Chapter 6
Looking at the agencies
Centrelink menu: Introduction | Complaint themes | Centrelink payments and benefits | Service delivery issues | Cross–agency issues | Compensation for Detriment Caused by Defective Administration | Looking ahead
introduction
In 2008–09 the Ombudsman's office received 7,226 approaches and complaints about Centrelink, compared to 7,573 in 2007–08, a 5% decrease. Given the volume, complexity and diversity of Centrelink's work, it is not surprising that we receive this number of approaches and complaints. Figure 6.3 shows the trend in approaches and complaints from 2004–05 to 2008–09.
TopComplaint themes
The largest number of complaints about Centrelink was from people claiming newstart allowance (NSA), followed in order by disability support pension (DSP), family tax benefit (FTB) and age pension. Common issues raised by complainants were Centrelink review of decisions, delays, the management of debt raising and recovery, and payment pending review.
From the beginning of 2009 there was a notable increase in complaints about access to Centrelink services. The large majority of these were calls made to our office by people unable to get through to Centrelink's normal service or customer relations unit phone lines. Through liaison with Centrelink we were able to identify this trend early on, and inform our public contact officers that Centrelink's capacity was being affected by the series of natural disasters, including the Victorian bushfires, and the economic stimulus packages. While this did not resolve the issue for those complainants, these timely explanations were valuable in helping to manage their expectations and the demand on our resources for complaint investigation.
FIGURE 6.3 Centrelink approach and complaint trends, 2004–05 to 2008–09
We have found that Centrelink is generally very responsive to our enquiries and suggestions. Complaints can be resolved within as little as 24 hours of being received, as the case study Urgent response shows.
Urgent response
Ms F complained about Centrelink's delay in processing her claim for carer payment in respect of her critically ill son. She contacted Centrelink for an update nine days after lodging the claim. Centrelink advised her that it was experiencing a systems problem that prevented her claim from being progressed. Ms F contacted Centrelink a number of times over the next few days, attempting to have the matter resolved, with no success. When she was told the matter could take up to 49 days to correct, Ms F complained to us.
We contacted Centrelink the next day to establish what was delaying the processing of Ms F's claim. Centrelink indicated that a systems error had been identified in her claim and the matter had been referred to Centrelink's systems section to resolve. We asked Centrelink to give the matter some priority, given the sensitivity of the case. As a result, Centrelink resolved the matter and granted carer payment to Ms F that day.
Often when we investigate an individual complaint, it becomes apparent that the issue being complained about is more widespread or systemic. In these situations we usually ask Centrelink to take a course of action that will ameliorate the problem so that it does not recur. The case study Misleading information illustrates how consideration of an individual complaint can provide a systemic solution.
Misleading information
Ms G complained that Centrelink's Disability and Carer Payment Rates brochure stated that the basic conditions for eligibility for DSP include an 'inability to work for at least the next two years as a result of impairment'. Ms G argued that potential claimants who might be eligible for DSP would not apply on the basis of the apparently definitive information in the brochure. More detailed information in other publications explained that the relevant level of incapacity was inability to work for 15 hours or more per week. After we raised the matter, Centrelink undertook to update the brochure from 1 July 2009 to include a reference to the 15–hour rule.
Centrelink payments and benefits
Job Capacity Assessments
Job capacity assessments (JCAs) assist Centrelink to determine eligibility for DSP and activity test requirements for activity–tested customers. The JCA program was administered by the Department of Human Services (DHS) in 2008–09, but is now administered by the Department of Education, Employment and Workplace Relations (DEEWR). Centrelink carries out approximately 50% of the assessments.
We received a number of complaints about the JCA process that indicated a lack of confidence in the assessor's understanding of the complainant's condition. Although we investigated few of these cases, it was clear that the perception that assessors did not have an adequate appreciation of the complainant's medical condition was widely held.
In early 2008 the Ombudsman's office published an own motion investigation report Implementation of job capacity assessments for the purposes of Welfare to Work initiatives: Examination of administration of current work capacity assessment mechanisms (Report No. 5/2008). One of the major recommendations arising from this report was that assessors be encouraged to consult treating doctors where it appears a lack of information about a person's medical condition may affect the assessor's understanding of its impact. The agencies commented that often doctors are unwilling to take the time to discuss their patients' medical issues over the phone, given they have already completed a medical report form, especially when there is no financial incentive to do so.
