Social Security (Modernisation) Amendment Bill
Social Security (Modernisation) Amendment Bill
Checking for alerts... Loading...
Social Security (Modernisation) Amendment Bill
Social Security (Modernisation) Amendment Bill
Government Bill
313—1
Explanatory note
General policy statement
The Social Security (Modernisation) Amendment Bill (the Bill) amends the Social Security Act 2018 (the Act) and the Social Security Regulations 2018 (the Regulations). The Bill aims to enable the administration of a more efficient, modern welfare system through the use of automated decision making (ADM).
Context
An automated decision is a decision within an automated process where there is no substantial human involvement in making the decision. The Act currently allows for the targeted use of ADM. The Ministry of Social Development (MSD) does not currently have a broad power to use ADM outside of the processes involved in that targeted use, and the Act contains discretionary powers that mean further use of ADM in some processes would require legislative change.
Objectives of Bill
The objectives of the Bill are to—
improve the efficiency and effectiveness of the administration of the welfare system:
enable the use of ADM with appropriate safeguards:
expand the list of specified benefits that will be subject to the mandatory reviews provisions in the Act:
require beneficiaries to provide a medical certificate, or other medical evidence, where appropriate, before MSD can grant, or continue to grant (where medical coverage expires), a medical evidence benefit (to be known as “medical reviews”):
ensure that the practice of excluding a child from a caregiver’s benefit when the child turns 18 years old is set out in law (to be known as the “end of school year review process”).
How Bill achieves objectives
General authorising provision
The Bill enacts a general authorising provision that enables MSD to approve the use of an automated electronic system by a specified person to make any decision, exercise any power, comply with any obligation, or take any other related action under any specified provision, with appropriate safeguards. It will also expand on existing legislative safeguards for the use of ADM.
ADM will continue to be used to administer aspects of mandatory reviews and will be used to administer aspects of medical reviews and the end of school year process.
Mandatory reviews
Under the Act, MSD must undertake mandatory reviews for specified benefits. That duty is to ensure that MSD can determine, at least once every 52 weeks, whether a beneficiary is eligible for and receiving the correct rate of assistance. The Bill modifies the mandatory review settings and expands the current listed specified benefits to include—
orphan’s benefit:
orphan’s benefit—overseas:
unsupported child’s benefit:
supported living payment—overseas:
widow’s benefit—overseas:
New Zealand superannuation—overseas:
veteran’s pension—overseas:
special benefit:
childcare assistance—childcare subsidy:
childcare assistance—out-of-school care and recreation subsidy.
Before deciding to continue to pay a specified benefit following a mandatory review, MSD staff will be required to consider whether further information is required if—
the beneficiary has not declared any changes in their accommodation costs, disability costs, or declared income in 3 years (“the 3-year rule”):
a person receiving supplementary assistance only has declared no income at their mandatory review (“the supplementary benefit rule”).
The Bill modifies mandatory review settings for the following benefits:
special benefit will not be eligible for an exception, an exemption, or an extension:
childcare subsidy or out-of-school care and recreation subsidy will not be eligible for an exception or an exemption:
youth payment and young parent payment beneficiaries receiving a disability allowance will no longer be subject to mandatory reviews:
exceptions for overseas beneficiaries will have the same settings as beneficiaries residing in New Zealand:
suitable engagements introduced in mandatory reviews will apply only to orphan’s benefit (domestic) and unsupported child’s benefit.
Medical reviews
The Bill requires beneficiaries receiving medical evidence benefits to provide a medical certificate or other medical evidence (where appropriate) before MSD can grant that benefit. Medical evidence benefits are—
jobseeker support—health condition, injury, or disability:
supported living payment (paid on any ground):
child disability allowance:
disability allowance.
The Bill includes provisions that allow for extensions and deferrals to give beneficiaries more time to provide their medical certificate or other evidence in exceptional circumstances.
MSD will have discretion to require a beneficiary to undergo a medical examination by a preferred health practitioner when there is a question about the beneficiary’s eligibility for a medical evidence benefit.
End of school year review process
The Bill requires MSD to exclude a child from a caregiver’s benefit after the child turns 18 years old unless the caregiver confirms (and MSD is satisfied) that the child is not financially independent and is in school or tertiary education. The child will then continue to be included in the caregiver’s benefit until the earlier of the child being financially independent, leaving school or tertiary education, or until 31 December following the child’s 18th birthday. MSD will notify the beneficiary at least 20 working days before excluding the child.
Some benefits may be suspended or cancelled as a result of the child being excluded where the caregiver is no longer eligible for their assistance or because the benefit that the beneficiary receives requires review after their child turns 18 years old.
Departmental disclosure statement
The Ministry of Social Development is required to prepare a disclosure statement to assist with the scrutiny of this Bill. The disclosure statement provides access to information about the policy development of the Bill and identifies any significant or unusual legislative features of the Bill.
A copy of the statement can be found at http://legislation.govt.nz/disclosure.aspx?type=bill&subtype=government&year=2026&no=313
Regulatory impact statement
The Ministry of Social Development produced a regulatory impact statement on 24 February 2025 to help inform the main policy decisions taken by the Government relating to the contents of this Bill.
