Adult Disability Assessment Determination 2018

The Determination revolves around a small set of concrete concepts that structure assessment, scoring and decision-making. Those concepts appear in the instrument itself and determine how officials and practitioners must act.

• Adult: defined in section 1.4 as "a person aged 16 or more". The Tool applies only to adults so defined.
• Claimant and claimant questionnaire: A claimant is the person described in section 2.1(2) who seeks to claim or continue to receive carer allowance or carer payment. The claimant questionnaire (Schedule 1, Part 1) is completed by that claimant. It is focused on observable activities of daily living, communication and behavioural features, with discrete multiple-choice responses mapped to response codes (a, b, c, d, e).
• Treating health professional and professional questionnaire: The Secretary may approve persons or classes of persons as treating health professionals (section 1.5). Only an approved treating health professional may complete the professional questionnaire in Schedule 1, Part 2 (sections 1.5, 2.1(3)-(4)). The professional questionnaire is an expert assessment of the care receiver; it contains guidance on observation, the temporal window for assessment (preceding 24-48 hours or preceding week for some items), and how to interpret degrees of independence (Schedule 1, Part 2, Division A introduction).
• Test and rating method: The "test" for assessing disability, emotional state, behaviour and special care needs is the combined assessment of the two questionnaires (section 2.2(1)). The Rating Method converts each questionnaire's answers into numeric values, sums division totals, and produces a final total score (Schedule 2, Steps 2-4). Values include integers and fractional values (for example 1.25, 1.5, 2.5) for particular response options (Schedule 2, Division A claimant and Division A professional).
• Secretary's satisfaction and replacement: The Secretary must be satisfied that the professional questionnaire accurately reflects the person; if not, the Secretary must request a replacement professional questionnaire completed by another treating health professional (section 2.2(2)(a)-(3)). This creates an administrative gatekeeping function.
• Terminal-phase adjustment: If a medical practitioner certifies that the care receiver is terminal and unlikely to live more than three months, an addition of 30 is applied to the professional questionnaire component of the total final score (Schedule 2, Step 1). The instrument notes an exception where the Act's qualification provisions set a final total score of 30 or less.
• Minimum professional questionnaire thresholds: Step 5 in Schedule 2 sets out formal professional questionnaire minima that must be achieved for different payment categories. For example, the minimum professional questionnaire score required for certain carer payment pathways is 8, 10 or 32, and for carer allowance is 12, depending on the specific provision of the Social Security Act referenced in the instrument (Schedule 2, Step 5).

Operational features worth noting:

• The instrument prescribes that, when more than one answer is given, the answer yielding the highest score is accepted for most questions (Schedule 2, Step 2(1) and Step 3(1)). This applies to both claimant and professional questionnaires, with stated exceptions.
• The professional questionnaire contains an Abbreviated Mental Test style Division B question 2, where points are awarded for wrong answers only. The instrument instructs that if all answers are left blank because the care receiver is unable to communicate, no points are awarded for that question and points should be allocated in accordance with question 3 (Schedule 1, Part 2 Division B; Schedule 2, Step 3(1)).
• Many items are time-bound for assessment: e.g., bowels and bladder items use the preceding week; grooming and some activities use the preceding 24-48 hours (Schedule 1, Part 2 Division A introduction and Division A items 1-3).

At a conceptual level, the Determination creates a two-legged assessment architecture. One leg is self-report (the claimant questionnaire), the other is professional clinical assessment (the professional questionnaire). Both legs are numerically weighted and aggregated, but the instrument introduces safeguards that ensure a minimum professional input is required for payment eligibility (Schedule 2, Step 5).

Primary affected parties

• Claimants seeking carer allowance or carer payment for the care of an adult. The claimant questionnaire in Schedule 1, Part 1 can be completed only by a claimant described in section 2.1(2). The completed claimant questionnaire is one component of the test and contributes to the final total score (Schedule 2, Steps 2 and 4).
• Adults who are the subject of a claim, defined as persons aged 16 or more (section 1.4). The questionnaires capture the adult's functional state, behaviour, and special care needs.
• Treating health professionals who are approved by the Secretary under section 1.5. Only such persons may complete the professional questionnaire in Schedule 1, Part 2 (section 2.1(3)-(4)). The Secretary may approve individuals or classes of persons as treating health professionals (section 1.5(1)-(2)).

