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Compensation Reduction Amount (CRA) — Nil CRA

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Compensation Reduction Amount (CRA) — Nil

The contents of this document are OFFICIAL

The purpose of this Standard Operating Procedure (SOP) is to support Compensation Recoveries (CR) Delegates in cases where a Participant’s compensation was received more than 5 years ago. It will also support Delegates to complete the CRA Task Card and Calculator. The Delegate will perform a preliminary assessment to determine the likelihood of a CRA being greater than nil. This enables a Delegate to use available information to determine if the CRA will result in a Nil CRA without gathering further information.

Note: This SOP must be used in conjunction with the Calculate and apply Compensation Reduction Amounts SOP and the CRA Task Card and Calculator.

Recent updates

Date What’s changed
04-10-2021 This SOP has been updated with the Agency template for SOPs.

Checklist

Topic Checklist
Pre-requisites - The payment received by the participant must meet the definition of compensation in section 11 of the National Disability Insurance Scheme Act 2013
  • Compensation was received more than 5 years ago from the date of calculation
  • Must have information relating to Centrelink Preclusion Period Value on file or have received it from Services Australia
  • Must have obtained Office of Scheme Actuary (OSA) data detailing expected lifetime and estimated lifetime costs. |

Procedure

3.1 Complete a preliminary Nil CRA assessment in the CRA 3.13 Calculator and Task Card

For the entries into the task card the Delegate is able to use the information provided by OSA, and Centrelink unless more appropriate evidence is on file.

Navigate to the CRA 3.13 Calculator and Task Card and on the 3.13 – Task Card tab enter the relevant information at items 1.11 to 1.22

| Section: 1.0 Participant and event details | | — | — | | Item | Key people | | 1.11 | Name of Participant | | 1.12 | CR Delegate |

  1. At item 1.31 enter the Participant’s LEX ID Number
  2. At item 1.32 enter the date of compensable event
  3. At item 3.1(a) enter:
  • the date the compensation payment was fixed
  • the amount of compensation fixed
  • LEX document ID number to evidence where the information was obtained

FOI 24/25-0530 - DISCLOSURE LOG

If date of settlement is over 5 years from the day of calculation the cell will highlight in red and the Nil CRA policy can be considered. Continue with the Nil CRA calculation. If the cell is not highlighted in red you must stop using this SOP, and commence using the Calculate and apply Compensation Reduction Amounts SOP to calculate and apply a Compensation Reduction Amount.

  1. At item 3.2 enter the date of the participant’s access met decision (Date of access)
  2. If the information for item 3.3 (Medicare recovery amount found on the Medicare Final Notice of Past Benefits) is not available, leave blank. If the information is available:
  • select from the drop down menu whether Medicare performed a recovery by choosing from either ‘Medicare Recovery letter on LEX - record LEX doc ID in Notes’ or ‘No recovery undertaken by Medicare - record reason in Notes’
  • the amount of the Medicare recovery
  • in the Notes identify the LEX document ID number of the document where the information was obtained
  1. Services Australia Centrelink has provided the participant’s Centrelink recovery and preclusion information. Open the Centrelink folder on the Compensation Recoveries secure drive and select the spreadsheet that corresponds with the month the participant’s plan is due to end (e.g. August 2020, September 2020, etc.). At item 3.4:
  • select from the drop down menu whether Centrelink performed a recovery (applied a charge) by selecting either: ‘Centrelink Recovery letter on LEX - record LEX doc ID in Notes’ or ‘No recovery undertaken by Centrelink - record reason in Notes’
  • the amount of the Centrelink recovery/charge applied
  • in the Notes, identify the document where the information was obtained (e.g. NDIA Preclusion Period and Compensation request_ August 2020)
  1. At item 3.5 (a) enter the Centrelink Preclusion Period start date – Insert the start date of the preclusion period as provided by Centrelink Services Australia. Note: If no preclusion start date is obtained from Services Australia, leave the default date of 14/11/1963 unchanged
  2. At item 3.5 (b) enter the Centrelink Preclusion Period end date – Insert the end date of the preclusion period as provided by Centrelink Services Australia. Note: If no preclusion start date is obtained from Services Australia, leave the default date of 14/11/1963 unchanged
  3. If a preclusion period did not apply, open the CRA 3.13 Calculation spreadsheet and at step 4, identify whether:

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FOI 24/25-0530 - DISCLOSURE LOG

  • The participant claimed damages in relation to lost earnings or lost capacity to earn; and
  • Whether the amount of compensation fixed included an amount in relation to lost earnings or lost capacity to earn. If this is the case then populate step 4, 3.13(d) i and ii within the 3.13 Calculation worksheet
  1. The OSA has provided the Participant’s life expectancy and the date from which the life expectancy was calculated. Open the OSA folder on the Compensation Recoveries secure drive and select the spreadsheet that corresponds with the month the participant’s plan is due to end (e.g., August 2020, September 2020, etc.).

At item 3.7 enter the dollar amount provided by the OSA as the estimated lifetime cost from injury date.

