Unit of competency Outline

Date retreived
22/07/2026 5:59 AM AWST

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Make claim determinations

Make claim determinations

Unit of competency
National Code
PSPINM004
State Code
AWU91
TGA Status
Deleted
DTWD Status
Deleted
Current Release Number
1.00
Current Release Date
07/03/2016
View on TGA
State Implementation and Classification
Approved Date
21/07/2016
Field of Education
081103 - Insurance And Actuarial Studies
Original Release Date
21/07/2016
Nominal Hours
30
Description
This unit describes the skills required to assess compensation claims for employment related injuries in order to make a determination. It includes assessing the claim and making a determination.This unit applies to those working in the area of worker compensation claim assessment.The skills and knowledge described in this unit must be applied within the legislative, regulatory and policy environment in which they are carried out. Organisational policies and procedures must be consulted and adhered to.Those undertaking this unit would work independently, while performing routine tasks in a range of familiar contexts.No licensing, legislative or certification requirements apply to unit at the time of publication.
Notes
Elements and Performance Criteria
1. Assess claim
  • 1.1 Assess available information to establish if it is sufficient for a determination to be made.
  • 1.2 Identify additional information required, if any, to make the determination.
  • 1.3 Obtain additional information.
  • 1.4 Re-assess information to determine if it is sufficient or if further investigation is required.
  • 1.5 Make a decision to defer where information is insufficient, and consider interim payments where applicable.
2. Make a determination
  • 2.1 Confirm the claimant’s eligibility and the reported condition as compensable under the legislation.
  • 2.2 Assess details of the claim to ensure they qualify for payment.
  • 2.3 Accept or reject the claim based on all available evidence.
  • 2.4 Calculate notional weekly earnings where required.
  • 2.5 Advise the claimant and other relevant parties in writing of the decision, and ensure advice contains all information required by the legislation.
  • 2.6 Complete case records ensuring they contain comprehensive details of the claim and justification for the decision.
No information
No information
Replaces
State Code National Code Title Type
C8168 PSPIM403A Make claim determinations Unit of competency
State Code National Code Title Type
AZX9 PSP40116 Certificate IV in Government Qualification