Secondary affected parties and administrative actors

• The Secretary of the Department of Social Services and departmental officers. The Secretary has multiple decision points in the Determination: approving treating health professionals (section 1.5), being satisfied as to the accuracy of professional questionnaires and requesting replacements (section 2.2(2)(a)-(3)), and applying the rating method to determine whether Social Security Act provisions apply (section 2.3(1)-(2)).
• Medical practitioners supplying terminal-phase certification. A medical practitioner can trigger the terminal-phase adjustment that adds 30 to the professional questionnaire component by certifying the care receiver is terminal and expected to live no more than three months (Schedule 2, Step 1).
• Other healthcare personnel and carers who provide evidence used by the treating health professional. The professional questionnaire guidance permits use of information from the person, friends, relatives and nurses and says direct observation or testing is not required (Schedule 1, Part 2 Division A introduction).

Legal and social-security consequences

• Eligibility for carer payment and carer allowance pathways under specific provisions of the Social Security Act are directly affected, because the final score produced under the Determination "determines whether the person is a care receiver to which" listed provisions apply (section 2.3(2)(2)). The instrument expressly links scoring outcomes to subparagraph 197D(1)(a)(i), paragraph 198(2)(a), subparagraph 198(2)(d)(i), paragraph 954(1)(c) and paragraph 954A(1)(c) of the Act (section 2.3(2)(2) and Schedule 2, Step 5).
• Approved treating health professionals bear consequential administrative load because their professional questionnaire responses are subject to Secretary review. If the Secretary is not satisfied with a professional questionnaire, a replacement by another treating health professional is required (section 2.2(2)(a)-(3)). This can lead to additional consultations, reports and possible delays for claimants.

Distribution of costs and control

• The administrative burden of completing forms and obtaining professional assessments falls on claimants and their treating health professionals. The Secretary controls approval of who may be a treating health professional and the acceptance of professional questionnaires, which centralises decision authority with the Department (sections 1.5, 2.2(2)(a)-(3)).
• The instrument does not itself authorise penalties; rather, it feeds into the Social Security Act eligibility framework. Therefore adverse financial consequences (loss of carer payments or allowances) fall on claimants and their dependants where scoring outcomes do not meet statutory thresholds.

Timing and delay-sensitive elements

• The professional questionnaire requires temporal reference to recent performance (preceding 24-48 hours for many items, preceding week for bowel and bladder items) (Schedule 1, Part 2 Division A). The Secretary’s power to request replacement professional questionnaires may introduce delay between initial assessment and a final administrative decision (section 2.2(3)).

Taken together, the Determination affects practitioners and administrative workflows as well as the financial position of carers and care receivers by converting clinical observations into formal administrative scores that interact with Social Security Act thresholds.

Duties imposed by the Determination

• Secretary’s duties:

  • Make approvals of persons or classes as treating health professionals (section 1.5).
  • Be satisfied that a completed professional questionnaire is an accurate reflection of the care receiver’s disability, emotional state, behaviour and special care needs; if not satisfied, request a replacement professional questionnaire from another treating health professional (section 2.2(2)(a)-(3)). The Secretary must calculate scores using the rating method provided and determine whether the person is a care receiver to which the specified provisions of the Social Security Act apply (section 2.2(2)(b) and section 2.3).
  • Apply the rating method set out in Schedule 2, including Step 5 minimum professional questionnaire thresholds (section 2.3(1)-(2)).