The 2009–10 Budget measures included funding for a Health Professional Advisory Unit within Centrelink to give assessors and Centrelink staff making decisions about income support eligibility specialist medical advice to complement a claimant's treating doctor's report. In addition, payments for doctors will be available when they provide additional diagnostic or further information about a claimant at the request of the unit.
We believe that these measures will go a long way in addressing the recommendation. The changes are due to take effect from 1 July 2010.
Acute and terminal illness
The Ombudsman's 2007–08 annual report highlighted the experience of some people suffering from acute or terminal illness, their inability to access DSP, and the difficulties in having to rely on the activity–tested alternatives such as NSA or parenting payment. In March 2009 the Ombudsman released a report Assessment of claims for disability support pension from people with acute or terminal illness: An examination of social security law and practice (Report No. 2/2009). The case study Limited information, taken from that report, illustrates the problems that people can experience.
Limited information
As part of her treatment for leukaemia Ms H commenced aggressive chemotherapy and radiation therapy almost immediately. The DSP medical report completed by her treating doctor indicated that she did not have a terminal condition with a prognosis of less than 24 months and that her condition was likely to improve significantly within the next two years. The doctor did not indicate that he would like to discuss any aspect of his report with Centrelink.
An assessor conducted a JCA on Ms H on the basis of the information provided in the DSP medical report. Although the doctor's diagnosis indicated Ms H had a particularly aggressive and usually terminal form of leukaemia, the JCA assessor did not have the necessary information to identify that Ms H's condition was serious and likely to prevent her from working for more than 24 months.
Centrelink rejected Ms H's DSP claim because it was not satisfied her condition was permanent for the purposes of the social security law. Instead she was granted NSA with an exemption from the activity test on the basis of medical certificates from her treating doctor. Ms H was still required to submit a continuation for payment form to Centrelink every 10 weeks.
The Ombudsman's office noted that in light of her ongoing and exhausting treatment it was physically difficult for Ms H to obtain and submit new medical certificates quarterly and a continuation for payment form every 10 weeks.
As a result of our intervention, Ms H's doctor provided further information that revealed that his initial prognosis and Ms H's own assessment of her circumstances had been overly optimistic. It had become clear that there would be no significant improvement in her condition for at least two years. Based on this information Centrelink decided to review its original decision and grant Ms H DSP from the original date of claim.
The Ombudsman report made seven recommendations for consideration by the four agencies involved—Centrelink, DEEWR, DHS and the Department of Families, Housing, Community Services and Indigenous Affairs (FaHCSIA).
The report recommended the creation of a new category of payment for people experiencing an illness requiring a lengthy period of treatment or recovery, or requiring further investigation to reach a more conclusive prognosis. It also recommended that a list of conditions might be developed that would automatically qualify a customer. In the alternative, the report suggested that consideration be given to allowing longer periods of exemption from activity testing for people who were on NSA or youth allowance.
While not agreeing with the recommendations, DEEWR and FaHCSIA acknowledged the issues and undertook to review them in order to achieve a more sensitive response. Changes made as part of the 2009–10 Budget should go some way to addressing the concerns raised in the report. The Minister for Families, Housing, Community Services and Indigenous Affairs announced a simplification of the DSP assessment to fast–track claimants 'who are clearly or manifestly eligible due to a catastrophic, congenital disability or cancer, enabling them to receive financial support more quickly'. A new policy will be implemented from March 2010 to allow customers with a serious illness receiving an activity–tested payment to be granted a long–term exemption from the activity test with a significant reduction in reporting requirements and without the need for referral to a JCA or to repeatedly lodge medical certificates.
The report recommended changes to the advice given to doctors and the format of the report they complete, in order to give them further context on how their responses will be treated in the decision–making process. It also recommended that JCA assessors reviewing the medical report be encouraged to seek further information from doctors. All the agencies agreed on the need to support doctors and facilitate their involvement in the process.
Economic Security Strategy payment
On 14 October 2008 the Government announced the Economic Security Strategy payment (ESSP) that was payable to eligible pensioners, veterans, families and concession card holders. FaHCSIA was responsible for the policy of the payment while Centrelink was responsible for its delivery.
