NTISthis.com

Evidence Guide: PSPINM004 - Make claim determinations

Student: __________________________________________________

Signature: _________________________________________________

Tips for gathering evidence to demonstrate your skills

The important thing to remember when gathering evidence is that the more evidence the better - that is, the more evidence you gather to demonstrate your skills, the more confident an assessor can be that you have learned the skills not just at one point in time, but are continuing to apply and develop those skills (as opposed to just learning for the test!). Furthermore, one piece of evidence that you collect will not usualy demonstrate all the required criteria for a unit of competency, whereas multiple overlapping pieces of evidence will usually do the trick!

From the Wiki University

 

PSPINM004 - Make claim determinations

What evidence can you provide to prove your understanding of each of the following citeria?

Assess claim

  1. Assess available information to establish if it is sufficient for a determination to be made.
  2. Identify additional information required, if any, to make the determination.
  3. Obtain additional information.
  4. Re-assess information to determine if it is sufficient or if further investigation is required.
  5. Make a decision to defer where information is insufficient, and consider interim payments where applicable.
Assess available information to establish if it is sufficient for a determination to be made.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Identify additional information required, if any, to make the determination.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Obtain additional information.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Re-assess information to determine if it is sufficient or if further investigation is required.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Make a decision to defer where information is insufficient, and consider interim payments where applicable.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Make a determination

  1. Confirm the claimant’s eligibility and the reported condition as compensable under the legislation.
  2. Assess details of the claim to ensure they qualify for payment.
  3. Accept or reject the claim based on all available evidence.
  4. Calculate notional weekly earnings where required.
  5. Advise the claimant and other relevant parties in writing of the decision, and ensure advice contains all information required by the legislation.
  6. Complete case records ensuring they contain comprehensive details of the claim and justification for the decision.
Confirm the claimant’s eligibility and the reported condition as compensable under the legislation.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Assess details of the claim to ensure they qualify for payment.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Accept or reject the claim based on all available evidence.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Calculate notional weekly earnings where required.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Advise the claimant and other relevant parties in writing of the decision, and ensure advice contains all information required by the legislation.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Complete case records ensuring they contain comprehensive details of the claim and justification for the decision.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Assess claim

  1. Assess available information to establish if it is sufficient for a determination to be made.
  2. Identify additional information required, if any, to make the determination.
  3. Obtain additional information.
  4. Re-assess information to determine if it is sufficient or if further investigation is required.
  5. Make a decision to defer where information is insufficient, and consider interim payments where applicable.
Assess available information to establish if it is sufficient for a determination to be made.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Identify additional information required, if any, to make the determination.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Obtain additional information.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Re-assess information to determine if it is sufficient or if further investigation is required.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Make a decision to defer where information is insufficient, and consider interim payments where applicable.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Make a determination

  1. Confirm the claimant’s eligibility and the reported condition as compensable under the legislation.
  2. Assess details of the claim to ensure they qualify for payment.
  3. Accept or reject the claim based on all available evidence.
  4. Calculate notional weekly earnings where required.
  5. Advise the claimant and other relevant parties in writing of the decision, and ensure advice contains all information required by the legislation.
  6. Complete case records ensuring they contain comprehensive details of the claim and justification for the decision.
Confirm the claimant’s eligibility and the reported condition as compensable under the legislation.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Assess details of the claim to ensure they qualify for payment.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Accept or reject the claim based on all available evidence.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Calculate notional weekly earnings where required.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Advise the claimant and other relevant parties in writing of the decision, and ensure advice contains all information required by the legislation.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Complete case records ensuring they contain comprehensive details of the claim and justification for the decision.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Assessed

Teacher: ___________________________________ Date: _________

Signature: ________________________________________________

Comments:

 

 

 

 

 

 

 

 

Instructions to Assessors

Evidence Guide

ELEMENTS

PERFORMANCE CRITERIA

Elements describe the essential outcomes

Performance criteria describe the performance needed to demonstrate achievement of the element. Where bold italicised text is used, further information is detailed in the range of conditions section.

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.

Required Skills and Knowledge

ELEMENTS

PERFORMANCE CRITERIA

Elements describe the essential outcomes

Performance criteria describe the performance needed to demonstrate achievement of the element. Where bold italicised text is used, further information is detailed in the range of conditions section.

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.

Evidence required to demonstrate competence must satisfy all of the requirements of the elements and performance criteria. If not otherwise specified the candidate must demonstrate evidence of performance of the following on at least one occasion.

applying legislation, regulations and policies relating to determination of compensation claims

assessing the sufficiency of information and the requirement for further investigation

analysing information and making judgments

calculating interim payments

reading and applying complex information

using communication with a diverse range of people including employers, unions, workplace supervisors, medical advisers, legal advisers, insurer/self-insurer

Evidence required to demonstrate competence must satisfy all of the requirements of the elements and performance criteria. If not otherwise specified the depth of knowledge demonstrated must be appropriate to the job context of the candidate.

public sector legislation, including work health and safety, and environment

regulations, policies, procedures and guidelines relating to determination of claims

privacy legislation

freedom of information legislation

procedures to ensure confidentiality and security of information

eligibility and compensable conditions under the legislation

expenses that may be claimed

non-economic loss

medical terminology

documentary requirements of a claim

organisational standards for claim determinations

range of payment options under the legislation