For some time now, there have been discrepancies between the way incorrect claims (220.127.116.11) and inappropriate claims have been handled. The purpose of this topic is to rectify this situation.
A delegate may apply the inappropriate claim provision in the SS(Admin)Act when a person makes an 'initial inappropriate claim' for an income support payment or a supplementary payment (1.1.S.427) under the social security law, or under an Act or program other than under the social security law and then some time later makes a 'later claim' for a different payment under the social security law for which the person was qualified.
If this is the case, the delegate may determine that the person has made a claim for the more appropriate payment under the social security law on the day on which the person made the initial claim (section 15(4)).
In deciding whether it is reasonable to apply this provision, the delegate should consider the following factors:
Act reference: SS(Admin)Act 15(4) Deemed claim-incorrect or inappropriate claims
For the purpose of SS(Admin)Act section 15, a payment other than under the social security law that is considered to be 'similar in character' to a social security payment includes:
If there remains uncertainty as to whether payments are in fact 'similar in character' to each other, a query can be made to the Public Law Branch through the relevant Centrelink Community Segment Team.
Under this provision, the later claim is taken to have been made on the day on which the initial (inappropriate) claim was made. However, the start day backdating rules should be checked in case an earlier start day is possible.
In order for payments to be backdated, delegates must consider whether all qualifications for the second (later) payment are met throughout the period of time between the initial and later claims.
Delegates should take particular care when there is a gap of more than 13 weeks between the making of the initial claim and the later claim. In these cases, the person would need to display acceptable reasons why he or she did not lodge the second claim within 13 weeks of lodging the first (see examples below).
Example 1: If this Department or another Department has taken more than 13 weeks to decide that the person is not qualified for the payment that was subject of the initial claim,
Example 2: If this Department or another Department has reviewed the person's documentation at the time of the initial lodgement and has mistakenly or inadvertently paid the person an incorrect or inappropriate benefit and the delegate only discovers this error after 13 weeks have elapsed:
Example 3: If the person could not lodge the later claim because they were hospitalised or immobilised by a medical condition or impairment.
Act reference: SS(Admin)Act section 15 Deemed claim-incorrect or inappropriate claims
Last reviewed: 13 May 2013