employer.
It should be noted that salary sacrifice details will not appear on the payment summary or tax return. If any salary sacrifice payments were made, details should be requested separately, usually from the employer.
The earnings credit scheme ceased on 20 March 1997. For more information see DI C21/97. When investigating an overpayment due to earnings for a period prior to this date, any earnings credit that may have accrued should be taken into account when working out the periods for the overpayment. Earnings credit accrues from 1 January 1987 or from the date the service pension is granted, whichever is the later. Couples may accrue a combined earnings credit, and a pensioner does not have to be on maximum rate service pension in order to utilise an accrued earnings credit. The calculation of an overpayment involving earnings credit is not commenced until the credit is exhausted.
From 1 July 1993, carers became eligible to accrue an earnings credit, but they must not work more than 10 hours per week.
More information on earnings credit is contained in CLIK.
Type of Income |
What to Verify |
What to Request |
Who to contact for Information |
Sole Trader |
|
Signed and dated personal tax returns, including profit and loss statement, balance sheet, and depreciation schedule. A statement from the pensioner(s) to verify when the business commenced operating. If operating for less than 12 months request business activity statement (BAS). |
Initially contact the pensioners and/or their accountant. If that fails to bring a response then contact the ATO for the details. |
Partnership |
|
Request signed and dated personal and if available (or prepared) partnership tax returns, including profit and loss statement, balance sheet, plus depreciation schedule. If operating for less than 12 months request business activity statement (BAS). Copy of Partnership Agreement if appropriate. |
Initially contact the pensioners and/or their accountant. If that fails to bring a response then contact the ATO for the details. |
Private Company & Private Trust |
Cases identified relating to private companies or private trusts should be immediately forwarded to the Trusts and Companies Team, Income Support Branch, National Office. If a claimant is involved in a private trust or company then the claim is processed by the Trusts and Companies Review Team. For filing a claim refer to P2/C1/S4 of the CLIK Procedure Library – Where the Claim Form Goes. |
||
Rental Income |
|
A hand written statement of gross rent received and a list of expenses, or a copy of the tax return, signed and dated detailing the above. A copy of lease agreement may be appropriate. |
The pensioner(s) should be able to provide the details, including receipts, but if they are not forthcoming then contact the ATO for the tax returns for the relevant period. In addition, real estate agents can often supply monthly details showing income and expenses of properties. |
Type of Income | What to Verify | What to request | Who to contact for information |
Superannuation |
| A written statement or copy of schedule showing the dates and amounts, plus the financial institution account the amount(s) is being paid into (i.e. is this account currently being assessed). | Paying authority (i.e. Commonwealth, State or Local Superannuation Boards). Income Stream Schedule Form D0563 should be used to request information from income stream providers under the authority of section 128 [22] VEA. |
Compensation |
| A copy of decision or settlement agreement by Compensation Court, and any Short Minutes of Order. A written statement detailing date of grant, whether a lump sum paid, dates and amounts of any variations to amount, and whether any dependant's allowance paid as part of sum. Terms of settlement to identify components for economic and non-economic loss. Details of the financial institution account amount(s) paid into (i.e. is this account currently being assessed). | Pensioner may be able to provide all letters received from paying authority. If not, contact paying authority direct. Bank records may also show dates and amounts received, however, these are likely to be the net rather than gross amounts. Documentation must be obtained regarding compensation from pensioner's solicitor or Compensation Court. As a last resort a financial year amount may be gained from the tax returns, so contact the accountant or the ATO. |
Overseas Pensions (refer to notes below) |
| A full statement regarding the information in What to Verify box. Conversion to Australian dollars is not required, however fortnightly amounts to 3 decimal places should be recorded into PIPS. Care should be taken when converting non-Euros to Euros. | Contact the pensioner(s) first and ask for the original letters and translations. Contact the paying authority if information insufficient on pensioner's advice letters. Tasmanian State Office may be able to help with the addresses of some paying authorities, as will embassies and consuls. Ask the pensioner to complete an authority to release information statement, and to advise the full name and address of the paying authority. A pensioner may complete Form D2717 which provides consent to the release of information from the Department of Social Security in the UK relating to a pensioner's British Pension. For other pensions refer to notes below. |
When gathering information for an assessment on an overseas pension be aware that:
For example:
"I authorise the Department of Veterans' Affairs to obtain from ...(insert name of overseas authority)... any information that is required to process my Service Pension application. I also authorise...(insert name of overseas authority)...to release this information to the Department of Veterans' Affairs".
