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Carer Payment and Carer Allowance Medical Report

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Carer Payment and Carer Allowance – Medical Report (for a child under 16 years)

Child’s details

You will need to provide a separate report for each child – contact us if you require additional reports.

This report may be used to decide eligibility for Carer Payment and Carer Allowance and Special Disability Trust beneficiary status.

Instructions for the parent/guardian (carer)

Give this report to the child’s doctor or Treating Health Professional to complete.

Read and sign this authority to release information.

• I give permission for medical details and clinical notes about the child to be supplied to the Australian Government Department of Human Services.

• I understand that the report will be used to assist in assessing a claim for Carer Allowance for current and future carers and may need to be released to that person(s) by the Australian Government Department of Human Services.

Instructions for the Treating Health Professional

This report may be used to decide eligibility for Carer Payment and Carer Allowance and Special Disability Trust beneficiary status.

Payment for your report

We have asked the carer of the child to let you know at the time of making their appointment that they require you to complete this report.

This is to make sure you have sufficient time for the examination.

The time taken to complete the medical report may be claimed under a Medicare item when included as part of a consultation.

Completing this report

In this report you will be asked to provide details of the child’s medical condition(s). Please complete all the required questions in this report.

If you have any questions about this report, you can call us on 132 717.

Recognised disabilities and medical conditions

1. Please tell us about the child’s disability or medical condition(s)

If a diagnosis has not yet been made, please provide a description of the condition(s).

2. Did the disability or medical condition begin more than 12 weeks ago?

No

Yes

3. What date did the disability or medical condition begin?

4. Is the child’s condition:

Permanent

Temporary

5. Is the permanent condition:

Non improving

Improving

6. Is the temporary condition expected to be present for:

At least 12 months

Less than 12 months

7. Does the condition require extra care and attention for 14 hours or more per week?

No

Yes

8. Please indicate if the child has any of the following disabilities:

Cerebral Palsy

Lower Limb Deficiencies

Spina Bifida

Other moderate to severe multiple or physical disability

Severe multiple or physical disability

Epilepsy - Absence Seizure

Epilepsy - Grand Mal

Epilepsy - Myoclonic Seizure

Epilepsy - Complex Seizure

Epilepsy - Simple Seizure

Angelman syndrome

Cri du chat syndrome

Edwards syndrome (Trisomy 18)

Patau syndrome (Trisomy 13)

Prader-Willi syndrome

Rett syndrome

Williams syndrome

Down Syndrome

Fragile X Syndrome

9. Please indicate if the child has any of the following medical conditions:

Chronic or end stage organ failure

HIV/AIDS symptomatic

Immunodeficiency requiring regular immunoglobulin infusions

Leukemia or other childhood malignancy

Haemophilia

Thalassaemia or haemoglobinopathy

Chronic Transfusion Dependent Anaemia

Langerhan Cell Histiocytosis

Severe congenital Neutropenia

10. Does the child have a disability or medical condition listed at question 8 or 9?

No

Yes

11. Please read this before answering the following questions.

Instructions for questions 12—19

Please indicate the statement that describes the child’s usual ability.

If the child cannot do any of the skills listed in a question, tick the last box.

If the child’s ability is appropriate for the age of the child, tick the first box.

The child’s abilities include what he/she can do when using his/her aids, appliances or special equipment items.

Where the child’s disability or medical condition is episodic or is only apparent at certain times, the question should be answered for what the child is currently able to do most of the time.

12. Receptive language skills (listening, reading and understanding)

Child’s ability is age appropriate.

Child understands adult speech or signed language of normal speed and complexity.

Child can read and interpret a paragraph from the front page of a daily newspaper.

Child can read a paragraph or page from a children’s story book appropriate for the child’s age group.

Child understands and responds appropriately to simple questions.

Child follows 2 step instructions.

Child knows the difference between ‘big’ and ‘little’.

Child recognises pictures of common objects.

Child responds to sound and tracks noise-making objects.

Child looks momentarily at speaker’s face.

Child cannot do any of the things listed above.

13. Expressive language skills (talking or signing)

Child’s ability is age appropriate.

Child has almost a full adult vocabulary.

Child can describe experiences in detail using complex sentences.

Child can tell a complex story involving several characters.

Child can write their own first name and state their name and home address.

Child talks or signs well and can use 6 or more words in a sentence.

Child can say sentences with 3 to 4 words.

Child can clearly say or sign more than 20 words and can use 2 words in combination.