The majority of payments were to be delivered between 8 and 19 December 2008. In order to qualify for the payment, a person had to be in receipt of an eligible pension or family assistance payment, or be the holder of an eligible concession card, on 14 October 2008.
Shortly after the majority of ESSPs had been made in December 2008, we received a large number of complaints from people who were expecting the payment, but had subsequently been advised by Centrelink that they did not qualify. These people told us that they did not qualify because they did not receive an instalment of their eligible payment for a period covering 14 October 2008. Further investigation revealed that people must have received an instalment of their payment for the period including 14 October 2008 in order to qualify for the ESSP. A large number of the complaints we received were from people who qualified for an eligible payment, but their rate had been set to nil for the fortnight that included 14 October 2008 due to casual earnings.
While this criterion was clear in the legislation governing the ESSP, it was not as clear in the communication regarding the payment, including media releases, advertisements, and fact sheets on the agencies' websites.
At the end of the reporting period we were still in discussion with Centrelink and FaHCSIA about a number of issues stemming from the administration of the ESSP. A draft Ombudsman report had been prepared and provided to the agencies.
Equine influenza assistance
Our 2007–08 annual report discussed some of the issues we observed through complaints about the Equine Influenza Business Assistance Grant (EIBAG) which assisted those affected by the equine influenza outbreak and related movement restrictions. The Department of Agriculture, Fisheries and Forestry (DAFF) held policy responsibility for the EIBAG and Centrelink administered it.
In May 2008 we received five complaints about Centrelink's decision to reject claims for the third round of assistance. The policy guidelines for the third EIBAG specified that, in order to qualify, businesses needed to be located in, or demonstrate that the majority of their income was derived from, a restricted movement zone.
Each of the claims was rejected on the basis that the claimants were not located in a restricted movement zone, nor did they conduct their business activities in one. While this was true, each of the businesses relied on customers that were located in restricted movement zones and therefore derived their income from those zones. DAFF subsequently reviewed and upheld Centrelink's decisions on the basis that the claimants had not provided sufficient evidence to demonstrate that their businesses qualified for the payment.
Upon investigation it appeared that Centrelink had misinterpreted the EIBAG policy guidelines and had been rejecting claimants incorrectly on the basis of whether they were actually conducting business activities in a restricted movement zone, rather than whether their income was derived from a restricted movement zone. Further enquiries revealed that DAFF was aware that Centrelink had misinterpreted the guidelines, yet failed to intervene.
DAFF was, in fact, rejecting these claims on appeal on a different basis: that claimants failed to demonstrate they derived their income from a restricted movement zone. While this was the correct basis, many claimants would have been able to provide further evidence to demonstrate they derived their income from a restricted movement zone, had they been given the opportunity to do so. Given that applicants were not provided with the correct reason for rejecting their EIBAG claims by Centrelink originally, they were denied the opportunity to provide the necessary evidence when appealing to DAFF. DAFF did not acknowledge this. As DAFF would only review a case once, people who would have technically been eligible for the EIBAG missed out.
In November 2008 the Ombudsman published a report Centrelink and Department of Agriculture, Fisheries and Forestry: Claim and review processes in administering the Equine Influenza Business Assistance Grant (third payment) (Report No. 13/2008). As a result of this report, Centrelink (in consultation with DAFF) undertook to contact all claimants of the third EIBAG who had been rejected incorrectly and invite them to reapply with evidence that demonstrated they derived income from a restricted movement zone. As a result, an additional $2,315,000 was paid to 463 claimants whose claims were originally unsuccessful.
This demonstrates how a small number of complaints to the Ombudsman's office can result in far–reaching, substantial remedies for others who may not have contacted us.
Service delivery issues
Alternative servicing arrangements
For several years the Ombudsman's annual reports have referred to the number of complaints received about the withdrawal of face–to–face service options for customers whose behaviour has been inappropriate. The Ombudsman released an own motion investigation report Centrelink: Arrangements for the withdrawal of face–to–face contact with customers (Report No. 9/2008) in August 2008.