The Ministry of Social Development also produced a related addendum to that regulatory impact statement on 30 April 2026.
Clause by clause analysis
Clause 1 is the Title clause.
Clause 2 is about commencement. The amendment Act arising from the Bill comes into force as follows:
any part of that amendment Act not otherwise specified comes into force on 1 July 2026 (see clause 2(1)); however,—
mandatory review provisions that come into force then apply to identified benefits only on and after specified dates (see new Part 14 of Schedule 1 of the Act, inserted by Part 2 of the Bill); and
there are 2 exceptions to clause 2(1), set out in clause 2(2):
the sections that make amendments relating to the effect of a child turning 18 years old come into force on 4 September 2026 (see clause 2(2)(a) and (3)):
the sections that make amendments relating to medical evidence come into force on 30 November 2026 (see clause 2(2)(b) and (4)).
Part 1Amendments to substantive provisions
Subpart 1—Amendments to Social Security Act 2018
Medical evidence
Clause 4 amends section 20 (jobseeker support: requirements). The amendment ensures that section 20 is subject to new sections 22A and 27(6) (entitlement to supported living payment, and medical certificate).
Clause 5 inserts new section 22A, which makes it clear that jobseeker support on the ground of a health condition, injury, or disability (see sections 20(b) and 22(c)) cannot be granted to an applicant (A) if A is entitled to a supported living payment on the ground of restricted work capacity under sections 34 to 39 for the reasons set out in new section 22A(2).
Clause 6 amends section 25 (jobseeker support: discretionary grant on ground of hardship). The amendment ensures that section 25 is subject to new section 27(6) (medical certificate).
Clause 7 replaces—
section 27 (jobseeker support: on ground of health condition, injury, or disability: application must include certificate); and
section 28 (Jobseeker support: on ground of health condition, injury, or disability: medical examination).
New section 27—
requires a medical certificate to be provided by—
an applicant for jobseeker support on the ground of a health condition, injury, or disability (A) (see sections 20(b) and 22(c)); and
a beneficiary (A) who is to move to that benefit in a review under section 304 or new section 310A; and
requires the medical certificate to be given by a prescribed health practitioner (PHP), and to certify and state specified matters, including the certificate’s coverage (which is also the period before the review for the medical review date in new section 205C); and
ensures that, if the health condition is that A is at least 27 weeks pregnant, and A has no other health condition, injury, or disability, then—
there is no period before the review for the medical review date (see new section 205C); and
the period in new section 27(4)(a)—
starts when A is 27 weeks pregnant; and
ends at the close of the date that MSD is satisfied, from relevant information available to MSD (for example, a notification by A to MSD under section 113 that A has given birth), is the date on which A’s pregnancy ended; and
until MSD has received, from, or on behalf of, A, a medical certificate that complies with new section 27, prevents MSD from granting jobseeker support on the ground of a health condition, injury, or disability—
in response to A’s application mentioned in new section 27(1); or
in the review mentioned in new section 27(2); and
ensures that new section 27(6)—
overrides sections 20, 25, 301, 302, 307, and 308 and new sections 310R and 310S; but
does not limit section 141 (jobseeker support: work capacity determination and work test) (for example, MSD’s duty under section 141(3)(a) to make a determination under section 141 after having had regard to a medical certificate under new section 27).
New section 28—
applies to an applicant for, or a person receiving, jobseeker support on the ground of a health condition, injury, or disability (P) (see sections 20(b) and 22(c)); and
enables MSD to at any time require P to undergo an examination by a PHP; and
requires the PHP to be agreed for the purpose between P and MSD or, failing agreement, to be nominated by MSD; and
requires the PHP to prepare, and send MSD a copy of, a medical report; and
requires the medical report to certify and state specified matters, including the medical report’s coverage (which is also the period before the review for the medical review date in new section 205C); and
defines the medical report’s coverage; and
ensures that, if the health condition is that P is at least 27 weeks pregnant, and P has no other health condition, injury, or disability,—
the medical report’s coverage does not include a period before the review for the medical review date in new section 205C; and
the period in new section 28(6)(a)—
starts when P is 27 weeks pregnant; and
ends at the close of the date that MSD is satisfied, from relevant information available to MSD (for example, a notification by P to MSD under section 113 that P has given birth), is the date on which P’s pregnancy ended; and
ensures that new section 28 does not limit section 141 (jobseeker support: work capacity determination and work test) (for example, MSD’s duty under section 141(3)(a) to make a determination under section 141 after having had regard to a medical report under new section 28).
Mandatory reviews
Clause 8 amends section 33 (expiry of sole parent support, and replacement with jobseeker support, when youngest dependent child turns 14 years old). New section 33(5) ensures that section 33 does not preclude a mandatory review under new subpart 3A of Part 6 of whether P satisfies the conditions of entitlement to jobseeker support.
Medical evidence
Clause 9 amends section 34 (supported living payment: on ground of restricted work capacity or total blindness: requirements). The amendment ensures that section 34 is subject to new section 36A(7) (medical evidence).