• Claimant duties:

  • Complete the claimant questionnaire (Schedule 1, Part 1) when claiming or seeking continuation of carer payment or carer allowance for an adult (section 2.1(2)). The claimant must tick only the response that best describes how well the person usually manages, and the instrument instructs that "for each question, the claimant must tick only the response code that best describes" (Schedule 1, Part 1 Divisions A-C). If more than one answer is marked the rating rules accept only the answer giving the highest score (Schedule 2, Step 2(1)).

• Treating health professional duties:

  • Only an approved treating health professional may complete the professional questionnaire (section 2.1(3)-(4) and section 1.5).
  • The professional questionnaire must be completed in accordance with its instructions about temporal windows and use of evidence, for example assessing bowel and bladder items for the preceding week and grooming for the preceding 24-48 hours, and using "best available evidence" (Schedule 1, Part 2 Division A).
  • For Division B question 2 in the professional questionnaire, the treating health professional must mark right or wrong for each item and apply the instrument's scoring rules where points are awarded for wrong answers only (Schedule 1, Part 2 Division B; Schedule 2, Step 3(1)).

• Medical practitioner duty for terminal-phase certification:

  • If a medical practitioner certifies the care receiver is terminal and likely to live no more than three months, the instrument requires an addition of 30 to the professional questionnaire component (Schedule 2, Step 1).

Rights and administrative protections referenced or implied in the Determination

• Right to have a professional questionnaire prepared by an approved treating health professional: only such professionals may complete Part 2 (section 2.1(3)-(4), section 1.5). The instrument does not create a private right to nominate any clinician; the Secretary’s approval is a precondition.
• Right to have a replacement professional questionnaire requested where the Secretary is not satisfied with the original (section 2.2(2)(a)-(3)). The instrument mandates that the Secretary must ask for a replacement from another treating health professional in that circumstance.
• The Determination imposes procedural constraints on how answers are scored to promote consistency: it sets the arithmetic mapping from responses to numerical values, rules on multiple answers, and special rules for Division B question 2 in the professional questionnaire (Schedule 2, Steps 2-3).

Matters not set out in the Determination that affect duties and rights

• Appeal and merits review processes: The Determination does not state internal review, merits review, or merits appeal procedures for Secretary decisions under the instrument. Those procedural rights and remedies, including objections, reviews and appeals, are governed by the Social Security Act and administrative law, not by the Determination itself. The Determination is silent on evidentiary thresholds beyond its own scoring rules.
• Criteria and process for Secretary approval of treating health professionals: The instrument provides the Secretary with the power to approve persons or classes as treating health professionals (section 1.5) but does not specify the criteria, application process, or renewal/registration mechanisms. This discretion will be operationalised through Departmental practice or guidance outside the Determination.

Operational obligations and documentation

• The professional questionnaire contains explicit instructions that responses should be based on the best available evidence and should be a record of what the person does, not what the person could do; direct testing is not required (Schedule 1, Part 2 Division A). This imposes an evidentiary expectation on treating health professionals to document observed behaviours and recent performance windows.

In short, the Determination creates a mixed administrative-clinical duty structure allocating evidence-gathering and documentation duties to claimants and treating health professionals, while concentrating approval and final assessment authority in the Secretary. It lays down arithmetic conversion rules that functionally convert clinical descriptions into administrative eligibility determinations.

Direct penalties in the Determination

• The instrument itself does not prescribe criminal or civil penalties, fines, or sanctions. It is an administrative determination that prescribes assessment instruments and numerical rating methods. There are no penalty provisions in the text of the Determination.

Enforcement mechanism

• Enforcement of the Determination is practical and administrative, not penal. The Determination is a tool used by the Department of Social Services, through the Secretary, to determine whether a person meets the statutory conditions in the Social Security Act for carer payment and carer allowance. The instrument therefore affects entitlement to social security payments. The immediate enforcement mechanism is the administrative decision to grant, continue or refuse carer payments or allowances based on the application of the Rating Method and the Secretary’s satisfaction with the professional questionnaire (sections 2.2 and 2.3; Schedule 2, Steps 1-5).