The report made five recommendations about the implementation of guidelines for alternative servicing which had been in place and supported by a Centrelink Chief Executive Instruction since February 2007. Despite staff training and the issuing of the instruction to support their introduction, the report found that inconsistent application of the guidelines continued. The main areas of concern were the provision of alternative contact details, the duration and review of arrangements, and the consideration of alternative approaches before face–to–face services were withdrawn. The report recommendations included that letter templates include advice about review rights, and that Centrelink record and monitor the implementation and regular review of arrangements. Centrelink agreed to all the recommendations.
We are aware that Centrelink has been reviewing its policy on alternative servicing arrangements since the publication of the report, and that updated guidelines currently under development are intended to address the concerns raised in the report. We have provided comments to Centrelink on these guidelines. The Ombudsman believes there needs to be greater clarity for both customers and Centrelink officers about how informal alternative service arrangements should be managed, and the continuing right of access to all face–to–face service points under those arrangements made clear to customers. The case study Banned for life illustrates this issue.
Banned for life
In 2005 Centrelink withdrew face–to–face servicing from Ms J for 12 months, a ban which was later extended to life. Following our intervention in September 2008, Centrelink restored face–to–face services because it had failed to review Ms J's case along with all other alternative servicing arrangements in February 2007 (as required by the Chief Executive Instruction).
In March 2009 Ms J was incorrectly told to leave a Customer Service Centre (CSC) because she was banned. Centrelink apologised to her, and gave her written advice of the arrangements in place. She was able to call the manager of her local CSC directly, or if she needed to visit an agent's office, she should call the CSC manager who would then arrange for her to have an appointment with the agency manager or a 'suitable staff member'.
In response to our enquiry about the failure to provide Ms J with details for a backup contact; start, end or review dates for the arrangement; or advice that she could ask for the arrangement to be reviewed, Centrelink advised that it had 'not entered into an alternative servicing arrangement with Ms J rather we have negotiated how to best meet her servicing needs in a different management response which is likely to have a more positive result'. Based on this conclusion, Centrelink did not believe it needed to apply the alternative servicing guidelines. Our view is that any decision to limit a customer's contact with Centrelink should be made according to the guidelines on the alternative servicing arrangements.
Reviews and delays
Our 2007–08 annual report noted continuing concerns with Centrelink's internal review processes. Concerns were expressed about:
- the practice of sending customer reviews to the original decision maker (ODM) when a customer has indicated that they want it referred directly to an authorised review officer (ARO)
- reviews not automatically progressing to an ARO review when the ODM has affirmed their original decision
- review forms which advise customers that, even if they ask to go directly to ARO review, the ODM may examine their matter first.
As the case studies No DSP and No card show, these problems continue. We have commenced an own motion investigation into Centrelink's internal review processes. We expect to release a report on the outcome of that investigation during 2009–10.
No DSP
Centrelink rejected Mr K's application for DSP in June 2008. Five days later, he asked for a review of the decision. More than four months after the initial review request, the ODM wrote to Mr K affirming the original decision and advising him that, as previously requested, a review by an ARO was underway. In November 2008 the ARO upheld the ODM's decision, and notified Mr K in writing nearly three weeks later. By that time Mr K had already lodged an appeal with the Social Security Appeals Tribunal, presumably on the basis of verbal advice of the review outcome.
No card
Mr L complained that he had sought a review of a decision not to grant him a Commonwealth Seniors Health Care Card at the end of December 2008. Centrelink advised us that, due to a large backlog of review requests, and given that the matter did not appear to involve an issue of hardship, it would not be given priority. By late April 2009, the matter had still not been seen by an ARO. In response to our investigation Centrelink apologised for the delay, and noted that it was improving its process for transferring cases between sites and staff, and increasing the number of staff to prevent this situation recurring.
Use of interpreters
In 2009 the Ombudsman's office conducted a cross–agency review of the use of interpreters, with the intention of providing best practice principles against which all agencies could measure their performance and make informed decisions about their potential for improvement.
The Ombudsman's report Use of interpreters: the Australian Federal Police; Centrelink; the Department of Education, Employment and Workplace Relations; the Department of Immigration and Citizenship (Report No. 3/2009) identified eight principles for clear and comprehensive policies to guide staff in the use of interpreters. It also considered the provision of staff training, a community language scheme for multilingual staff, recordkeeping, complaint–handling mechanisms and the way in which agencies address challenges when using interpreters. Encouragingly, Centrelink's policies were found to generally align with best practice principles in the use of interpreters.