Type of Income |
What to Verify |
What to request |
Who to contact for information |
Financial Institution Income |
|
A written statement of the investment containing all the information in the What to Verify box. A departmental questionnaire for these type of cases may be sent. Account books, copies of statements, investment certificates. Signed and dated income tax returns which may identify investments, if the above is not available. |
The pensioner(s) may have all the certificates and details you require so contact them first. Contact the financial institution direct, and request they complete the questionnaire or provide a statement covering all details required. The ATO can provide a summary of the tax returns. |
Managed Investments What to verify or request may depend on whether pre-extended deeming or post-extended deeming applies. |
|
A completed copy of D0523 Income Support Pension Claim – Investment Form B Copies of investment certificates. Details of any withdrawals made and the value of the investment immediately prior to each withdrawal. |
The pensioner(s) may have all the details you require on certificates so contact them first. If not, or if you require verification of pensioner's information, then contact the fund manager, or the pensioner's financial planner. The Investment Database Unit will be able to help you to identify the fund(s) and how to assess the income. Information on unit values, % or CPU rates is available via PIPS – under the VIEW/MI history. |
Shares |
|
Dividend and share certificates or CHESS statements - both for the initial period and any subsequent certificates or statements issued for purchase/sale/shares in lieu of dividend. |
The pensioner(s) should have all the certificates or CHESS statements, but if some are missing or there appears to be a discrepancy, contact the company. The company can provide a schedule with all the share details including when dividends paid and how much was paid. As a last resort contact the pensioner's stockbroker or accountant for the details. Information about return/dividends is also available via PIPS – under the VIEW/SH history. |
Income Streams |
|
A trust deed under which the income stream is paid (for SMSF or SAF). Copy of contract/statement. A statement containing the details of the income stream if the above not available. DO563 – Income Stream Schedule for Veterans' Affairs assessment purposes sent to a financial product provider to collect information about a pensioner's income stream. If the pensioner is claiming the income stream is assets-test exempt, a current Actuarial Certificate prepared in accordance with the Institute of Actuaries (Australia) Guidance Note 465 (GN 465), stating that a SMSF or SAF has a high probability of meeting the income stream payments specified in the contract, trust deed or governing rules. |
Pensioner(s) should have copy of the income stream schedule so contact them first. Paying company can provide a copy of income stream schedule or a statement in lieu. |
Overseas Shares and Managed Investments |
|
Certificates stating initial investment, and any additions. |
Contact the pensioner or their accountant. The Investment Database Unit can help establish and gain what you require for managed investments and shares. |
The rules for income assessments still apply when investigating an overpayment. When assessing managed investments, private superannuation, immediate/deferred annuities, approved deposit funds, allocated pensions, check to verify the types of investments and how they were assessed historically as well as how DVA assesses them now. The historical assessment is especially important as it may apply to periods of the overpayment. The Investment Database Unit (IDU) will be able to assist you, as will Income Support Training Officers and supervisors.
Deemed interest was introduced in March 1991 and applied to money held as cash or in deposits. Exemptions to deeming were pensioners over 80, those in Nursing Homes (initially, but this was later revoked), accounts held overseas and other exemptions made by the Minister. From 21 August 1991 deeming was extended to include deprived assets, loans, bonds and debentures.
Further changes to deeming were made from 1 July 1996. More information is available in DI C08/96 and C44/96. Changes were also made on 4 April 2002 in relation to the deeming of a financial asset that is also an unrealisable asset. This was an unintended consequence flowing from the introduction of the extended deeming rules in 1996. More information on this topic is available in DI C21/2002. If you are still unclear whether a financial asset may be considered unrealisable, or whether the person satisfies the conditions of financial hardship please contact the Income Support Policy Section by emailing [24] [24] [24]NAT Policy Advisings Income Support.