• The Secretary must calculate the score using the rating method and determine whether the care receiver is a person to which particular provisions of the Act apply (section 2.2(2)(b) and section 2.3(2)). If the scores do not meet the required thresholds and statutory requirements are not satisfied, the practical effect is non-award or cancellation of payments under the Social Security Act.

Administrative compliance actions and procedural steps

• The instrument permits the Secretary to require a replacement professional questionnaire if the Secretary is not satisfied that the original accurately reflects the care receiver’s condition (section 2.2(3)). The requirement for a replacement is a procedural enforcement tool. It may produce additional evidence collection, delay, or requirement to engage another treating health professional.

• The instrument imposes scoring rules that effectively enforce consistency , for example rules about accepting only the highest-scoring marked response when multiple responses are ticked (Schedule 2, Steps 2 and 3). Administrative decisions will enforce these rules when calculating totals.

Interaction with statutory enforcement and review

• Decisions made by the Secretary under this Determination will be embedded within the Social Security Act framework. The Act contains statutory review, objection and appeal mechanisms for social security decisions. The Determination does not replace or override those statutory review routes, but it does feed into the primary decision-making facts and criteria that will be the subject of any review.

Sources of discretionary enforcement risk

• The Secretary’s broad discretion to approve treating health professionals (section 1.5) and to be satisfied as to accuracy of professional questionnaires (section 2.2(2)(a)) concentrates administrative enforcement discretion in the Department. The Determination does not set objective criteria for what will satisfy the Secretary or how approvals are made. That discretion can result in intra-departmental enforcement variance unless the Department documents its approach in policy guidance or procedural manuals.

Practical consequences of non-compliance or failure to meet scoring thresholds

• The practical penalty for failing to meet scoring thresholds or for not providing an approved professional questionnaire is loss or non-qualification for carer payments or allowances under the Social Security Act provisions referenced in the Determination (section 2.3(2), Schedule 2, Step 5). The Determination does not itself provide financial penalties but non-entitlement is an effective economic enforcement consequence.

In sum, the Determination enforces eligibility standards by prescribing an assessment mechanism, by requiring the Secretary’s satisfaction in relation to professional questionnaires, and by embedding the resulting numeric outputs into Social Security Act entitlement decisions. It does not introduce separate statutory penalties or offences.

Primary statutory connection

• The Determination is made under section 38C of the Social Security Act 1991 (section 1.3 and the note at section 1.6). The Determination operationalises the delegated power in subsection 38C(1) to "devise a test" and provide a method for rating adults for the purposes of social security. The Determination explicitly states that the part of the determination setting out the test and rating method is the Adult Disability Assessment Tool (section 1.6).

Direct references to particular Social Security Act provisions

• The instrument ties its scoring outcomes to specific provisions in the Social Security Act. Section 2.3(2)(2) provides that the method gives the person a score that determines whether the person is a care receiver to which subparagraph 197D(1)(a)(i), paragraph 198(2)(a), subparagraph 198(2)(d)(i), paragraph 954(1)(c) or paragraph 954A(1)(c) of the Act applies. Step 5 in Schedule 2 further identifies minimum professional questionnaire scores required for eligibility pathways linked to those same provisions, for example a professional questionnaire score of 8 for certain carer payment paths and 12 for carer allowance paths (Schedule 2, Step 5).

Definitions sourced from the Social Security Act

• Section 1.4 notes that some expressions are defined in sections 5 and 23 of the Social Security Act, including dependent child, officer and Secretary. This means that the Determination relies on the Act for foundational terms and must be interpreted in concert with the Act’s definitions (section 1.4).

Interaction with statutory qualification thresholds

• The Determination establishes the method for calculating the final total score but does not itself set the final total score thresholds required to qualify for particular payments. Those thresholds are part of the Social Security Act qualification provisions. The Determination therefore functions as an implementing instrument: it provides the arithmetic and procedural machinery that yields a score, and the Act determines how that score maps to eligibility, including any minimum total final score thresholds (Schedule 2, note and section 2.3).