Child can say or sign 3 or more simple words.

Child smiles and babbles or makes purposeful sounds.

Child makes a vocal sound other than crying.

Child cannot do any of the things listed above.

14. Feeding and mealtime skills

Child’s ability is age appropriate.

Child can use all cooking equipment and kitchen appliances without assistance.

Child can follow a recipe and prepare a simple meal.

Child can cook a simple snack.

Child can prepare a simple uncooked snack.

Child can use a fork and spoon at mealtimes.

Child can eat most solid foods if food is cut up.

Child uses spoon well.

Child can drink from a normal cup without help.

Child can drink from a modified cup when held by an adult.

Child can suck from a breast or baby’s feeding bottle.

Child cannot do any of the things listed above.

15. Hygiene and grooming skills

Child’s ability is age appropriate.

Child can style own hair and clean and cut own finger and toe nails.

Child can attend to basic hygiene without assistance.

Child manages basic hygiene with little assistance.

Child can wash hands and face and brush own teeth.

Child is reliably toilet-trained during the day and can manage own toileting with minimal assistance.

Child can indicate toilet needs during the day but needs some assistance.

Child is toilet-timed during the day or is indicating toilet needs.

Child requires full assistance with toileting.

Child cries when nappy is soiled or wet.

Child cannot do any of the things listed above.

16. Dressing skills

Child’s ability is age appropriate.

Child can purchase and care for own clothing without assistance.

Child can wash and iron own clothing if required.

Child can choose own clothing appropriate to the weather and can dress and undress without assistance.

Child can do up buckles and untie shoelaces.

Child can do up buttons and zippers.

Child dresses and undresses but needs assistance with buttons, laces or tight clothing.

Child can undress with little assistance.

Child tries to help with dressing.

Child lifts arms to be picked up.

Child snuggles in to an adult when cuddled.

Child cannot do any of the things listed above.

17. Social and community skills

Child’s ability is age appropriate.

Child can use all major community facilities with little assistance.

Child is able to undertake basic activities in the community with little supervision.

Child understands basic personal safety.

Child is aware of being left in the care of others without getting unduly upset.

Child takes turns in conversations.

Child initiates contact with other people and involves other people in games or activities.

Child responds to affection from familiar people.

Child laughs and giggles when happy and cries when upset or angry.

Child smiles. Child settles when picked up and cuddled.

Child cannot do any of the things listed above.

18. Mobility — fine motor skills

Child’s ability is age appropriate.

Child can use a variety of tools or hobby items with accuracy.

Child can write clearly.

Child can write all letters of the alphabet clearly.

Child can hold a pencil and draw basic shapes.

Child can manipulate smaller objects accurately.

Child can build a tower of 9 blocks.

Child can manipulate larger objects and toys.

Child can make purposeful movements with objects.

Child grasps and releases objects such as a rattle or feeding bottle.

Child can grasp an adult finger but may need assistance to release it.

Child cannot do any of the things listed above.

19. Mobility — gross motor skills

Child’s ability is age appropriate.

Child can hit a ball with a bat and can kick a ball with reasonable accuracy.

Child can catch a small ball and skip well or ride a two-wheel bike.

Child can jump and hop on each leg.

Child can run fast and balance on 1 leg for 3 seconds.

Child can balance briefly while standing on 1 leg.

Child can walk and can run a few steps.

Child has even muscle tone and strength in all limbs.

Child can pull himself or herself from floor to standing position.

Child can independently move between prone and supine positions.

Child can lift head when in prone position.

Child cannot do any of the things listed above.

20. Behaviour

Child is consistently uncooperative and disruptive during treatment or assessment episodes.

Child demonstrates self injurious behaviour.

Child displays aggressive behaviour or violence towards other people or property.

Child persistently attempts to leave or abscond from the treatment or assessment setting.

Child is extremely active and is unable to concentrate on a task for more than 30 seconds.

Child displays obsessional, repetitive behaviours.

None of the above apply.

21. Special care needs

Child has chronic and progressive suppurative lung disease.

Child is receiving a course of chemotherapy or radiotherapy treatment for cancer.

Child has poorly controlled seizures requiring emergency medication or first aid.

Child is assisted on a daily basis with at least 2 blood tests and injections.

Child receives all food and fluids by tube feeding.

Child has a tracheostomy.

Child requires a ventilator to support respiration.

Child requires regular oxygen therapy at home.

Child requires a CPAP or BiPAP machine.