Inability to contact by phone
It is not uncommon for the Ombudsman's office to receive a few complaints from people who are experiencing difficulty getting through to Centrelink call centres when contacting the agency by telephone. However, during 2008–09 we received a substantially higher number of complaints about this issue.
We found that Centrelink had been dealing with abnormally large call volumes over 2008–09. Centrelink attributed this to the number of unusual functions it had to perform during the year. These included the delivery and operation of:
- the Economic Security Strategy payment
- the Household Stimulus payment
- assistance relating to the Victorian bushfires
- assistance relating to the Queensland floods
- the information line for the Mumbai crisis
- the swine flu hotline.
It appeared to us that Centrelink was handling the call volumes as best it could, given the circumstances. Centrelink advised us that customers would not be disadvantaged as a result of not being able to get through on the phone. For example, if a person was unable to report their income to Centrelink due to telephone congestion, Centrelink would take this into account in making decisions about the person's payment.
While we did not investigate the individual complaints, we were able to explain the reasons for the telephone difficulties to complainants and that they could contact us again if their payments were affected in some manner as a result of not being able to get through to Centrelink.
Cross–agency issues
Cross–agency issues frequently arise where one agency has policy responsibility for a scheme or payment, and another agency is responsible for delivery. One of the most common interdependencies involves the relationship between DEEWR and its contracted providers (providers of government employment services—now called Employment Service Providers) and Centrelink.
Income support recipients on activity–tested payments are usually required to register with a provider, and Centrelink supports provider referrals. Because of the relationship between a person's payment and the activities they are required to participate in with their provider, much information is exchanged between Centrelink, DEEWR and its providers. Sometimes this exchange is automatic, and invisible to the parties involved. At other times, the exchange relies on a manual intervention by one or more parties. Complainants to this office are often put at a disadvantage in not knowing where and how to pursue an issue if the boundaries of responsibility are not clear. In some cases this confusion extends into the agencies themselves. In these cases it is imperative that agencies define their respective roles through clear procedures and guidelines and liaise with each other frequently on these. The case study Too voluntary shows one such case.
Too voluntary
Mr M was on DSP and was a voluntary job seeker. Mr M complained that DEEWR would not allow him to participate in an intensive employment support program even though DEEWR had referred him to it in March 2007. Mr M had tried to clarify with both Centrelink and DEEWR why he was not able to participate in the program, to no avail.
On contacting Centrelink to investigate his complaint, we established that Mr M's referral to the program stalled because his DSP was cancelled six days before the referral. Centrelink explained that the cancellation occurred due to a systems error which resulted in Mr M's report of earnings not being registered. Centrelink discovered the error and restored Mr M's DSP in April 2007. Centrelink advised us that, while information on payment restoration automatically transfers to DEEWR where job seeking is compulsory, this does not happen for voluntary job seekers. It must be done manually.
Ultimately, although Mr M had been on DSP since May 2006, he had to wait until July 2008 to be eligible for intensive support, an avoidable 12–month delay. In response to our investigation, Centrelink apologised to Mr M, and undertook to update internal reference materials to ensure that future restorations for voluntary job seekers are recorded on the DEEWR system.
Compensation for Detriment Caused by Defective Administration
We have been undertaking an own motion investigation into the administration of the Compensation for Detriment caused by Defective Administration (CDDA) scheme by Centrelink, the Australian Taxation Office and the Child Support Agency. The Department of Finance and Deregulation is responsible for the policy underpinning the scheme, and the practices of the other agencies were used to illustrate the complexities and challenges in administering the scheme.
The final report, to be published in August 2009, focuses on the accessibility of the scheme to potential claimants, the treatment of evidence in support of claims, and the moral, rather than legal, obligations which underpin decision making under the scheme but which are often frustrated by a legalistic approach to its administration.
Looking ahead
This year we have been closely monitoring preparations for changes under the same sex legislation and employment service reforms, both of which come into full effect from 1 July 2009. Through regular liaison with Centrelink and stakeholder groups in the community, we have been able to contribute constructively to the identification of issues that may lead to complaints in relation to these changes. We will monitor their implementation closely.
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