Clause 10 replaces section 37 (supported living payment: on ground of restricted work capacity or total blindness: medical examination) with—
new section 36A (supported living payment: on ground of restricted work capacity or total blindness: requirement to provide medical certificate or other medical evidence); and
new section 37 (supported living payment: on ground of restricted work capacity or total blindness: medical examination).
New section 36A—
requires a medical certificate, or other medical evidence, that complies with new section 36A, to be provided by—
a person who applies for a supported living payment on the ground of restricted work capacity or total blindness (P); or
a beneficiary (A) who is to move to that benefit in a review under section 304 or new section 310A; and
requires the medical certificate, or other medical evidence, under new section 36A to be given by a PHP, and to certify and state specified matters, including the evidence’s coverage (which includes the period before the review, if any, for the medical review date in new section 205C); and
ensures that the requirements to provide medical evidence do not apply if the benefit is, or would be, payable in Australia; and
enables MSD to accept, instead of a medical certificate that complies with new section 36A, other medical evidence that MSD is satisfied—
establishes what must be certified by, and stated in, a certificate that complies with new section 36A; and
that it is appropriate in the circumstances for MSD to accept instead of a certificate that complies with new section 36A; and
until MSD has received, from, or on behalf of, A, a medical certificate or other medical evidence that complies with new section 36A, prevents MSD from granting a supported living payment on the ground of restricted work capacity or total blindness—
in response to P’s application mentioned in new section 36A(1); or
in the review mentioned in new section 36A(2); and
ensures that new section 36A(7) overrides sections 34, 301, 302, 307, and 308 and new sections 310R and 310S.
New section 37—
applies to a person (P) who is an applicant for, or who is receiving, a supported living payment on the ground of restricted work capacity or total blindness; and
enables MSD to at any time require P to undergo an examination by a PHP; and
requires the PHP to be agreed for the purpose between P and MSD or, failing agreement, to be nominated by MSD; and
requires the PHP to prepare, and send MSD a copy of, a medical report; and
requires the medical report to certify and state specified matters, including the medical report’s coverage (which is also the period before the review for the medical review date in new section 205C); and
defines the medical report’s coverage.
Clause 11 amends section 40 (supported living payment: on ground of caring for another person: requirements). The amendment ensures that section 40(1) is subject to new section 41(5) (medical certificate).
Clause 12 replaces sections 41 and 42.
New section 41—
requires a medical certificate to be provided by—
a person (C) who applies for a supported living payment on the ground of caring for another person (P); and
a person (C) who is required to give full-time care and attention at home to a person (P) who is to move to that benefit in a review under section 304 or new section 310A; and
requires the medical certificate to be given by a PHP, and to certify and state specified matters, including the certificate’s coverage; and
until MSD has received, from, or on behalf of, C, a medical certificate that complies with new section 41, prevents MSD from granting a supported living payment on the ground of caring for another person—
in response to C’s application mentioned in new section 41(1); or
in the review mentioned in new section 41(2); and
ensures that new section 41(5) overrides sections 40(1), 301, 302, 307, 308 and new sections 310R and 310S.
New section 42—
applies if a supported living payment on the ground of caring for another person (P) has been applied for by, or granted to, a person (C); and
enables MSD to at any time require that P be examined by a PHP; and
requires the PHP to be agreed for the purpose between P and MSD or, failing agreement, to be nominated by MSD; and
requires the PHP to prepare, and send MSD a copy of, a medical report; and
requires the medical report to certify and state specified matters, including the medical report’s coverage (which is also the period before the review for the medical review date in new section 205C); and
defines the medical report’s coverage.
Mandatory reviews
Clause 13 amends section 75 (winter energy payment: termination on review). The amendment ensures that MSD may terminate a winter energy payment if satisfied, after reviewing the payment under new section 310A (see also new section 310T), that—
the rate of the beneficiary’s qualifying benefit (under section 72(1)(a)) is required by section 206 to be reduced to the rate payable to long-term hospital patients (even if MSD pays a higher rate under section 206(2)); and
continuing the payment is not consistent with the purpose of the winter energy payment stated in section 70.
Medical evidence
Clause 14 amends section 78 amended (child disability allowance: discretionary grant). New section 78(3) ensures that section 78(1) is subject to new section 80(5) (medical evidence).
Clause 15 replaces sections 80 and 81.
New section 80—
requires a medical certificate, or other medical evidence, that complies with new section 80, to be provided by a person (A) who applies for a child disability allowance for a child (C); and
requires the medical certificate, or other medical evidence, under new section 80 to be given by a PHP, and to certify and state specified matters, including the evidence’s coverage (which includes the period before the review, if any, for the medical review date in new section 205C); and
enables MSD to accept, instead of a medical certificate that complies with new section 80, other medical evidence that MSD is satisfied—
establishes what must be certified by, and stated in, a medical certificate that complies with new section 80; and
that it is appropriate in the circumstances for MSD to accept instead of a medical certificate that complies with new section 80; and
until MSD has received, from, or on behalf of, A, a medical certificate or other medical evidence that complies with new section 80, prevents MSD from granting a child disability allowance for C in response to A’s application mentioned in new section 80(1); and
ensures that new section 80(5) overrides sections 78(1), 301, and 302.