At item 3.16 enter the OSA Life Expectancy end date. From the spreadsheet provided by OSA, use the date in the ‘calculation date’ column and add the figure from the ‘Life expectancy from calculation date’. This will provide the CRA end date required.

Determine if there is a likely Nil CRA

  1. To check if a Nil CRA is applicable the delegate will need to go to the Nil CRA 3.13(f) calculator tab and
    • Check that all steps have a value in them
    • At step 9 from the dropdown select “Yes”. To check if a Nil CRA is applicable, proceed to instruction in step 2 below.
  2. In the 3.13 Task Card tab, navigate to item 4.1, the green highlighted section of the task card at row D will provide the amount of the calculated CRA based on the information recorded in the task card.

If the figure is zero, you are able to implement the Nil CRA policy. Use the information calculated in the Nil CRA calculation at 3.13(f) of the CRA calculation. The amount calculated under step 8 of the Nil CRA 3.13(f) calculator tab will populate into the CRA 3.13 calculation as the amount used for past expenditure.

If there is a positive number at 4.1, the Nil CRA policy will not apply and a full CRA calculation will need to be processed. See section 6.4.

A Nil CRA is likely to apply

If it is determined that there is a likely Nil CRA, there is no need to proceed with a full CRA calculation and the following steps need to be followed:

  1. Fill in any remaining required administration sections of the task card

FOI 24/25-0530 - DISCLOSURE LOG

  1. Prepare and issue the Nil CRA Letter
  2. Prepare the CRA Delegate Decision Form detailing the decision of a Nil CRA outcome
  3. Arrange for the draft Nil CRA Calculation and CRA Letter 5 – Nil CRA Confirmation letter and the CRA Delegate Decision Form to be Quality Checked (QC).
  4. Once QC has been finalised, save a copy of Nil CRA calculation, the Nil CRA Letter and the CRA Delegate Decision Form to the Participant’s LEX Case
  5. Arrange for the CRA Letter 5 – Nil CRA confirmation letter to be posted to the Participant and/or their correspondence Nominee
  6. Save a copy of the letter to Inbound Documents to the Business System CRM. Attach the letter to Inbound Documents:
    • In the NDIS Account screen: Select Documents
    • Select Add Items then select Inbound Document
    • In Description: Letter – Letter name to be advised
    • In Document Type: Select Compensation Information
    • In Site Location select: Others
    • In Manual Site Location type: Compensation
    • In Status: Select Completed
    • In Category 1: Select NDIA Service
    • In Category 2: Select Other correspondence
    • In Re: Business Process: Do not select any option (leave blank)
    • In Employee Responsible: Enter your details
    • In Team Responsible: Comp Rec – Compensation Recoveries
    • In Note: Letter detailing no Compensation Reduction Amount is to be applied to the Participant’s plan
    • Select Save
  7. Record the following Interaction in the business system: Compensation awarded to the Participant relating to settlement dated: XX INSERT DATE XX has been assessed. No Compensation Reduction Amount will apply. For any future compensation received, please refer to the Compensation Recoveries Branch. Please see the letter sent to the Participant detailing the decision saved in inbound documents.
  8. File note the LEX file detailing the decision
  9. Close the LEX Case in line with the current Compensation Recoveries Case Closure SOP

A CRA is likely to apply

If there is a positive figure as a result of the Nil CRA calculation, in the Nil CRA 3.13(f) calculator tab under step 9 Select ‘No’ from the drop down, and proceed to calculate and apply a CRA in line with the Calculate and apply Compensation Reduction Amounts SOP.

  • National Disability Insurance Scheme Act 2013
  • National Disability Insurance Scheme (Supports for Participants - Accounting for Compensation) Rules 2013
  • NDIS Compensation Operational Guideline – Compensation Reduction Amount (CRA)
  • Compensation Practice Guide
  • LEX User Guide
  • Navigate the participant record in the NDIS Business System SOP
  • Search the NDIS Business System SOP
  • Restricted Access Participant SOP
  • Consent and Authority SOP
  • Alerts in the NDIS Business System SOP
  • Create, assign, search and edit an Interaction SOP
  • Create, update and verify a participant’s My NDIS Contact SOP
  • Inbound Documents SOP
  • Compensation Reduction Amount fact sheet
  • Nil Compensation Reduction Amount SOP
  • SOP – Compensation Recoveries Case Closures
  • Rule 3.11 CRA estimate preparation SOP
  • Rule 3.13 CRA estimate preparation SOP

Feedback

If you have any feedback about this Standard Operating Procedure, please email.CRA.Operations@ndis.gov.au. In your email remember to include the title of the product you are referring to and describe your suggestion or issue concisely.

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6. Version control

Version Amended by Brief Description of Change Status Date
V0.1 KLC721 DRAFT DRAFT 2020-11-18
V0.2 SON787 Reviewed DRAFT DRAFT 2020-11-19
V1.0 JW0023 SES Approval Approved 2021-03-25
V1.1 BD0009 Update SOP Template DRAFT 2021-08-17
V2 KDL565_ Review of BM comments and finalisation of SOP FINAL 2021-10-04

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