Asset |
What to Verify |
What to Request |
Who to Contact for Information |
Real estate |
|
Copies of documents relating to purchase or sale. Rates notices for the relevant period. If gifting occurred, the date of effect of the transfer and to whom the real estate was gifted. |
Initially the pensioner should be able to provide the documents, but better to go direct to the Australian Valuation Office as they can also provide the value of the real estate on the departmental review dates. Check with your supervisor for the dates the Department reviewed property values during the overpayment period and only use these dates when calculating. The AVO can also supply copies of titles if required. For example, this may be required where a denunciation is made that a person owns additional real estate. If access is provided in your State Office Information may also be supplied quickly through an information broker on the internet. |
Financial Institutions |
|
Investment certificates, statements, or account books. A statement of account from the financial institution, including all the details listed in What to Verify. |
The pensioner may have all the certificates/ statements you require. If not contact the financial institution(s) and request a full statement of the required details or have them complete a departmental financial institution questionnaire. |
Public Shares |
|
Share certificates. Schedule from the company. Stock Broker records. |
Pensioner should be able to supply the certificates. The company will provide a print out of the share records for the pensioner(s). Stock Broker for his/her records. Financial Review can provide share values. For historical record of share values contact the Investment Database Unit. |
Managed Investments – including Approved Deposit Funds |
|
Investment certificates. A statement of the details of investment for overpayment period as listed in What to Verify. |
Pensioner should have some of the certificates. The Fund Manager can provide copies of the certificates or a statement of the investment. The Investment Database Unit or your supervisor should be able to provide a historical record of departmental review dates for managed investments and the asset amounts for those dates. |
Life Insurance Policies |
|
Copy of certificate. Copy of advices to pensioner(s). |
Pensioner can provide copies of certificates. Paying company can provide details of policy for historical and current assessment. |
Partnership |
|
Request personal and if available (or prepared) signed and dated partnership tax returns and financial statements, including the balance sheet. |
Initially contact the pensioners and/or their accountant. AVO can provide historical information on any properties that require valuation. Other asset values are to be taken off the balance sheets. |
Private Company (private shares) |
Cases identified relating to private companies or family trusts should be immediately forwarded to the Trusts and Companies Team, Income Support Branch, National Office. If a claimant is involved in a private trust or company then the claim is processed by the Trusts and Companies Review Team. |
||
Sole Trader |
|
Signed and dated personal tax returns, including balance sheet. A statement from the pensioner(s) to verify when the business commenced operating. |
Initially contact the pensioners and/or their accountant. Keep in mind that with a sole trader the assets of the business are their assets. The AVO can provide property valuations. |
Private Trusts |
Cases identified relating to private companies or private trusts including family trusts should be immediately forwarded to the Trusts and Companies Team, Income Support Branch, National Office. If a claimant is involved in a private trust or company then the claim is processed by the Trusts and Companies Review Team. |
||
Debts owed to the Pensioner |
|
Pensioner's records. If there is a formal agreement (such as a mortgage loan through a solicitor), obtain a copy of the agreement. If loan is to a company etc, then action as for private companies above, i.e. forward case to the Trust and Companies team in National Office. |
Pensioner(s) should be able to provide any documentation if there is a formal agreement. If an informal arrangement then a statutory declaration should be obtained from the pensioner. In some cases a supporting statement from the debtor may be required. In addition copies of bank statements or a passbook may also indicate a withdrawal or transfer of funds. |
Overseas Assets |
|
Copies of the original documents of sale/purchase. Copies of any documents showing increases/reductions in amounts held in financial institutions or other investment types. |
In the first instance the pensioner. Tasmanian State Office can help you with the investigation of these cases as they handle the reviews of overseas pensions. If the asset is shares you may be able to get values through your State or local library by accessing overseas financial newspapers. The IDU can assist. |
Vehicles |
|
Original purchase/sale documents. Details of any amounts owing. |
The pensioners may be able to provide all the details, including documentation. If not, contact the seller, finance company, bank, etc, if purchased with a loan. The AVO may value vehicles at points in time if required. |
Other assets |
|
Documents of purchase. Details of any loans to make purchase. In whose name the asset is held. |
If the pensioners cannot supply the documents required then go to the source of the purchase (i.e. the seller). Collectibles can be valued historically by a recognised auction house or collector (found in phone book or referred to by the auction house). Road Traffic Authorities can value taxi licences. Jewellers should be able to provide values on collections of jewellery. The AVO commonly values property, including taxi plates and licences and commercial leaseholds. |
With Assets overpayments it is important to remember to request details as at departmental review dates. For instance for properties, the initial value should be requested for the date of grant of service pension or the acquisition of the property, whichever is the later, and subsequent reviews of the asset value should be requested for the date the Department normally reviews properties, i.e. June each year. The same applies for managed investments and shares in March and September.
However, for private companies and tax return assessments, the first payday in the financial year is the date to be used for review.
