{"id":"F2019L00825","name":"Treatment Benefits (Special Access) (Claims, Applications and Lodgements Procedures) Determination 2019","slug":"treatment-benefits-special-access-claims-applications-and-lodgements-procedures-determination-2019","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":99439,"registerId":"commonwealth-F2019L00825-current","compilationNumber":null,"startDate":"2026-04-02","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Name","content":"#### 1 Name\n\n    This instrument is the Treatment Benefits (Special Access) (Claims, Applications and Lodgements Procedures) Determination 2019.","sortOrder":0},{"sectionNumber":"2","sectionType":"section","heading":"Commencement","content":"#### 2 Commencement\n\n    This instrument commences on the day on which it is made.","sortOrder":1},{"sectionNumber":"3","sectionType":"section","heading":"Authority","content":"#### 3 Authority\n\n    This instrument is made under subsection 8(2) of the Treatment Benefits (Special Access) Act 2019.","sortOrder":2},{"sectionNumber":"4","sectionType":"section","heading":"Definitions","content":"#### 4 Definitions\n\n    In this instrument:\n    Act means the Treatment Benefits (Special Access) Act 2019.\n    Department means the Australian Government Department of Veterans’ Affairs.\n\n5 Procedures for making claims or applications or giving other documents\n\n    (1) A claim, application or other document under the Act:\n    (a) is to be in writing; and\n    (b) is to be made or given, as the case requires, by lodging it at an office of the Department in Australia.\n    (2) Section 5T of the Veterans’ Entitlements Act 1986 is taken to apply to the lodgement of a claim, application or other document under the Treatment Benefits (Special Access) Act 2019 as if it were a claim, application or other document that could be made or given under the Veterans’ Entitlements Act 1986.\n\nNote 1: Section 5T of the Veterans’ Entitlements Act regulates the lodgement of claims, applications and other documents under that Act, and provides for physical and electronic lodgements.\n\nNote 2: The Veterans’ Entitlements (Electronic Lodgement Approval) Instrument 2018 made under section 5T of the Veterans’ Entitlements Act 1986 applies to electronic lodgements. The Veterans’ Entitlements (Electronic Lodgement Approval) Instrument 2018 is available at: [http://clik.dva.gov.au/legislation-library](http://clik.dva.gov.au/legislation-library). It is not a legislative instrument within the meaning of the Legislation Act 2003.\n\n    6 Additional procedures – sections 9, 10, 24, 25, 33 and 37 of the Act\n    (1) A claim under section 9 of the Act is to be in the form approved by the Secretary of the Department.\n    (2) A notice to withdraw a claim under section 10 of the Act is to contain the name and address of the person withdrawing the claim including, if appropriate, the name and address of the person on whose behalf the claim is being withdrawn.\n    (3) A claim under section 24 of the Act is to be in the form approved by the Secretary of the Department.\n    (4) A notice to withdraw a claim under section 25 of the Act is to contain:\n    (a) the name and address of the person withdrawing the claim including, if appropriate, the name and address of the person on whose behalf the claim is being withdrawn; and\n    (b) details of the claim.\n    (5) A request for a review under section 33 of the Act of a decision made by the Commission is to contain:\n    (a) the name and address of the person requesting the review including, if appropriate, the name and address of the person on whose behalf the request is made; and\n    (b) details of the decision to be reviewed; and\n    (c) the grounds for the review.\n    (6) A notice to withdraw a request for review of a decision under section 37 of the Act is to contain:\n    (a) the name and address of the person withdrawing the request for review including, if appropriate, the name and address of the person on whose behalf the request is being withdrawn;\n    (b) details of the decision originally sought to be reviewed.\n    7 Other procedures\n    (1) A claim, application, request or notice under the Act (in this section referred to as a claim) may be made or given:\n    (a) by the person eligible to be granted the benefit under the Act to which the claim relates; or\n    (b) with the approval of that person or of the Commission, by another person on behalf of that person.\n\n    (2) If a person eligible to be granted a benefit under the Act is unable, by reason of physical or mental ailment, to approve a person to make a claim for that benefit on his or her behalf, the Commission may approve a person to make the claim on his or her behalf.\n    (3) If a claim for a benefit under the Act is made by a person on behalf of another person, the other person on whose behalf the claim is made, and not the person making the claim on behalf of that other person, is to be treated as the claimant.