Following the determination of the claim for a mental health condition.
Section 45SB VEA and section 6 Veterans’ Entitlements (Veteran Payment) Instrument 2018.
Following the determination of a liability claim for a mental health condition, Veteran Payment will continue for a period of 42 days (six weeks) or until other benefits are granted such as incapacity payments or other means of income support. In certain circumstances, the payment may be extended beyond this period. Delegates are required to assist the transition to another form of financial support, such as an income support payment, or return to paid employment through a vocational rehabilitation plan. This is to ensure that Veteran Payment is extended beyond the 42 day period and is not ceased until the transition to another form of income support is complete.
If the claim for a mental health condition has not been accepted, DVA will actively assist to transition the current or former member of the ADF to another form of financial support (such as an income support payment from another Department such as the Department of Human Services or support from the Commonwealth Superannuation Corporation), or to return to work. Veteran payment should not be ceased until the transition has occurred, even if the 42 day period has expired.
Transition to other forms of support or employment should begin as soon as possible after a determinationof the person's last mental health condition claimed. It is DVA’s responsibility to ensure that Veteran Payment continues until the transition to other income support or employment is complete.
Multiple liability claims for a mental health condition(s).
Sub-sections 6(2) & 6(3) of the Veterans’ Entitlements (Veteran Payment) Instrument 2018.
If the current or former member of the ADF has made liability claims for a mental health condition(s), including under more than one Act, Veteran Payment eligibility will continue until 42 days following the date of determination of the last claim to be determined. This also applies if separate claims (whether under the same or different Acts, for different mental health conditions) have been lodged on different dates. Note that Veteran Payment should not be ceased until the veteran is transitionsed to another payment or the veteran returns to paid employment.
Example: Judy has made a claim under the MRCA for PTSD and anxiety on 11 June 2018. She meets the eligibility criteria for Veteran Payment and payment begins on the 14 June 2018. On 8 July 2018, Judy makes a claim under the DRCA for depression. The claim for depression is determined on 5 August, but as the claim for PTSD and anxiety are still outstanding, the 42 day period is not triggered. The claims for PTSD and anxiety are determined on 30 August. As there are no more outstanding claims for mental health conditions, this date is considered to be the date of determination of the last claim, and will trigger the start of the 42 day post-determination payment period.
Section 17 of the instrument provides for extension of veteran payment in special circumstances:
The Commission may extend the period of payment for a veteran payment to a person if the Commission is satisfied that there are special circumstances.
The intent of this provision in the instrument is that no veteran is left vulnerable.
The Veteran Payment can continue to be paid for 42 days following the determination of the final liability claim for a mental health condition. This provision provides for an extension of the payment period in special circumstances. This is to ensure that a current or former ADF member receiving Veteran Payment (Veteran Payment recipient) does not lose their financial support before being transitioned to another payment (such as incapacity payments) or returning to work. Veteran Payment recipients are not expected to initiate the extension process, rather it is DVA’s responsibility to ensure that the payment continues until alternative financial support arrangements are in place.
Special circumstances include but are not limited to:
Where the claim for a mental health condition is accepted:
If incapacity payments are yet to be determined, or there is evidence that the incapacity payments will not be determined, within the 42 day payment period, then Veteran Payment may be extended.
If incapacity payments are determined not to be payable, then Veteran Payment may be extended beyond the 42 day period to enable the Veteran Payment recipient to transition to another Australian Government income support payment.
Where the claim for the mental health condition is not accepted:
If the claim for a mental health condition has been rejected and there are no more outstanding claims for a mental health condition, then Veteran Payment may be extended to ensure the Veteran Payment recipient has continuous financial support while they are transitioning to another Australian Government income support payment or returning to work.
If the Veteran Payment recipient is on a return to work rehabilitation plan, Veteran Payment may be extended while they successfully complete their return to work rehabilitation plan and either return to work or access other forms of financial support.
Veteran Payment may continue throughout the appeal process. This extension can include the period after finalisation of the appeal while the member is transitioned onto another form of financial support.
This is not an exhaustive list of special circumstances. For other circumstances please contact the Eligibility and Payments Policy Branch for assistance.