Change |
What to Verify |
What to Request |
Who to Contact for Information |
A defacto relationship commences |
|
Statutory Declarations and supporting statements from the pensioner(s) and the partner. Income and asset form to be completed (A Statement of Circumstances Form D2589). |
The pensioner and their new partner should present for interview at the counter. If interview is not possible, mail the request to them. If a questionnaire regarding these relationships is available in your State have them complete that as well. You could also check the medical and hospital files as these may give a hint as to the length of time the veteran has been in the defacto relationship, and the name of the defacto. Centrelink may be able to help if the pensioner is in payment at Centrelink. You may also have to get supporting statements from a third party such as a solicitor, friend or family member. |
Defacto couple separates |
|
Statutory declarations and supporting statements from pensioner and partner. Any documents that state the division of assets, if this occurred. |
The pensioner and their ex-partner should provide all documents. You may have to get supporting statements from a third party such as a solicitor, friend or family member. |
Pensioner marries |
|
A copy of the marriage certificate. An income/assets statement from the pensioner and their partner (A Statement of Circumstances Form D2589). |
The pensioner and their new partner are required to provide all the details requested. If some problem verifying the date of marriage then contact the Registrar of Births Deaths and Marriages for a copy of the marriage certificate. |
Pensioner divorces |
|
A copy of the Decree Absolute. Copy of any papers relating to property settlement. Copy of any Family Court order relating to payment of spousal maintenance. An income/assets review form to be completed with current circumstances (if not done already). |
Pensioner should have copies of these papers. The Supreme Court keeps copies of pre-1975 property settlement papers, or contact the pensioner's solicitor. Since 1975 property settlements have been handled by the Family Court of Australia. The Registrar of Births Deaths and Marriages can provide the date of the Decree Absolute. |
Separated couple reconcile |
|
Statements from client and partner. Income/asset review forms to be completed. |
The client and the reconciled partner will provide the statements required, but if you require further verification then supporting statements from friends, family or some other third party may be requested. |
A person who wilfully makes a false statement in a statutory declaration under the Statutory Declarations Act 1959 as amended is guilty of an offence against that Act. The punishment for which is a fine not exceeding $200 or imprisonment for a term not exceeding six months, or both, if the offence is prosecuted summarily, or imprisonment for a term not exceeding four years if the offence is prosecuted upon indictment.
A statutory declaration under the Statutory Declarations Act 1959 as amended may be made only before a Chief, Police, Resident or Special Magistrate, Stipendiary Magistrate or any Magistrate in respect of whose office an annual salary is payable, a Justice of the Peace; a person authorised under any law in force in Australia or its Territories to take affidavits, a person appointed under the Statutory Declarations Act 1959 as amended or under a State Act to be a Commissioner for Declarations, a person appointed as a Commissioner for Declarations under the Statutory Declarations Act 1911, or under that Act as amended, and holding office immediately before the commencement of the Statutory Declarations Act 1959, a Notary Public, a person before whom a statutory declaration may be made under the law of the State in which a declaration is made, or a person appointed to hold, or act in, the office in a country or place outside Australia of Australian Consul-General, Consul, Vice-Consul, Trade Commissioner, Consular Agent, Ambassador, High Commissioner, Minister, Head of Mission, Commissioner, Charge d'Affaires, or Counsellor, Secretary or Attache at an Embassy, High Commissioner's office, Legation or other post.
Guidelines for investigating relationship status (including defacto). These are contained in section 11A [15] VEA.
VEA ? [27]
To verify the above you may need to obtain:
In certain cases it may be useful to seek address histories from various State or Australian Government bodies including State traffic authorities, financial institutions, Centrelink, ATO, Australian Electoral Commission etc. These cases may include:
Type |
What to Verify |
What to Request |
Who to Contact for Information |
Child/student ceases to be dependent - due to pensioner losing care, custody and control |
|
Copies of any formal custody agreements. Copies of any maintenance agreements. Supporting statements from the pensioner and the new custodian of the child. A Centrelink check if separated partner has custody and is not in payment with DVA. |
The pensioner will provide a statement and may have supporting documents if it is a formal custody agreement. The Family Law Court can provide copies of formal custody agreements. The Child Support Agency can provide details of custody and maintenance paid. Verification can also be obtained from a separated partner, the new custodian, or the pensioner's solicitor. State Children's Courts may be able to provide details for children not considered 'children of marriage'. |
Child/student ceases to be dependent - due to ceasing full time education or entering a non-approved course. |
|
Statement from pensioner. Verification from school or educational institute regarding date ceased and if non-approved course, the type of course. Verification from Centrelink of claim or grant of benefit or pension, or no record of such. |
Pensioner should have all the details, but it is advisable to contact the education facility to verify dates and course details. |
Child/student ceases to be dependent - due to commencing employment |
|
Statement from pensioner. Statement from employer. |
The pensioner should be able to provide the dates education ceased and employment commenced. If not contact the school. The employer can confirm the start date. |
Pensioner ceases to contribute support to the child/student |
|
Statement from pensioner. Statement from child's custodian, other parent, solicitor. |
A Court Order may have been issued and if so, request a copy. The pensioner may be able to provide details from their point of view only, so get verification from a third party as listed in the previous column. |
Student Child becomes a Prescribed Student Child |
|
Statement from pensioner. Verification from paying authority. |
The pensioner's statement should tell you which authority is paying the student, i.e. Austudy, Abstudy, VCES, etc. Contact the authority for verification of amounts of allowance and dates paid. |
Student Child's income exceeds the allowable limit |
|
Statement from pensioner, or accountant. Copy of child's signed and dated Income Tax Return if required. |
The pensioner will be able to provide at least general details, but an accountant is more accurate. If this avenue fails you can contact the ATO for taxable income details for the period. |
A section 128 [15] VEA notice may be used to obtain information from individuals, employers, State bodies such as schools, and Australian Government bodies that do not have secrecy provisions. Personal information cannot be obtained from Centrelink under section 128 [15] VEA because Centrelink must comply with their secrecy provisions when disclosing information. However, information may be obtained from Centrelink on the basis of a Centrelink Disclosure Certificate for DVA. The Certificate of Disclosure is very specific. Only the information specified in the Certificate of Disclosure may be disclosed. There is no discretion to release information not specified.