\n    (4) If:\n    (a) a person makes a claim for a benefit under the Act, but otherwise than in accordance with the appropriate form required by this determination; and\n    (b) the person subsequently makes a claim for the benefit in accordance with the appropriate form:\n\n    (i) at a time when the person had not been notified by the Department, in writing, that it would be necessary to make the claim in the appropriate form; or\n\n    (ii) within 3 months after the person had been so notified;\n\nthe Commission may treat the claim referred to in paragraph (b) as having been received on the date on which the claim referred to in paragraph (a) was received at an office of the Department in Australia or at the electronic address to which the claim was transmitted electronically, as the case requires.","sortOrder":3}],"analysis":{"flash_summary_failed":{"failed":true,"reason":"A positive credit balance is required for all requests, including BYOK, so fallback providers remain available. Add credits at https://vercel.com/d?to=%2F%5Bteam%5D%2F%7E%2Fai%3Fmodal%3Dtop-up to continue.","source":"analysis-cron"},"flash_summary":{"complexity_score":4,"scope_assessment":{"changed":false,"description":"This Determination sets procedural and evidentiary requirements for making, withdrawing and reviewing claims under the Treatment Benefits (Special Access) Act 2019 (see ss5–7). It does not change who is eligible for benefits or the substantive criteria for entitlement; instead it prescribes how documents are to be presented, which officers decide on forms (Secretary) and approvals (Commission), and how lodgement timing is treated."},"complexity_factors":["Cross‑references to multiple statutes and instruments: the Determination operates under the Act (s3) and adopts section 5T of the Veterans’ Entitlements Act 1986 for lodgement rules (5(2)); it also points users to an external electronic lodgement approval instrument (Note 2).","Form approval delegated to the Secretary: several claim types must use forms 'approved by the Secretary' (6(1), 6(3)), introducing administrative discretion about required formats and potential change over time.","Content specificity for notices and requests: withdrawal and review notices must contain specified information (6(2), 6(4)–6(6)), creating precise compliance requirements for claimants and representatives.","Commission discretion for third‑party and incapacity approvals: the Commission may approve third‑party lodgement when the claimant cannot give approval due to physical or mental ailment (7(2)), and treats the represented person as the claimant (7(3)), concentrating decision power in the Commission.","Conditional backdating rule with procedural thresholds: where an initial non‑compliant lodgement is later corrected, the Commission may treat the corrected claim as received on the earlier date only if no written Departmental notification was received or the correction occurs within three months (7(4)(b)(i)–(ii)), adding a time and notice dependency.","Mandatory physical lodgement location with electronic exception: primary rule requires lodging at a Department office in Australia (5(1)(b)), but electronic routes are available only as applied via s5T of the VEA (5(2)), creating potential ambiguity for cross‑jurisdictional or remote filers."],"plain_english_summary":"This instrument sets the procedures for making claims, applications and related documents under the Treatment Benefits (Special Access) Act 2019: they must be in writing and lodged at an Australian Department of Veterans’ Affairs office, with electronic lodgement treated under section 5T of the Veterans’ Entitlements Act 1986. It prescribes Secretary‑approved forms for specific claims, the required contents of withdrawal and review notices, permits third‑party lodgement with approval, and lets the Commission in limited circumstances treat a corrected form as received earlier."},"kimi_summary":{"content_quality":"ok","complexity_score":3,"scope_assessment":{"changed":false,"description":"The instrument remains tightly focused on its original purpose: establishing administrative procedures for claims and applications under the Treatment Benefits (Special Access) Act 2019. It does not expand beyond procedural mechanics into substantive benefit entitlements or eligibility criteria."},"complexity_factors":["Short instrument (7 sections, approximately 1.5 pages)","Only 2 defined terms ('Act' and 'Department')","Single cross-reference to external legislation (Veterans' Entitlements Act 1986, section 5T)","Straightforward procedural requirements with minimal conditional logic","Simple nested structure in section 7(4) with basic timing condition (3-month window)","No exceptions to exceptions or deeply layered provisions"],"plain_english_summary":"This law sets the procedural rules for veterans and eligible family members seeking special medical treatment benefits under the Treatment Benefits (Special Access) Act 2019. It requires written (or approved electronic) claims using DVA-approved forms, describes how to act for another person with approval or Commission consent, and allows certain backdating when correct forms are lodged promptly after an error is identified.\n\nIt matters because it creates a clear, consistent process, protects vulnerable claimants, and reduces penalties for minor administrative mistakes."}},"importantCases":[],"_links":{"self":"/api/acts/treatment-benefits-special-access-claims-applications-and-lodgements-procedures-determination-2019","history":"/api/acts/treatment-benefits-special-access-claims-applications-and-lodgements-procedures-determination-2019/history","analysis":"/api/acts/treatment-benefits-special-access-claims-applications-and-lodgements-procedures-determination-2019/analysis","conflicts":"/api/acts/treatment-benefits-special-access-claims-applications-and-lodgements-procedures-determination-2019/conflicts","importantCases":"/api/acts/treatment-benefits-special-access-claims-applications-and-lodgements-procedures-determination-2019/important-cases","documents":"/api/acts/treatment-benefits-special-access-claims-applications-and-lodgements-procedures-determination-2019/documents"}}