Once a decision has been made that special circumstances exist, a file note must be made on the veteran’s record detailing the reason for the extension and its duration.
Termination of Special Circumstances.
Where special circumstances no longer exist then the Veteran Payment will cease. This should be on transition to another form of income support or on return to work and should documented and reviewed periodically at least on a quarterly basis.
Note: This policy was approved by the Repatriation Commission on 23 August 2018 Decision CM7409.
If incapacity payments are determined to be payable and the veteran put into regular payment, Veteran Payment is to be cancelled from the first regular incapacity payment.
For further details about restrictions on dual payments, please see: Payment [1].
Any amount of Veteran Payment paid to a current or former member of the ADF for the same period as incapacity payments are received will be recovered from the incapacity payment arears amount only.
If the current or former member has outstanding debts to the Department, then the existing debts are recovered from incapacity payment arrears before any Veteran Payment amount.
If: | Then: |
---|---|
A person was receiving Veteran Payment and their claim(s) for a mental health condition were rejected. | Veteran Payment is not recovered. |
A person was receiving Veteran Payment before their claim for incapacity payments was accepted and no debts exist. | Veteran Payment will be recovered for any overlapping period in which incapacity payment is paid, and Veteran Payment has been paid. The recovery amount will not exceed the amount of incapacity payment arrears. |
A person was receiving Veteran Payment before their claim for incapacity payments was accepted and put into paymentand the person has outstanding debts. | The outstanding debts will be recovered first. Remaining incapacity payment arrears will be used to recover Veteran Payment for any overlapping period in which incapacity payment is paid, and Veteran Payment has been paid (this may lead to Veteran Payment only being partially recovered or not at all). The maximum amount of Veteran Payment to be recovered is the remaining amount of incapacity payment arrears available after all other debts have been recovered. |
A person was receiving Veteran Payment and does not progress to incapacity payments. For example:
| Veteran Payment is not recovered. |
A partner of a current or former member of the ADF was receiving Veteran Payment. | Veteran Payment paid to the partner is not recovered. |
Date of effect for cancellation of Veteran Payment
VEA 45SB (7)
Following determination to grant incapacity payments, the date of effect for the cancellation of Veteran Payment will be the day after the action is taken to grant and put the veteran into regular incapacity payment. This will ensure that no additional recovery action is required.
Example: Adam and his partner Georgia have been receiving Veteran Payment since 4 May and Adam’s claim for liability for a mental health condition was accepted by DVA on 25 May. Medical evidence meant that Adam’s incapacity payments were backdated to 10 May.
Action is taken to cancel Adam’s and Georgia’s Veteran Payment on 7 June, with the cancellation taking effect one day later on 8 June. The recoverable amount from incapacity arrears is only Adam’s Veteran Payment from 10 May to 7 June. The remainder of the Veteran Payment, being the amount paid from 4 May (commencement of Veteran Payment) to 9 May (day prior to commencement of incapacity eligibility,) is not recovered.
| 4 May | 9 May | 10 May | 25 May | 7 June | 8 June |
Veteran payment | y | y | y | y | y |
|
Incapacity Payments |
|
| y | y | y | y |
Recoverable Period |
|
| y | y | y |
|
There is no recovery of any amount of Veteran Payment made to the partner from the current or former member’s incapacity payments.
This also applies where both members of a couple are current or former members of the ADF with outstanding liability claims for mental health conditions. In this situation, both members of the couple are eligible for the Veteran Payment in their own right. Incapacity payments made in respect of one individual’s claims will not be used to recover Veteran Payments made to the other member of the couple.
The date of cancellation of a partner’s payment must be the same as the primary person’s date of cancellation.
Example: Action was taken to cancel Adam’s Veteran Payment on 7 June, taking effect of 8 June. As Georgia was receiving Veteran Payment as Adam’s partner, her payment was also cancelled on 7 June (effective 8 June) as she was no longer eligible (partners are required to be the partner of someone receiving Veteran Payment). Georgia’s payments are not a debt and will not be recovered.
Links
[1] https://clik.dva.gov.au/compensation-and-support-policy-library/part-3a-veteran-payment/payment/restrictions-dual-payments