Child is over 4 years of age and is incontinent both day and night.

Child is over 3 years of age and cannot stand without support.

Child requires a wheelchair and requires assistance to propel the wheelchair.

Child requires a wheelchair, quad sticks, prosthesis, crutches or walking frame but can move around with little assistance.

Child uses an electric wheelchair.

Child requires urinary catheterisation several times each day.

Child requires specialised equipment or technology to communicate.

Child is over 5 years of age and has persistent difficulties with memory, concentration, planning and organisation.

None of the above apply.

Child has a severe eating disorder such as anorexia nervosa or bulimia.

22. For the following questions personal care means ongoing care required for a significant period every day...

Please read this before answering the following questions.

23. Does the child have a condition that may significantly reduce their life expectancy?

No

Yes

24. Is the average life expectancy of a child with this or a similar condition substantially longer than 24 months?

No

Yes

25. Does the child need personal care for a significant period every day for the duration of the condition?

No

Yes

Not sure

26. Is the care load associated with the child so high that more than 1 carer is required?

No

Yes

27. How many carers are required to provide this care?

28. Does the child need personal care because of a severe disability or severe medical condition for a significant period every day?

No

For 6 months or more

For 3 to less than 6 months

Not sure

29. What is the estimated start date and end date for the period that the child will need this care?

30. Is the child likely to have future episodes of the same or a similar condition?

No

Yes

31. Is the care load associated with the child so high that more than 1 carer is required?

No

Yes

32. How many carers are required to provide this care?

33. Are you a legally qualified medical practitioner?

No

Yes

Please provide the details of the legally qualified medical practitioner who can certify the diagnosis indicated at question 1.

34. Are there any other comments you wish to make?

35. Release of medical information about the child requiring care

Is there any information in this report which, if released, might harm the child’s physical or mental well-being?

No

Yes

36. Identify the information and state why it should not be released.

37. IMPORTANT INFORMATION

Privacy and your personal information

Your personal information is protected by law, including the Privacy Act 1988, and is collected by the Australian Government Department of Human Services for the assessment and administration of payments and services.

Your information may be used by the department or given to other parties for the purposes of research, investigation or where you have agreed or it is required or authorised by law.

You can get more information about the way in which the Department of Human Services will manage your personal information, including our privacy policy at www.humanservices.gov.au/privacy or by requesting a copy from the department.

38. Details of the Treating Health Professional completing this report

Please print in BLOCK LETTERS or use stamp.

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What the Carer Payment and Carer Allowance Medical Report Is

The Carer Payment and Carer Allowance Medical Report documents a care recipient's medical condition and functional needs to support claims for carer benefits. It records diagnoses, treatment history, medication, mobility and daily living limitations, and the expected duration of care. Clinicians complete objective observations and may attach clinical notes or test results. Agencies use the report to determine eligibility, assess support intensity, and set review timelines. Accurate, current medical information speeds decisions and reduces requests for follow-up clarifications from assessors.

Why a Thorough Medical Report Matters for Carer Benefits

A complete medical report provides the factual basis evaluators need to decide eligibility and payment levels. It reduces back-and-forth clarifications, helps establish the expected care duration, and protects claimants by documenting clinical need in a standard, auditable format.

Why a Thorough Medical Report Matters for Carer Benefits

Who Completes and Reviews This Medical Report

Clinical providers complete the report; agencies and claims officers review it to make eligibility decisions.

  • Primary care physicians and specialists who treat the care recipient and can describe functional limitations and prognosis.
  • Registered nurses and allied health professionals who provide objective assessments of activities of daily living.
  • Claims assessors and case managers who evaluate reports to determine eligibility, payment amounts, and review schedules.

Accurate, legible clinical entries and supporting records reduce processing delays and support consistent determinations.

Step-by-Step: Completing the Medical Report

Complete the report in one session when possible and attach supporting clinical documents to minimize follow-up requests and processing time.

  • 01
    Prepare Records: Gather recent notes, test results, and medication lists before beginning.
  • 02
    Fill Identifiers: Enter patient name, DOB, and assessment date exactly as on file.
  • 03
    Document Findings: Describe diagnoses, treatments, functional limits, and assistance required.
  • 04
    Sign and Attach: Add clinician signature, license number, and include clinical attachments.

How the Report Moves Through the Review Process

The report follows a standard routing: clinical completion, submission to the benefits agency, triage for completeness, and eligibility decision or request for clarification.