Procedural interaction: reviews and appeals

• The Determination is silent on administrative review and merits appeal processes. Those processes are provided by the Social Security Act and administrative law more generally. Therefore contested outcomes arising from application of this Determination will be subject to the statutory and judicial review frameworks outside the Determination itself.

Potential overlap with professional regulation and clinical law

• The professional questionnaire must be completed by "treating health professionals" approved by the Secretary (section 1.5). The Determination does not define clinical registration standards, scope of practice or professional conduct. Those matters remain governed by health practitioners’ registration and professional regulation regimes and relevant practitioner standards. Where a treating health professional provides false or misleading information, professional or legal consequences would arise under other laws or professional codes, not under the Determination itself.

Evidence and privacy regimes

• The instrument requires health professionals and claimants to provide potentially sensitive medical and behavioural information. Privacy, health records and disclosure obligations are governed by other laws, such as privacy legislation and health records legislation, and by administrative policies of the Department. The Determination does not address consent, data sharing, or privacy processes.

Compatibility with other social security instruments

• The Determination links to other provisions of the Social Security Act beyond section 38C through the eligibility references in section 2.3(2). It therefore interacts with the broader social security legislative framework that governs income and allowance entitlements and associated assessments, means tests, residence tests and other qualification criteria found elsewhere in the Act.

In short, the Determination is an implementing administrative instrument that must be read and operated in the context of the Social Security Act 1991 and the operation of health practitioner regulation, privacy and administrative review law. It supplies the assessment methodology; substantive entitlement and procedural rights are primarily found in the Act and other laws.

Textual origin and commencement

• The instrument identifies itself as the Adult Disability Assessment Determination 2018 and records that it was made by Kathryn Campbell, Secretary of the Department of Social Services, dated 9 August 2018 (beginning of the instrument). It states an operative commencement date of 1 October 2018 (section 1.2). The instrument contains no internal amendment provisions.

Amendments recorded in the instrument

• The Determination text provided includes no schedules of amendments, no substitute provisions, and no history of prior instruments or earlier versions. The instrument as provided is self-contained and does not show any insertions or deletions or transitional or savings clauses.

Implication for users

• Absent any amendment text in the provided instrument, the Determination as presented represents the instrument as made on 9 August 2018 and operative from 1 October 2018. Any changes to this Determination after that date would be made by subsequent legislative instruments or amendments under the Social Security Act framework. Those are not contained in the provided text.

Practical note for legal users

• Practising lawyers, compliance professionals and advisers should not assume the 2018 Determination remains unchanged in later practice. The Determination may have been amended, replaced, or supplemented by other instruments or Departmental policy since 2018. The instrument itself does not record later amendments; to determine the current law and operative text, check the Federal Register of Legislation or Department of Social Services legislative instruments database for subsequent instruments or amendments to the Adult Disability Assessment Determination 2018.

Transitional and grandfathering provisions

• The provided text contains no transitional, savings or grandfathering provisions. If earlier assessment tools were in use before 1 October 2018, this Determination does not itself set out how existing claimants or ongoing assessments were to be transitioned; any transitional arrangements must be located in the earlier or the later legislative or administrative materials, which are not included here.

Summary

• The instrument shows a single-making event dated 9 August 2018 and a commencement date of 1 October 2018. It does not record any amendments. For current compliance or litigation matters, practitioners must verify whether later instruments have amended the Determination and consult the Social Security Act for any legislative changes that interact with it.

Material in the Determination

• The Determination text supplied contains no references to case law, no judicial decisions, and does not cite any litigation history. It is an administrative instrument; it does not include judicial interpretations or references to court rulings.

Implication for research and advocacy

• There is no litigation history contained within the instrument itself. Practitioners seeking to understand how courts have treated the Adult Disability Assessment Tool, Secretary satisfaction requirements, or particular scoring rules must search external judicial databases, administrative law judgments and social security tribunal decisions. The Determination does not furnish any such case citations.