Similarly, information cannot be obtained from the ATO under section 128 [15] VEA because the ATO has its own secrecy provision. DVA may still request the ATO to provide information, but DVA must convince the ATO that the request satisfies the requirements of their secrecy provisions. A request for information must be made under paragraph 16(4)(d) of the Income Tax Assessment Act 1936.
When requesting information from the ATO the letter must set out that:
The Repatriation Commission is a body corporate that continues to exist under section 179 [15] of the Veterans' Entitlements Act 1986 (VEA). The functions of the Repatriation Commission are set out in section 180 [15] of the VEA and include “the general administration of this Act”.
The Repatriation Commission makes a wide range of decisions that impact on the granting of pensions, allowances and other benefits to veterans. It is assisted in the performance of its functions by Australian Public Service employees of the Department of Veterans' Affairs pursuant to 196 of the VEA. These employees (including the author of this letter) exercise delegated powers on behalf of the Repatriation Commission under section 213 [15] of the VEA.
A number of other Australian Government agencies must comply with their own secrecy provisions, and therefore, are unable to respond to a request for information under section 128 [15] VEA. A list of the most relevant secrecy provisions are contained in Schedule 3 of the Freedom of Information Act 1982. The effect of these provisions, is that DVA has no right to demand the exercise of the discretion by the agency subject to the secrecy provisions to release the required information. The normal process is to refer to the secrecy provision itself and frame a request having regard to those requirements.
When investigating any overpayment involving a dependent child, be aware that if the pensioner has a child over the age of 16 who is on Youth Allowance, and no children under 16 year of age, DVA pays rent assistance as part of their service pension or income support supplement.
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Also, if a pensioner with a saved child is eligible for rent assistance, the rate of rent assistance payable may be increased because of that child.
An additional amount of Remote Area Allowance (RAA) may also be paid to a service pension or Income Support Supplement recipient who has a Family Tax Benefit Child (FTB).
The number of children also affects the ordinary/adjusted income free area for service pension and income support supplement.
Student children who receive an education allowance are not eligible for the Dependent Child Add On rate, but the pensioners can receive an income deduction of $24.00 per fortnight, which is used when calculating any earnings credit. The Earnings Credit Scheme was abolished on 20 March 1997.For more information on the Earnings Credit Scheme refer to this manual's Section 6.5.7 Earnings Credit.
Responsibility for administering Dependent Child Add-on Allowance was transferred to Centrelink on 1 January 1998. To ensure that no pensioner was financially disadvantaged from the transfer, savings provisions were applied to certain categories of cases. DIs C16/1998 and C56/2002 cover the procedures for saved cases.
DI B04/94 refers to a problem in the DVA computer system that allowed children over the age of 18 years who are in receipt of an allowance under the prescribed education scheme, and are not in receipt of a social security Child Disability Allowance, to retain the Guardians Allowance (GA) and the income deduction. The only children over 18 years of age and in receipt of a prescribed allowance that remained eligible for the GA and income deduction after 1 January 1990 were those who were over 18 and already in receipt at that time.
Policy Library – Effect of Children on Assessment of Income Support Payments
P9/C4/S3 [31]
Type | What to Verify | What to Request | Who to Contact for Information |
Pensioner ceases paying rent |
| A statement from the pensioner, and an income and assets form. Verification of date rent ceased being paid. | The landlord or real estate agent will be able to provide the date the rent ceased being paid, and if necessary a forwarding address. |
Pensioner pays rent at a lower rate |
| A statement regarding the new rental amount. Copies of rent receipts. If moved, an income/assets review may be in order. | A copy of the new lease agreement or rent receipts can be obtained from the pensioner, landlord or real estate agent. |
Pensioner commences paying rent to a Government Authority |
| Statement of new rental amount and verification of start date. | The Government Authority should be contacted and will be able to provide all details. |
Pensioner leaves Australia |
| Statement from pensioner(s). Verification in the form of travel documents, passport etc. | If pensioner is overseas, then ask a relative to verify dates, or contact the Department of Immigration. |
Refer to DI C25/2000 Simplified International Payments for changes to the eligibility for certain allowances while a pensioner is overseas. The new rules apply to all pensioners who leave Australia from 20 September 2000 onwards. Those who depart from Australia prior to 20 September 2000 are assessed under the old rules regardless of when DVA was notified.
