DOCUMENT 35
IRT – Identify if further information is required (access and revocation)
This article provides guidance for a review officer to identify steps through key indicators.
Recent updates
1 July 2024
Removed Next steps section.
Identifying key indicators
When completing an access or revocation internal review, review officers need to consider key indicators as part of their desktop review to determine whether further information is required.
Examples of key indicators are, but not limited to:
- An applicant relies on prescribed aides and devices for most tasks most of the time (other than a common item).
- An applicant has a List B (External) impairment.
- Applicant demonstrates a reliance or noted deterioration requiring the support/intervention of other people for most tasks most of the time.
- Applicant is unable to perform tasks or actions needed to participate in an activity.
- Sections of the access criteria are met (for example, an applicant has a substantial reduction in functional capacity).
- A new or recent diagnosis has been provided.
- The applicant has a degenerative condition.
Review officers need to identify whether these key indicators exist for an applicant and if this will lead to a confirmed or set-aside decision. This will determine the appropriate pathway for the internal review. During the review, information or evidence provided may change the path of the review.
There are two primary examples as to how to progress an internal review:
- Option 1 - original decision is likely to be confirmed.
- Option 2 – original decision is likely to be set-aside with additional evidence.
Note: During initial contact, information can be gathered to determine next steps, including whether seeking additional information is required.
Option 1
If an internal review has no key indicators, the outcome is likely to be confirmed even if the applicant provides further evidence.
Before progressing, a review officer must make sure:
- Information and evidence provided for the internal review clearly indicates the original decision was correct.
- The impairment is not a List A (External), List B (External) or List D (External) impairment.
- Sections of the access criteria are not met (for example, a recent assessment will not meet the access criteria for permanence).
- The evidence-based treatments and therapies have not been trialled or ruled out by treating practitioners.
- Other than a new assessment impairment or rapid deterioration in functional capacity, the applicant is unlikely to meet the access requirements.
- The applicant has indicated they do not intend to provide further information or evidence in support of their review.
While a review officer does not need to request further information for an Option 1 review, they must make sure the applicant is provided the opportunity to supply further information. If the applicant wishes to provide further evidence, refer to article IRT - Requests for further information.
Option 2
If an internal review has key indicators and the original decision may be set-aside with additional evidence, the review officer must seek addition evidence. Refer to article IRT - Requests for further information.
A review officer may speak to an applicant directly to gather supplementary functional information or try to seek consent to contact an applicant’s health professional (where appropriate) to confirm information.