What the absence of litigation references means

• The Determination’s silence on litigation is ordinary for delegated instruments. Judicial review and merits review of decisions made using the Determination would arise under general administrative law and the Social Security Act frameworks. Challenges could address procedural fairness, reasonableness of Secretary decisions about the accuracy of professional questionnaires, interpretation of the rating method, or application of Step 1 terminal adjustments. None of these are discussed in the Determination itself.

Research steps for litigators

• To develop litigation or appeal strategies, locate decisions of:

  • Social Security Appeals Tribunal or Administrative Appeals Tribunal where application of the Adult Disability Assessment Tool was contested.
  • Federal Court or Federal Circuit Court judicial review decisions concerning the Secretary’s treatment of professional questionnaires or approval of treating health professionals.
  • Tribunal or court decisions addressing evidentiary sufficiency of claimant questionnaires and the interplay between claimant and professional questionnaire scores.

• Because the Determination sets numerical and procedural rules, litigation is likely to engage both factual disputes (e.g. what the care receiver actually does) and legal disputes over procedural fairness, the Secretary’s exercise of discretion, or interpretation of the Determination and relevant Social Security Act provisions.

Summary

• The Determination provided contains no litigation history or case references. Practitioners must consult external judicial and tribunal records to identify relevant litigation that applies or interprets this instrument in practice.

Several practical, legal and operational pitfalls arise directly from the text of the Determination. These are concrete rules, gaps and design features that frequently create implementation difficulties.

1. Secretary approval of treating health professionals is undefined

• Section 1.5 grants the Secretary power to approve persons or classes as treating health professionals. The Determination does not set out approval criteria, application processes, or renewal and reporting obligations. This centralises approval discretion in the Secretary without prescriptive standards in the Determination, creating potential variability and uncertainty for practitioners and claimants about who may lawfully complete the professional questionnaire.

2. Secretary satisfaction standard is not articulated

• Section 2.2(2)(a) requires the Secretary to be "satisfied" that a completed professional questionnaire is an accurate reflection of the person’s condition and section 2.2(3) requires a replacement questionnaire if the Secretary is not satisfied. The Determination does not specify the evidentiary standard, timeframes for assessing satisfaction, or the reasons that will be given to a claimant or treating health professional when a questionnaire is deemed unsatisfactory. That absence can cause delay and makes contested decisions vulnerable to arguments about reasonableness and procedural fairness.

3. Multiple answers accepted only in the claimant’s favour without clear controls

• Schedule 2 Step 2(1) and Step 3(1) state that where more than one answer is marked, the answer that gives the highest score is accepted. This rule can advantage claimants who mark multiple boxes. Although the claimant questionnaire instructions require claimants to tick only the response code that best describes the person, the rating rule mitigates consequences of marking multiple answers. This duality may incentivise marking multiple boxes to preserve a higher score and can complicate evidentiary analysis where answers conflict.

4. Fractional scoring and no rounding rule

• The Rating Method includes fractional values (for example 1.25, 1.5, 2.5) across both questionnaires (Schedule 2, Division A claimant and Division A professional). The Determination does not specify rounding rules, precision to maintain in totals, or how decimals interact with statutory thresholds that may be integers. That omission places an implementation burden on Department systems and can be a source of dispute where final totals sit near eligibility cut-offs.

5. Minimum professional questionnaire thresholds create gating effects

• Schedule 2 Step 5 sets minimum professional questionnaire scores that must be achieved for different payment pathways. This means a claimant cannot rely solely on a high claimant questionnaire score; an approved treating health professional must also produce a sufficiently high professional questionnaire score. The professional questionnaire thus becomes a gatekeeping mechanism and the Secretary’s power to approve treating health professionals and to demand replacements amplifies that gatekeeping power.

6. Terminal-phase adjustment is blunt and conditional

• Step 1 adds 30 points to the professional questionnaire component where a medical practitioner certifies the person is in the terminal phase with expected survival not exceeding three months. The Determination then states "No further steps are relevant where the relevant qualification provisions of the Act state that the final total score to qualify for carer payment or carer allowance is 30 or less." This is a mechanical, large addition that may alter qualification quickly, but the instrument does not state who qualifies as a "medical practitioner" for this purpose, nor how disputes over terminal prognosis are handled.