New section 81—
applies if a child disability allowance for a child (C) has been applied for or granted; and
enables MSD to at any time require C to be examined by a PHP; and
requires the PHP to be agreed for the purpose between the person who applied for, or who is receiving, the allowance for C and MSD or, failing agreement, to be nominated by MSD; and
requires the PHP to prepare, and send MSD a copy of, a medical report; and
requires the medical report to certify and state specified matters, including the medical report’s coverage (which is also the period before the review for the medical review date in new section 205C); and
defines the medical report’s coverage.
Clause 16 amends section 85 (disability allowance: discretionary grant). New section 85(1), (1A), and (1B) re-enacts section 85(1) to clarify how grants under section 85(1) are applied for, and are made to, or on account of, a person who—
meets the criteria for eligibility in section 85(2); or
falls into a special category of eligibility specified in regulations made under section 425.
New section 85(5) ensures that new section 85(1) is subject to new section 87A(4) (medical certificate).
Clause 17 replaces section 88 (disability allowance: medical examination) with—
new section 87A (disability allowance: requirement to provide medical certificate); and
new section 88 (disability allowance: medical examination).
New section 87A—
requires a medical certificate that complies with new section 87A to be provided by a person (A) who applies for a disability allowance for a person (P); and
requires the medical certificate to be given by a PHP, and to certify and state specified matters, including the evidence’s coverage (which includes the period before the review, if any, for the medical review date in new section 205C); and
until MSD has received, from, or on behalf of, A, a medical certificate that complies with new section 87A, prevents MSD from granting a disability allowance to or on account of P in response to A’s application mentioned in new section 87A(1); and
ensures that new section 87A(4) overrides new section 85(1) and sections 301 and 302.
New section 88—
applies if a disability allowance for a person (P) has been applied for or granted; and
enables MSD to at any time require P to be examined by a PHP; and
requires the PHP to be agreed for the purpose between the person who applied for, or who is receiving, the allowance for P and MSD or, failing agreement, to be nominated by MSD; and
requires the PHP to prepare, and send MSD a copy of, a medical report; and
requires the medical report to certify and state specified matters, including the medical report’s coverage (which is also the period before the review for the medical review date in new section 205C); and
defines the medical report’s coverage.
Effect of child turning 18 years old
Clause 18 replaces subpart 18 of Part 2. Subpart 18 contains section 103.
Section 103 applies where a child (C) aged 18 years—
is not financially independent; and
is attending school or a tertiary educational establishment.
Section 103 gives MSD discretion, even though C is 18 years old, and for such period as MSD determines (expiring not later than the pay day immediately after 31 December in the year in which C turns 18 years old), to—
grant or continue to pay an orphan’s benefit or unsupported child’s benefit in respect of C:
pay any other benefit at the appropriate rate that includes C as a dependent child of the beneficiary.
New subpart 18 contains new sections 103 to 103H.
New subpart 18 sets out how a dependent child (C) turning 18 years old may affect eligibility for, and the appropriate rate of benefit for, the following kinds of benefits (as defined in new section 103A):
a non-discretionary dependent child rate benefit:
a discretionary dependent child rate benefit:
a specified children’s benefit.
New subpart 18 also requires MSD, at least 20 working days (or, if that period is not possible, as early as practicable) before C’s 18th birthday, to give the beneficiary a notice that—
explains the effect of the general rules in new sections 103B to 103E and of the exceptions to those general rules (which include the exception in new section 103F (if C is not financially independent and is continuing education)); and
asks the beneficiary to provide to MSD, before C’s 18th birthday, any information relevant to whether an exception applies.
Medical evidence
Clause 19 amends section 141 (jobseeker support: work capacity determination and work test). Section 141(3)(a) is amended to make it clear that a certificate given under new section 27 is a medical certificate.
Clause 20 amends section 183, which is a guide to Part 4 (factors affecting benefits). The amendment inserts new section 183(2)(la), which identifies, as a factor that may affect a benefit, a failure to provide updated medical evidence for a medical evidence benefit (see new sections 205A to 205I).
Mandatory reviews
Clause 21 amends section 198A (how section 252 of Accident Compensation Act 2001 affects entitlement to, and rate of, specified supplementary assistance). The amendment aligns a cross-reference in section 198A with new subpart 3A of Part 6.
Medical evidence
Clause 22 inserts new sections 205A to 205I and a cross-heading. Those new sections are about a failure to provide updated medical evidence for a medical evidence benefit.
New section 205A applies if—
a beneficiary is receiving a medical evidence benefit (as defined in new section 205C); and
a period was identified in the coverage (as defined in Schedule 2) of the medical certificate, or other medical evidence, for that benefit; and
that benefit therefore has a medical review date (as defined in new section 205C); and
the beneficiary is not excluded from requirements under new section 205A (in circumstances, and for the relevant period, specified) by regulations made under new section 434A(1)(a); and
the beneficiary’s compliance with requirements under new section 205A has not been deferred under new section 205D (for example, in circumstances, and for the relevant period, specified by regulations made under new section 434A).