The guidelines for recovering Rent Assistance where notification was received through a change of address are contained in DI C10/99. This DI amends DI B24/93 which stated that an overpayment of Rent Assistance could not be raised where a pensioner(s) had advised of a change of address within the specified time, but DVA failed to adequately follow up the details of the change. This broad directive that no overpayment is to be raised where a change of address has been provided, regardless of the circumstances, is no longer appropriate.
Instead, when determining whether a recipient of rent assistance has complied with notification requirements the delegate must:
For example, if a recipient of RA notifies of a change of address, and the Department fails to ask the relevant questions, or undertakes follow-up action, then some responsibility rests with the Department. The extent of that responsibility and its impact on the consequent overpayment would depend on a number of other factors and would differ in each case.
Rent Assistance may be paid to granny flat dwellers who pay an entry contribution less than their 'extra allowable limit' to establish a right to accommodation and who pay rent as defined in the VEA. From 22 August 1990 the establishment of a granny flat interest in a private residence is to be treated in the same way as an entry contribution to a retirement village. DI B13/92 refers. The information on eligibility for rent assistance if an entry contribution to a retirement village has been made is contained in DI B44/88.
Change |
What to Verify |
What to Request |
Who to Contact for Information |
Pensioner leaves Australia |
|
Statement from pensioner. Verification in the form of travel documents/ passports or similar documents. |
If pensioner is overseas contact a relative, the travel agent (if known), or the Department of Immigration. |
Pensioner is absent from the remote area for longer than 8 weeks |
|
Statement from pensioner. Verification in the form of statements from neighbours, landlords, agents (if on holiday), family members. |
If the pensioner is still absent then contact neighbours or family members, which may lead to the names of travel agents, employers, landlords who can verify the dates. |
Pensioner ceases to reside in a remote area |
|
Statement from pensioner. Verification from a third party. |
If sold remote property, then verification can be gained from the selling agent. If rented property, then contact agent for verification. |
Child in respect of whom RAA is paid leaves Australia |
|
Statement from child and/or pensioner. Verification in the form of travel documents/ passports or similar documents. |
If pensioner is overseas contact a relative, the travel agent (if known), or the Department of Immigration. |
Dependent child ceases to be dependent |
|
Statements from the pensioner and verification from a third party. If custody has changed then a statement from the new custodian or a copy of the court order is warranted. |
If child has left full time education then the school can verify the date the child ceased studies. The new custodian can provide the date the child ceased being dependent on the pensioner. Family Law Courts can provide formal custody agreements. |
Person's partner is granted RAA from Centrelink or DVA |
|
Statement from pensioner and/or their partner. Verification from granting department. |
Pensioner and/or their partner. Verification from Centrelink or DVA. |
Remote Area Allowance (RAA) was introduced in 1984 to help offset the higher than normal costs incurred in remote areas. It is a component of the income support pension. RAA is not currently indexed.
Barred dual payments |
What to verify |
What to Request |
Who to Contact for Information |
DVA service pension and social security pensions or benefits * or ISS and social security pensions or benefits |
|
Verification of date of second grant of pension. |
Centrelink to either arrange a cancellation of their payment (if pensioner claimed for DVA pension after being in payment with Centrelink), or to arrange a cancellation of DVA pension if pensioner is transferring to Centrelink. *** |
Service pension as a partner and war widow's / widower's pension (WWP) |
|
Request pension file in which the qualification as a partner is under. |
May need to establish service details for a person in order to determine if the person had qualifying service in their own right. |
*Part payment of pensions can be received for cases paid under the DSS Working Rule B and AMS pensions if paid prior to 16 March 1973.
**Prior to the Social Security Act re-write of 1 July 1991, the bar was contained in the Repatriation Act 1920 and then the VEA only. This in effect meant that regardless of who paid the later pension, DVA had to recover the overpayment.
***War widows/widowers are excluded from receiving a social security pension or benefit due to multiple exclusion clauses contained within the SSA. A war widow/widower may however, be eligible for Youth Allowance or Austudy payments if not in receipt of income support supplement.
Prior to 20 September 2002, ISS was payable to eligible war widows/widowers at a maximum ceiling (frozen) rate of $124.90, unless the war widow/widower was in receipt of income support immediately prior to 1 November 1986 and had been in receipt of income support continuously since that date.
From 20 September 2002, the ceiling rate ISS/SP is to be indexed every March and September in line with percentage increases in the maximum rate service pension. For indexed rates post 20 September 2002 refer to the pension rates charts contained within the CLIK Reference Library.