7. Temporal assessment windows can be misapplied

• The professional questionnaire directs assessors to use the preceding 24-48 hours for many activities and the preceding week for bowel and bladder. Claimants and professionals may provide evidence drawn from longer or shorter periods, or atypical episodes, and the Determination’s strict windows can cause misalignment between the assessor’s observations and historical medical records. The professional questionnaire does state that occasionally longer periods will be relevant, but offers no guidance on objective criteria for when longer windows should be used.

8. Division B professional scoring anomaly

• In Division B (professional questionnaire), question 2 is scored only for wrong answers; Step 3(1) instructs that no score is given for a right answer and each wrong answer is allocated the score indicated. If all answers are blank because the care receiver is unable to communicate, no points should be awarded for the question but points should be allocated in accordance with question 3. This atypical scoring increases the potential for inconsistent application and requires careful adherence to the instrument’s instructions.

9. No internal appeal or review rules in the Determination

• The Determination does not provide procedural protections or timelines for requesting a replacement professional questionnaire, contesting disallowance of a professional questionnaire, or managing the consequences of the Secretary’s dissatisfaction. The reliance on external review pathways under the Social Security Act and administrative law means that claimants may face practical delays and costs when contesting decisions that are effectively finalised by the Department’s application of the Determination.

10. The instrument does not address privacy, consent or record-keeping standards

• The questionnaires require disclosure of sensitive health information. The Determination does not set rules on consent, data access, record retention, or disclosure to third parties. These matters must be navigated against separate privacy and health records laws, potentially complicating evidence gathering and sharing between claimants, treating health professionals and the Department.

In practice, these "gotchas" are concrete operational and legal risks that the Department, clinicians, claimants and advisers must manage. The Determination supplies precise scoring but leaves important discretion, process design and interface matters to other instruments or administrative practice.

This section sets out a pragmatic, source-grounded compliance checklist and recommended practices for claimants, treating health professionals, Department officers, and advisers, based solely on the rules and instructions in the Determination.

For claimants (persons seeking carer payment or carer allowance for an adult)

• Complete the claimant questionnaire (Schedule 1, Part 1) accurately and in accordance with instructions. The questionnaire must be completed only by the claimant described in section 2.1(2). For each question tick only the response code that best describes how well the person in your care usually manages, noting that "help" includes physical assistance, guidance or supervision and "without help" means the person initiates and completes activities without assistance or supervision (Schedule 1, Part 1 Division A instruction).
• Prefer single, well-supported answers. Although Schedule 2 Step 2(1) instructs acceptance of the highest-scoring answer where more than one is marked, best practice is to mark only one response per question to avoid later challenges about inconsistent or unclear answers. If a question has a response code "Does not take medication" or "Does not have treatment", use those where appropriate (Schedule 1, Part 1 Division A items 14-15).
• Keep contemporaneous evidence and notes to corroborate subjective responses, including dates and times for events referenced in the questionnaire where possible. Many professional assessments refer to preceding 24-48 hours or the preceding week; aligning claimant evidence with those windows helps reduce ambiguity (Schedule 1, Part 2 Division A introduction).

For treating health professionals (approved under section 1.5)