New section 205A(2) requires the beneficiary to ensure that MSD has received updated medical evidence (as defined in new section 205C)—
for that benefit; and
from, or on behalf of, the beneficiary; and
before whichever is applicable of the following dates:
the medical review date for that benefit:
the date to which the beneficiary’s compliance with requirements under new section 205A is deferred under new section 205D.
New section 205A(3) provides that new section 205A(4) applies if the medical evidence benefit is granted—
for, or in respect of, the beneficiary; and
on an application made by, or on behalf of, any other person; and
to any other person on account of the beneficiary.
New section 205A(4) ensures that a reference, in any of new sections 205A(2) and 205B to 205I, to the beneficiary includes a reference to the other person to whom the medical evidence benefit is granted on account of the beneficiary.
New section 205B(1) ensures that new section 205B applies only if, on the medical review date (as defined in new section 205C), the medical evidence benefit—
is suspended; or
is not for the time being payable under the Act.
New section 205B(2) requires the beneficiary to ensure that MSD has received updated medical evidence under new section 205A only if the beneficiary contacts MSD—
in the period that—
starts on the medical review date; and
ends on the day on which the benefit is to be cancelled; and
seeking to have the suspension end and the benefit become payable under the principal Act, or the benefit otherwise become payable under the principal Act.
New section 205B(3) provides that, if the beneficiary contacts MSD as provided in new section 252B(2),—
the requirements of new section 205A apply (despite anything to the contrary in new section 205A or new sections 205D to 205I) subject to the modifications set out in new section 205B; and
MSD must promptly give the beneficiary a notice advising the beneficiary of the effect of those modifications.
New section 205B(4) to (7) sets out the following modifications:
the suspension can end and the benefit can become payable under the Act, or the benefit can otherwise become payable under the Act, only after MSD has received updated medical evidence in line with those requirements:
if MSD has not received updated medical evidence in line with those requirements by the day on which the benefit is to be cancelled, MSD must cancel the benefit effective from the date of suspension and, in order to receive it again, the beneficiary must apply for it, and be granted it, again:
new sections 205A(1)(d) and (e) and 205D to 205G do not apply to the benefit or to the beneficiary ensuring that MSD has received updated medical evidence for the benefit:
the beneficiary must, before a deadline that MSD specifies and that is before the day on which the benefit is to be cancelled, ensure that MSD has received updated medical evidence for the benefit.
New section 205C defines terms used in new sections 205A to 205I (namely, beneficiary receiving a hospital rate of benefit, beneficiary receiving residential care subsidy, beneficiary receiving residential support subsidy, hospital or residential care beneficiary, medical evidence benefit, medical review date, and updated medical evidence).
New section 205D(1) provides that regulations made under new section 434A(1)(b) for the purposes of new section 205A(1)(e) may, under new section 205D(1), defer compliance with requirements under new section 205A by a specified class of beneficiaries for a specified period not exceeding 52 weeks if MSD is satisfied that—
a specified area (in or outside New Zealand) is affected by any circumstances specified; and
the specified class of beneficiaries is present in or residing in, and cannot reasonably leave, that specified area.
New section 205D(2) ensures that deferral of compliance under new section 205D(1) in respect of a beneficiary does not affect or limit MSD’s duty under new section 205E(1) to, at least 20 working days (or, if that period is not possible, as early as practicable) before the medical review date, give the beneficiary notice of the requirement under new section 205A(2).
New section 205D(3) provides that new section 205D(4) applies only if a beneficiary receiving jobseeker support on the ground of a health condition, injury, or disability, or a supported living payment on ground of restricted work capacity or total blindness, is a hospital or residential care beneficiary.
New section 205D(4) ensures that, for the purposes of new section 205A(1)(e), the beneficiary’s compliance with requirements under new section 205A is deferred under new section 205D until the first Monday after the beneficiary ceases to be a hospital or residential care beneficiary.
New section 205E(1) requires MSD, at least 20 working days (or, if that period is not possible, as early as practicable) before the medical review date, to give the beneficiary notice of the requirement under new section 205A(2) and that, if they do not comply with it, MSD must suspend, with effect from the end of the day before the relevant deadline stated in new section 205G(5),—
the medical evidence benefit that the beneficiary is receiving; and
every other benefit, or special assistance granted under section 100 or 101, if any, that—
the beneficiary is receiving; and
is required to be suspended under new section 205G(2) or (3).
New section 205E(2) ensures that new section 205E(1) does not apply if, when MSD must give notice under that subsection, the medical evidence benefit—
is suspended; or
is not for the time being payable under the principal Act, for example, under—
section 217 (benefit not payable during custody in prison or on remand); or
section 219 (general rule: benefit not payable while beneficiary absent from New Zealand).
New section 205E(3) ensures that new section 205E(4) applies, despite new section 205E(1) and (2), if—
the suspension ends and the medical evidence benefit becomes payable under the Act; or
the medical evidence benefit otherwise becomes payable under the Act.
New section 205E(4) requires MSD, as soon as practicable, to take reasonable steps to notify the beneficiary of the requirement under new section 205A(2).