Type | What to Verify | What to Request | Who to Contact for Information |
Disability Compensation Payment retrospective reduction. |
| The medical and pension files. | Check pension files to see if arrears are being held for SP or from the original DCP grant/increase. This may also be done by accessing the Arrears Enquiry Folder located under the Payabilities Tab in VIEW. If DP reduced due to veteran losing eligibility due to working then contact employer for dates employment commenced, although this should be on file, and check if SP in payment as this may affect SP rate. |
War widow's /widower's pension (WWP) from two different veterans. |
| Request the pension and medical files for both veterans that qualified the pensioner as a war widow/widower. | The Department will have all records in these cases. Contact the war widow /widower to establish which file will be the number under which they are paid if eligible for WWP under two different file numbers (i.e. two different veterans). |
Disability Compensation Payment paid under section 70 VEA and compensation paid for the same incapacity. (Also refer to Part II, Division 5A, Section 30A VEA to section 30P VEA) NB - Includes dual payment of WWP and 3rd party compensation in respect of death of veteran. |
| Copy of the documents relating to compensation payment, which will state the amounts and methods of payment. The dates and amounts of any variations in amounts. | Department of Defence if the compensation has been paid by them. If a third party, contact the solicitor or paying authority, such as an insurance firm for the documents. |
DVA single/double orphan's pension |
| Copies of advice of grant of assistance and dates and amounts of any increases to payment. | Departmental files may have the information, if not then contact the custodian, or paying authority (e.g. VCES, Austudy). |
Payments under the law of a State or foreign country (e.g. EATS & Composite cases) paid for the same incapacity |
| Copy of the documents relating to compensation payment, which will state the amounts and methods of payment. The dates and amounts of any increases in amounts. | In EATS or composite cases then request DVA files to gain access to the records of payment. Contact overseas pensions clerk who can give the contact for the overseas authority if no record is on DVA files. |
Recreation Transport Allowance* |
| Details of participation in the Vehicle Assistance Scheme. Details of admission to care. Details of any contributions being paid by the pensioner. | The medical file may have the details you require. If not then contact the institution that admitted the pensioner. |
Attendant Allowance* |
| Details of admission and discharge. Details of any contributions being paid by the pensioner. Details of grant of carer's pension. | The medical and/or the hospital files may have the details of admissions/ discharges. If not, contact the institution that admitted the veteran. DVA grant of carer's pension will be on the pension file. For a social security grant of carer's pension contact Centrelink for the date and amount of grant. |
Loss of Earnings Allowance |
| Details of SP/DCP grant. | The pension or medical file will have all details required to investigate this case type. |
The date of death must be verified with the Bereavement Unit before a cancellation of pension can be effected. The Department is usually advised of a pensioner's death, either in writing or verbally, by relatives or a representative (e.g. Ex-Service Organisations, Solicitors, Public Trustee). To reduce the need for further contact by DVA during the bereavement period, the examiner should obtain as much of the following information as possible about the deceased, when the death is first notified:
The examiner should check with their supervisor or Bereavement Unit on the availability of a standard death notification form for their State, and the preferred method of sending this form to the processing area. Bereavement Units have been established in the majority of State Offices to provide a centralised area for bereavement-related processing and any resulting enquiries. Once a death notification form is received by a Bereavement Unit, the date of death is recorded on VIEW (tab: Record Maintenance, folder: Death Recording). The case is then processed through the Death Processing System (DPS). DPS will automatically process a case where the deceased had a debt recorded. A daily report is then produced which is given to the OMU. The report is a debt management and recovery report with the title Pension Cancelled Death – Daily Summary Report. The code for this report is dr_pcd_zlt2200_*. Any case that DPS is unable to automatically process will be identified on the DPS Processing Report and will require manual processing through PIPS. Overpayment units must action bereavement unit reports as a priority. The overpayment of pension can occur in the following ways:
Where the surviving partner had been overpaid pension because of a failure to notify of a change in circumstances that will reduce his/her rate of pension, the overpayment should be investigated in the same manner as discussed previously in the chapter. If the deceased and/or partner had been overpaid prior to the death of the pensioner, then the overpayment to the deceased is a debt against his/her estate. If the estate has already been settled prior to the discovery and/or advice of the debt to the executor, then there is a recoverable overpayment which is to be written off under section 206 [15] VEA (refer to this Manual's Section 7.16 Write-Off for write-off policy). Where a debt has been raised against a pensioner, and the debtor dies leaving no estate, and there is no likelihood of a family member making, a voluntary repayment the debt may be waived under extreme or unusual circumstances (refer to this manual's Section 7.18 Waiver). |
5.9.1.1 — The most common situations that require investigation and which may lead to prosecution are:
5.9.1.2 — False statements are generally self-evident when comparing written documents to the actual facts of a case. Determining whether a failure to advise of a change in circumstances is deliberate may be more difficult. Such a decision should be made by looking at context, the history of previous advices from the client, the likelihood of them knowing a change had occurred and that it should be reported to DVA, etc.