• Confirm your approval status with the Department. Section 1.5 requires Secretary approval of treating health professionals. The Determination does not set a public process for approval; therefore check Departmental guidance or registration information about how you are, or can be, approved to complete Part 2.
• Follow the professional questionnaire instructions closely. Use the "best available evidence" and record observations of what the person actually does, not what they could do (Schedule 1, Part 2 Division A introduction). Apply the temporal windows specified: bowels/bladder preceding week, grooming preceding 24-48 hours, and other items often 24-48 hours (Schedule 1, Part 2 Division A).
• For Division B question 2 (Abbreviated Mental Test), mark right or wrong for each item, remember that wrong answers attract points and right answers attract nil points for that specific question (Schedule 1, Part 2 Division B and Schedule 2, Step 3(1)). If the care receiver is unable to communicate and the items are left blank, follow the instruction to allocate no points for that question but then complete question 3 to allocate points (Schedule 2, Step 3(1)).
• Avoid marking multiple responses to a single question where possible. The Determination instructs that multiple answers will be scored by accepting the answer with the highest score (Schedule 2, Step 3(1)). For transparency and to reduce challenge risk, provide clear single responses supported by brief explanatory notes where appropriate.
• Document sources of information: family reports, nursing notes, direct observation, and any tests used. The professional questionnaire explicitly permits using information from the person, friends, relatives and nurses and notes that direct testing is not required (Schedule 1, Part 2 Division A introduction).
• For terminal-phase cases, ensure a qualified medical practitioner provides the required certification if the terminal-phase addition is being sought, noting the 3-month prognosis requirement (Schedule 2, Step 1).

For claimants and treating health professionals together

• Anticipate the Secretary’s verification. The Secretary must be satisfied that the professional questionnaire accurately reflects the care receiver’s status (section 2.2(2)(a)); record-keeping and contemporaneous notes will assist if the Department requests justification or a replacement questionnaire.
• Be prepared for replacement requests. If the Secretary is not satisfied, the instrument requires a replacement professional questionnaire from another treating health professional (section 2.2(3)). Coordinating in advance about alternate approved practitioners can reduce delay.

For Department officers and decision makers

• Apply the rating method exactly as prescribed. Use Schedule 2 Steps 1-4 to compute claimant and professional totals, aggregate them and produce the final total score, observing the special rules for multiple answers, Division B question 2 scoring, and fractional values (Schedule 2).
• Maintain audit trails for Secretary satisfaction decisions. Section 2.2(2)(a) requires the Secretary to be satisfied as to the accuracy of professional questionnaires; record reasons and evidence supporting satisfaction decisions and any replacement requests to support review and defend administrative choices.
• Ensure systems handle fractional scores and do not introduce rounding errors. The Determination provides fractional point values; Departmental IT and decision systems should preserve decimal precision and document rounding or truncation policies if they must be applied.
• Provide guidance and transparency to approved treating health professionals about expectations, turnaround times for replacement questionnaires, and the criteria used to assess questionnaire accuracy, because the Determination itself does not set those criteria.

For legal advisers and compliance professionals

• Confirm the relevant Social Security Act thresholds. The Determination prescribes the scoring method but not the final total score thresholds that determine payment eligibility. Identify the particular qualifying provisions referenced in section 2.3(2) and Schedule 2 Step 5 and consult the Act to determine the minimum total final scores applicable to the claimant’s situation.
• Prepare to challenge procedural failures through statutory review. The Determination is silent on procedural timeframes or the content of satisfaction decisions. Where a claimant faces administrative delay or an unsupported replacement request by the Secretary, consider objection and tribunal review pathways under the Social Security Act and administrative law remedies.
• Anticipate and test the Secretary’s approval register. Because section 1.5 vests approval power in the Secretary without criteria, seek Departmental records identifying approved classes or individuals if a dispute turns on whether a professional was properly authorised when completing a professional questionnaire.

Summary compliance checklist

• Claimant: complete Part 1 accurately, keep contemporaneous evidence aligned with specified temporal windows, avoid multiple ticks.
• Treating health professional: verify approval status, use prescribed temporal windows, record "what the person does", avoid multiple ticks, document evidence sources, obtain/record medical certificates for terminal cases.
• Department officers: apply Schedule 2 arithmetic precisely, preserve decimal precision, document Secretary satisfaction decisions, publish or provide guidance on approval and replacement processes where possible.
• Advisers: verify relevant Act thresholds, prepare for administrative review where procedures are unclear, check approval lists for treating health professionals.

Following these procedural steps will align practice with the Determination’s prescriptions and manage the principal operational and legal risks that arise from the instrument’s features.