New section 205E(5) ensures that new section 205E(1) does not apply if the beneficiary is a hospital or residential care beneficiary.
New section 205E(6) ensures that new section 205E(1) does not apply if the medical evidence benefit ends under any of new section 326 and sections 327 to 329 because either of the following has died:
the beneficiary who was receiving that benefit:
a child, or other person, for whom, or on account of whom, that benefit was granted.
New section 205F(1) and (2) enables MSD to extend, by up to 40 working days, the deadline under new section 205A(2) for providing updated medical evidence if—
the beneficiary (B) contacts MSD before that deadline; and
MSD is satisfied that B has a good and sufficient reason for not being able to provide the updated medical evidence before that deadline.
New section 205F(3) enables the extension to be for more than 40 working days but not more than 52 weeks if B is paid the benefit for B’s absences from New Zealand longer than 4 weeks in any 52-week period—
under section 219(3) and regulations made under section 436; and
because MSD is satisfied that payment of the benefit complies with the relevant qualifying circumstances set out in new section 205F(4).
New section 205F(4) provides that the relevant qualifying circumstances for new section 205F(3) are that—
B’s return to New Zealand from an absence in respect of which the benefit is paid has been prevented by new circumstances that—
were not reasonably foreseeable at the time when B last left New Zealand; and
are outside B’s control; and
MSD is satisfied that the extension of the absence is not longer than is necessitated by the new circumstances.
New section 205F(5) enables MSD to extend the deadline under new section 205A(2) for providing updated medical evidence, by up to 40 working days after the medical evidence benefit is suspended under new section 205G, if—
B was a hospital or residential care beneficiary; and
B contacts MSD after that deadline; and
MSD is satisfied that B had a good and sufficient reason for not being able to provide the updated medical evidence before that deadline.
New section 205G sets out the consequences if the beneficiary fails to comply with a requirement under new section 205A(2).
New section 205G(1) provides that, if the beneficiary fails to comply with a requirement under new section 205A(2), MSD must suspend, with effect from the end of the day before the relevant deadline stated in new section 205G(5), the medical evidence benefit that the beneficiary is receiving.
New section 205G(2) provides that, on suspending under new section 205G(1) a child disability allowance or a disability allowance, MSD must also suspend, with effect from the end of the day before the relevant deadline stated in new section 205G(5), any temporary additional support that the beneficiary is receiving.
New section 205G(3) provides that, on suspending under new section 205G(1) a medical evidence benefit other than a child disability allowance or a disability allowance, MSD must also suspend, with effect from the end of the day before the relevant deadline stated in new section 205G(5), every other benefit, or special assistance granted under section 100 or 101, if any, that the beneficiary is receiving and that is not of a kind excluded from suspension under new section 205G(4).
New section 205G(4) specifies the kinds of benefits, or special assistance, that are excluded from suspension under new section 205G(3).
New section 205G(6) is an exception: every benefit or special assistance must be resumed from when it was suspended under new section 205G(1), (2), or (3) if the beneficiary—
was a hospital or residential care beneficiary; and
is granted an extension under new section 205F(5).
New section 205G(7) requires MSD to cancel a benefit or special assistance with effect from when the benefit or special assistance is suspended under new section 205G(1), (2), or (3) if—
the benefit or special assistance is suspended under new section 205G(1), (2), or (3); and
the beneficiary fails to comply with a requirement under new section 205A(2) within 8 weeks starting at the relevant deadline stated in new section 205G(5).
New section 205H applies to a medical evidence benefit only if it is—
jobseeker support on the ground of a health condition, injury, or disability (see new section 27); or
a supported living payment on the ground of restricted work capacity (see new section 36A).
New section 205H applies, under new section 205H(2), if the updated medical evidence that MSD received for the medical evidence benefit is a medical certificate that is—
equivalent to, and satisfactory to and accepted by MSD in the same way as, the medical certificate that new section 27 or 36A requires MSD to receive before MSD may grant that benefit; and
issued on a date stated in it, and by a prescribed health practitioner who is, or who falls within a class or description that is, recognised by MSD for the purposes of new section 205H(2)(b); and
received by MSD—
using an electronic means recognised by MSD for the purposes of new section 205H(2)(c); and
within 20 working days after the date on which it is issued; and
before the relevant deadline under new section 205G(5).
New section 205H(3) requires MSD to ensure that details of, and of any variation or revocation of, any recognition by MSD of prescribed health practitioners or electronic means for the purposes of new section 205H(2)(b) or (c), are published as soon as practicable—
in the Gazette; and
on an internet site that—
is maintained by, or on behalf of, the responsible department; and
is publicly available free of charge.
New section 205H also applies, under new section 205H(4), if MSD is satisfied from the updated medical evidence that MSD received for the medical evidence benefit that no relevant change in the applicable medical circumstances has occurred since whichever is the last to occur of the following dates:
the date on which that benefit commenced:
the date on which MSD last completed consideration of updated medical evidence that MSD received for that benefit.
