Determination without Application

A determination without application (SS Act 2018, s.52) is a new determination of entitlement that replaces an earlier determination. Case managers must make determinations without applications when there is either:

• a scheduled review of the individual’s award (ADP regs, reg. 47)
• an unscheduled review of the individual’s award (ADP regs, reg. 48, 49, 50 and 51) 

Moving between rates of ADP

Individuals are able to move between rates of both components of ADP. This will result from a new determination made during a scheduled or unscheduled review. This is because individual’s needs can change over time. This will affect the level of assistance they are entitled to.

The backwards and forwards tests are applied differently when the needs of individuals entitled to ADP change. This depends on whether the individual is entitled to an enhanced, standard or no award as a result of the change. For information on how to apply the backwards and forwards tests in these situations, see the ‘Change to Impact of the Condition or Level of Need’ chapter. 

Entitlement to ADP is not affected until the case manager has made a new determination. Case managers must follow the rules on when changes in entitlement take effect. These rules are found in the following chapters:

• the Scheduled Reviews chapter
• the Unscheduled Reviews chapter. 

Challenging Determinations of entitlement to ADP

Individuals can challenge determinations of entitlement made by case managers (SS 2018 Act, s41). This includes determinations made on applications and on-going awards of ADP. This is a re-determination. For more information, see the Re-determinations chapter.