|
|
|
|
|
This part provides detailed information about the rights of claimants and employers to have decisions reviewed under the PPLAct.
Other than decisions made by PPL agency representatives (1.1.P.160) and certain income test determinations, decisions may be reviewed internally. Centrelink may authorise officers to be AROs (1.1.A.140) (section 271) to undertake internal reviews of officer's decisions.
An income test determination may not be changed or reviewed if the person did not knowingly make a false or misleading representation or provide false or misleading information or documents in relation to the income determination (section 273).
The SSAT may review decisions that were made personally by PPL agency representatives and decisions that have been reviewed internally.
Centrelink, or people whose interests are affected by a decision of the SSAT may apply to the AAT for review of the SSAT's decision. Employers may not seek AAT review of SSAT decisions, although they can appeal on a question of law to the Federal Court.
A person, including a primary, secondary or tertiary claimant, or a DAPP claimant, whose interests are affected by a claimant decision (1.1.C.110) may seek review of that decision, provided the decision is not one of those decisions listed in subsection 206(1), (i.e. decisions about payment of instalments by employer, employer determinations, compliance or decisions under the PPL Rules or regulations if the decisions are excluded from review under the rules or regulations). An employer cannot make an application for review of a claimant decision in relation to PLP.
If a claim is not effective, the claimant can seek review only of the decision that the claim is not effective. The claimant also may claim again for PLP or DAPP.
Employers may seek review only of decisions either that they are to pay an employee their instalments of PLP (section 101), (i.e. an employer determination decision (1.1.E.70)) or relating to PPL funding amounts (section 75), (i.e. an employer funding amount decision (1.1.E.80)). An employer cannot apply for internal review of an employer determination decision that was made by a PPL agency representative. (The SSAT may review an employer determination decision made by a PPL agency representative). A claimant may not seek review of employer determination decisions or of funding amount decisions.
There are no provisions for an employer to seek a review of a debt raising or debt recovery decision.
An ARO may review an original decision where the review is claimant or employer initiated (section 205).
Exception: An ARO may not review a claimant decision made by a PPL agency representative.
Having reviewed the original decision, an ARO may affirm or vary the decision or set aside the decision and substitute a new decision.
Centrelink may review a decision at its own initiation other than an employer determination decision (6.1.1) made under the PPL scheme, whether or not a person has applied for review of a decision, and whether or not an application has been made to the SSAT or the AAT for review of the decision, if satisfied there is sufficient reason to review the decision.
If a decision has been affirmed, varied or set aside by an ARO, a person affected by the decision may apply to the SSAT for review of the decision as affirmed, varied or substituted.
If the SSAT has affirmed, varied or set aside and substituted a claimant decision, a person (but not the employer) affected by the decision, including Centrelink, may apply to the AAT for review of the decision as affirmed, varied, or substituted.
Act reference: PPLAct section 75 Payment of PPL funding amounts, section 101 Making employer determinations, section 203 Internal review-own initiative review by Secretary, section 205 Internal review-review following application, section 271 Authorised review officers, section 273 Certain income test determinations not to be changed on review
If Centrelink, SSAT or AAT (the review body) is reviewing a decision and is satisfied that an event would have happened had the original decision not been made, then that event can be deemed to have happened for the purposes of the review. Similarly, if an event would not have happened had the original decision not been made, then that event can be deemed to have not happened for the purposes of the review (section 272).
Example: A person made a primary claim pre-birth, or within the 28 days immediately following birth, for which Centrelink determined the claimant was not eligible and, because of this, the claimant did not verify the child's birth within the required time. If, on review, the SSAT decides that the individual is eligible it may set the decision aside, remitting it back to Centrelink. The intention is to allow Centrelink to be able to seek verification at that time of the birth but be able to treat the claim as though the verification had been provided at a time which allows the claimant's nominated start date to determine the start of their PPL period. Centrelink should be satisfied that verification would have been provided within the required time but for the decision that the claimant was not eligible for PLP.
Similarly, if a person returned to work because Centrelink determined that PLP or DAPP was not payable to him or her, this event will not necessarily disqualify the person from PLP or DAPP. If, on review, Centrelink decides that the claimant was payable and Centrelink was also satisfied that PLP or DAPP would have been payable from the claimant's nominated start date, but for the decision that PLP or DAPP was not payable to the claimant, it would be open to Centrelink to deem that the claimant had not returned to work and PLP or DAPP would be payable despite the person having returned to work in the PPL period.
Act reference: PPLAct section 272 Review body may determine events to have happened, or not to have happened
Where a review is being conducted by an officer, the SSAT or the AAT (the review body) for the purposes of the PPL scheme, and the review involves a review of a decision that:
then the review body cannot vary the income determination in such a way that the person does not satisfy the income test or set aside the income determination and substitute it with a new determination that the person did not satisfy the income test.
The intention of this provision is that once a person has provided their ATI and Centrelink has decided that PLP or DAPP is payable, this decision should not be overturned should it later be found that the person's ATI exceeds the income limit. Paragraph 273(1)(d) specifies that this provision DOES NOT APPLY where a person provides false or misleading information/representation in relation to the income test (section 273).
This part contains the following chapters:
8.1 Internal Review of Decisions
8.2 SSAT Review of Claimant & Employer Decisions
8.3 AAT Review of Claimant Decisions
_______________________________________________________
Last reviewed: 2 October 2012