New section 205H, if it applies under new section 205H(2) or (4), ensures that the beneficiary remains entitled to receive the following that the beneficiary received immediately before the medical review date:
the medical evidence benefit:
the rate of the medical evidence benefit.
New section 205I(1) ensures that new sections 205A to 205H do not limit other specified provisions. New section 205I does not limit regulations made under new section 434A(1)(a) excluding a beneficiary who is receiving a medical evidence benefit from requirements under new section 205A because all or any provisions specified in new section 205I(1)(a) to (j) apply to the beneficiary: new section 205I(2).
Mandatory reviews
Clause 23 amends section 296, which is a guide to Part 6 (administration). New section 296(b) and (ba) indicates that Part 6 contains provisions about—
discretionary reviews by MSD of a beneficiary’s past or current entitlement to a benefit or rate of benefit (see subpart 3 of Part 6):
mandatory reviews by MSD of a beneficiary’s past or current entitlement to a specified benefit or rate of specified benefit (see new subpart 3A of Part 6).
Clause 24 amends section 298, which,—
in section 298(1), requires MSD to inquire into every claim for a benefit made by, or on behalf of, an applicant for a benefit (subject to exceptions set out in section 298(2)); and
in section 298(3), permits MSD to inquire into the circumstances of a person who has been receiving a benefit as those circumstances existed—
immediately before the benefit was granted; or
during the period or periods that the benefit was paid.
New section 298(4) ensures that section 298(3) does not limit specified provisions, including new subpart 3A of Part 6.
Medical evidence
Clause 25 amends section 301 (MSD decides whether to grant benefit). New section 301(2) makes section 301(1) subject to specified sections that prevent MSD from granting specified benefits until MSD has received, from, or on behalf of, the applicant, a specified medical certificate or other specified medical evidence.
Clause 26 amends section 302 (immediate provisional grant, and later backdating of other benefit). New section 302(4) makes section 302 subject to specified sections that prevent MSD from granting specified benefits until MSD has received, from, or on behalf of, the applicant, a specified medical certificate or other specified medical evidence.
Mandatory reviews
Clause 27 amends the subpart 3 heading in Part 6 to clarify that reviews under that subpart are discretionary reviews of entitlement to a benefit and of the rate of benefit payable. In contrast, reviews under new subpart 3A of Part 6 are mandatory reviews of entitlement to a benefit and of the rate of benefit payable.
Clause 28 repeals section 304(3) and (4) and the heading above section 304(3). They are repealed because they are re-enacted in new section 310AA. New section 310AA is equivalent to new section 310V in new subpart 3A of Part 6.
Clause 29 amends section 304A (grounds for review of whether person’s information share child support payment is or was their weekly income) as a consequence of new section 326 inserted by clause 33.
Clause 30 amends section 305 (information for review). New section 305(3) makes it clear that section 305 does not limit specified sections, including—
specified medical evidence sections:
new sections 205A to 205I:
new subpart 3A of Part 6.
Clause 31 inserts new section 310AA (Part 7 gives rights to seek review or appeal against decision), which—
re-enacts section 304(3) and (4), and the heading above section 304(3) (as repealed by clause 28); and
is equivalent to new section 310V in new subpart 3A of Part 6.
Clause 32 replaces subpart 3A of Part 6, which is about mandatory reviews by MSD of a beneficiary’s past or current entitlement to a specified benefit or rate of specified benefit.
New subpart 3A of Part 6 re-enacts subpart 3A of Part 6 with changes that—
enable regulations to designate a kind of benefit to be a specified benefit for the purposes of new subpart 3A of Part 6 only if it meets prescribed conditions:
require those regulations to also state the following for that specified benefit and those purposes:
if it is a universal review benefit or an independent review benefit (and so it is reviewed with, or apart from, other specified benefits):
a review start deadline:
clarify and simplify subpart 3A of Part 6, and align it better with subpart 3 of Part 6 (discretionary review of entitlement to, or rate of, benefit granted) and with related provisions of the Act.
Clause 33 amends section 325 (general rule if person’s entitlement to benefit ceases). Section 325(2) is amended to ensure that the general rule in section 325(1) about when a person’s entitlement to a benefit ceases is subject to modifications set out in new subpart 18 of Part 2 (effect of child turning 18 years old).
Clause 34 replaces section 326 to clarify the period for which MSD will continue to pay a benefit following the death of a beneficiary.
Clause 35 amends section 334, which sets out exceptions to the general rule in section 332 (that a beneficiary’s entitlement to a specified benefit ceases not later than, and the specified benefit expires on, the expiry date for that specified benefit). The exceptions in section 334 are for a specified benefit and are based on prescribed circumstances (as defined in section 334(5)). Section 334(4) is amended to ensure that section 334 does not limit any review under new section 310A.
Use of automated electronic systems
Clause 36 amends section 363A.
Section 363A(1) enables MSD to approve the use of an automated electronic system by a specified person to make any decision, exercise any power, comply with any obligation, or take any other related action under any specified provision. The terms specified person and specified provision are defined in section 363A(2).