The Commission approved Selection Criteria for Referral of Overpayment Cases for Investigation Leading to Possible Prosecution Action should be consulted to guide decision making. A summary of the selection criteria titled Summary of reasons to consider when submitting a case for possible prosecution can be found at:
http://sharepoint/servingourcustomers/incomesupport/Pages/DebtManagement.aspx#prosecution [40]
Experience and judgement should be used, but when in doubt, refer the matter to the Business Compliance Section for further investigation.
5.9.2.1 — The following factors should be considered in determining whether it is likely that fraud has occurred. If the answer to any of the following questions is 'yes', the case must be considered to be potentially fraudulent:
5.9.2.2 — A basic guide for determining whether fraud exists is to evaluate the following questions:
5.10.1.1 — If deceit or attempted deceit has occurred, there is no question that further action is warranted. However, if benefits or money to which the person had no lawful entitlement were received, but there is no evidence of a deliberate attempt to mislead, then a decision to take no further action beyond overpayment recovery may be warranted. There may also be situations where a decision is made not to recover the overpayment. For example, extreme or unusual circumstances may exist, or the overpayment may be uneconomical to recover. Be aware that where any doubt exists, further investigation should be undertaken to determine whether prosecution is warranted.
5.10.1.2 — This section provides guidelines on determining which cases should be investigated for possible prosecution action. These guidelines should be used to assist in making decisions and ensuring greater consistency in the number and type of cases being referred to the Commonwealth Director of Public Prosecutions (DPP) for possible prosecution. They should be used in conjunction with the Prosecution Policy of the Commonwealth. The Prosecution Policy of the Commonwealth may be obtained from the DPP website.
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5.10.2.1 — All cases that are 'serious' in nature are to be investigated. These include:
Note:This list is not all-inclusive. Cases may not fit neatly into the suggested categories. Judgement should be used in such cases. However, if after conducting the investigation and you are still in doubt, contact your local DPP contact officer.
5.10.2.2 — While the amount allegedly defrauded may be an influencing factor in whether or not to investigate, it should not be determinative. Cases meeting any of the following criteria should be investigated:
Links
[1] https://clik.dva.gov.au/user/login?destination=comment/reply/24209%23comment-form
[2] https://clik.dva.gov.au/user/login?destination=comment/reply/24309%23comment-form
[3] https://clik.dva.gov.au/user/login?destination=comment/reply/24386%23comment-form
[4] clik://LEGIS/VEA/section 30P
[5] clik://LEGIS/VEA/section 79
[6] https://clik.dva.gov.au/user/login?destination=comment/reply/24220%23comment-form
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[15] https://clik.dva.gov.au/service-eligibility-assistant-updates/all-determinations-order-date-signed-oldest-most-recent/determinations-under-vea
[16] https://clik.dva.gov.au/user/login?destination=comment/reply/24284%23comment-form
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[22] clik://LEGIS/VEA/section 128
[23] https://clik.dva.gov.au/user/login?destination=comment/reply/24265%23comment-form
[24] mailto:
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[27] https://clik.dva.gov.au/book/export/html/24209#tgt-csref_manual_ftn10
[28] https://clik.dva.gov.au/book/export/html/24209#ref-csref_manual_ftn10
[29] https://clik.dva.gov.au/user/login?destination=comment/reply/24181%23comment-form
[30] https://clik.dva.gov.au/book/export/html/24209#tgt-csref_manual_ftn11
[31] https://clik.dva.gov.au/service-eligibility-assistant-0
[32] https://clik.dva.gov.au/book/export/html/24209#ref-csref_manual_ftn11
[33] https://clik.dva.gov.au/user/login?destination=comment/reply/24094%23comment-form
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[40] http://sharepoint/servingourcustomers/incomesupport/Pages/DebtManagement.aspx#prosecution
[41] https://clik.dva.gov.au/user/login?destination=comment/reply/24399%23comment-form
[42] https://clik.dva.gov.au/user/login?destination=comment/reply/24225%23comment-form
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[44] https://clik.dva.gov.au/book/export/html/24209#tgt-csref_manual_ftn12
[45] http://www.cdpp.gov.au/Prosecutions/Policy/
[46] https://clik.dva.gov.au/book/export/html/24209#ref-csref_manual_ftn12
[47] https://clik.dva.gov.au/user/login?destination=comment/reply/24249%23comment-form