  • Clinical Completion: Provider completes report and attaches records.
  • Agency Intake: Claims team receives and logs the report.
  • Triage Review: Verifier checks for completeness and legibility.
  • Decision or Query: Eligibility decision issued or clarifying questions sent.

Key Components of a Professional Medical Report

A reliable report balances clinical accuracy with clear descriptions of daily function to support objective eligibility assessments.

Patient Identifiers

Full legal name, date of birth, contact information, and any claim or reference numbers used by the agency to match records.

Clinical Summary

Concise medical history, principal diagnosis, comorbidities, and relevant prior interventions or hospitalizations that affect care needs.

Functional Assessment

Specific, observable limitations in activities of daily living and instrumental tasks, including frequency and level of assistance required.

Medications and Treatments

List current medications, recent procedures, and ongoing therapies that influence daily functioning and supervision needs.

Care Plan

Recommended care level, supervision requirements, and any equipment or home modifications necessary to support safety and independence.

Clinician Verification

Signature, professional license number, workplace contact details, and date to verify qualifications and allow follow-up if needed.

Essential Data Elements to Include

Patient Name: Full legal name
Date of Birth: MM/DD/YYYY
Diagnosis: Primary ICD-10 code
Functional Limits: Activities affected
Clinician Details: Name and license
Sign-off Date: MM/DD/YYYY

Common Preparation Pitfalls to Avoid

  • Leaving fields blank or using vague language such as 'needs help' without specifying tasks, frequency, or level of assistance.
  • Listing diagnoses without linking them to observable functional impacts; assessors need the connection to decide eligibility.
  • Submitting illegible handwritten entries or missing clinician identifiers, which often triggers requests for clarification.
  • Failing to include recent supporting records such as hospitalization summaries, therapy notes, or medication lists that corroborate findings.

Risks of Incomplete or Incorrect Reports

Delayed Decision: Processing delays
Denial of Benefits: Claim ineligibility risk
Appeals Required: Additional workload
Reputational Impact: Provider follow-up burden
Data Privacy Risk: Improper record handling
Audit Exposure: Incomplete evidence risk

Configuring an Electronic Submission Workflow

Set up a repeatable electronic workflow that captures required fields, attachments, and clinician authentication to ensure consistent submissions.

Field Configuration
Required Fields Make identifiers, diagnosis, and signature mandatory
Attachments Allow PDF, DOCX, imaging files
Authentication Use clinician credentials and contact verification
Audit Trail Enable timestamps and action logs

Technical and Security Considerations for eSubmission

Choose a platform that supports secure upload, audit trails, and appropriate signer authentication to protect clinical data.

  • File Formats: PDF, DOCX, image files
  • Authentication: Email, SMS code, or stronger methods
  • Audit Trail: IP, timestamps, and action logs

For health data, ensure the platform supports HIPAA controls and a Business Associate Agreement where required by 45 CFR §164.502(e).

Timelines and Typical Processing Expectations

Processing times vary by agency and caseload; the following are typical milestones to plan around when submitting a medical report.

Submission Timing:

Include the report with the initial application to avoid processing delays

Initial Triage:

Agency intake and completeness check commonly within 7–14 days

Clinical Review:

Medical review typically completed in 2–8 weeks depending on workload

Clarification Requests:

Expect requests for more information within 30 days if items are unclear

Appeals Window:

Appeal or review deadlines vary; respond promptly to agency letters for applicable deadlines

Key Milestones from Assessment to Decision

A sequential timeline highlights core stages from clinical assessment through final eligibility decision and potential review.

01

Assessment Completed

Clinician documents findings and signs the report.

02

Report Submitted

Report uploaded or mailed to the agency with supporting records.

03

Completeness Check

Intake team verifies required fields and attachments.

04

Final Determination

Agency issues eligibility decision or requests further evidence.

eSignature Pricing Comparison for Submitting Medical Reports

Compare baseline pricing and core features of common eSignature providers when selecting a platform for secure medical report submission and auditability.

signNow DocuSign Adobe Sign PandaDoc HelloSign
Starting Price $8/user/mo $15/user/mo $14/user/mo $19/user/mo $15/user/mo
Free Trial 7-day free trial Varies by vendor Varies by vendor Varies by vendor Varies by vendor
Bulk Send Yes Yes Yes Yes Yes
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes Yes Yes No No

Frequently Asked Questions: Common Issues and Solutions

Answers address frequent problems clinicians and claimants encounter, including authentication, missing information, and secure transmission.


Need help? Contact support

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