Section 363A(2) is amended to replace the definition of specified provision. The new definition enables MSD to approve the use of an automated electronic system by a specified person to make any decision, exercise any power, comply with any obligation, or take any other related action under an administrative programme. An administrative programme, as defined in section 363A(2), means a programme—
of social assistance; and
not in or under legislation; and
that the responsible department administers (alone or jointly with other departments).
Section 363A(3) and the heading above section 363A(3) are repealed. The repeal removes the requirement, in paragraphs (a) to (d) of section 363A(3), that the specified provision must be about a matter specified in any of those paragraphs.
Section 363A(5) requires MSD to ensure that there is in force at all times on and after 1 July 2023 an approved standard for MSD’s use of automated electronic systems. New section 363A(6)(a) requires the standard, and any amendment, revocation, or replacement of the standard, to be approved by MSD in consultation with not only the Privacy Commissioner appointed under the Privacy Act 2020 (as mentioned in section 363A(6)(a)) but also with—
the Human Rights Commission continued by section 4 of the Human Rights Act 1993; and
any other person, body, or organisation that MSD considers appropriate.
New section 363A(6A) requires the standard to include provisions that address the following topics:
accuracy and reliability:
bias and discrimination:
legal and policy considerations:
fraud considerations:
transparency:
human oversight:
compliance and assurance.
Medical evidence
Clause 37 amends section 418 (regulations: general). Section 418(1)(a) enables the making of regulations prescribing, for a provision’s purposes, of health practitioners acting within their scope of practice (see, in Schedule 2, the definition of prescribed health practitioner). The amendment adds, to section 418(1)(a), references to new provisions that mention prescribed health practitioners.
Clause 38 inserts new section 434A (regulations: factors affecting benefits: beneficiary’s duty to provide updated medical evidence). New section 434A enables the making of regulations for either or both of the following purposes:
excluding a beneficiary who is receiving a medical evidence benefit from requirements under new section 205A (beneficiary required to provide updated medical evidence), for the purposes of new section 205A(1)(d):
deferring compliance with requirements under new section 205A—
for the purposes of new section 205A(1)(e); and
under new section 205D(1).
Mandatory reviews
Clause 39 amends section 438A (regulations: requirement regarding specified benefits). In general, the amendments align section 438A with new subpart 3A of Part 6. In particular, the amendments enable regulations under section 438A to—
designate the kinds of benefit that are specified benefits for the purposes of new subpart 3A of Part 6:
provide that a kind of benefit is designated to be a specified benefit for those purposes only if it meets prescribed conditions:
prescribe circumstances for the exception under new section 310G(3) from the requirement for MSD to undertake and complete a review under new section 310A:
provide that a specified benefit is excluded from an exemption under new section 310H:
provide that a specified benefit is excluded from an extension under new section 310K(4).
Clause 40 amends section 439 (regulations: certain benefits granted, or granted at rate, not taking into account certain insurance payments). The amendments ensure that regulations can be made under section 439 for the purposes of new section 310U (certain specified benefits granted, or granted at rate, not taking into account certain insurance payments).
Definitions
Clause 41 amends Schedule 2 (dictionary), which defines terms used in the Act. The amendments insert, or cross-reference, definitions for the purposes of, or in, new provisions inserted by the Bill.
Mandatory reviews, and when benefit ends after death of beneficiary
Clause 42(1) amends clause 11 (interpretation) of Schedule 3 (income and liabilities) by replacing the definition of specified provision. As Schedule 2 makes clear, specified provision,—
in relation to the use of automated electronic systems to make decisions, exercise powers, comply with obligations, and take related actions, is defined in section 363A(2) for the purposes of subpart 5A of Part 6; and
in relation to a reference to income for a period,—
is defined in clause 11 of Schedule 3 for the purposes of clauses 12 to 14 of Schedule 3; and
is defined in clause 15C of Schedule 3 for the purposes of Part 3A of Schedule 3.
The new definition of specified provision covers (and gives examples of) any provision that is all or a part of any legislation that the responsible department (as defined in Schedule 2) administers (alone or jointly with other departments) by doing either or both of the following:
leading advice to the Minister on its policy and effect, and on any proposed amendments to it:
exercising or performing powers, duties, or functions under it.
Clause 42(2) amends clause 15A(3) of Schedule 3 as a consequence of new section 326 inserted by clause 34.
Clause 42(3) amends clause 15B(4)(a) of Schedule 3 as a consequence of new Part 3A of Part 6.
Clause 42(4) replaces clause 15H(1)(a) of Schedule 3 as a consequence of new section 326 inserted by clause 34.
Subpart 2—Amendments to Social Security Regulations 2018
Medical evidence
Clauses 44 to 55 amend or replace provisions of the Regulations to make consistent references to medical certificates, align the Regulations with section 85 of the Act as amended by the Bill, and prescribe health practitioners for the purposes of specified provisions of the Act. Those clauses amend the following provisions:
regulation 5, which is a guide to Part 2 (assistance):
the subpart 2 heading (jobseeker support: certificates and medical examinations) in Part 2:
regulation 8 (certificates: prescribed health practitioners):
regulation 11 (certificates and medical examinations: prescribed health practitioners):
regulation 34 (payment of childcare subsidy if caregiver not engaged in approved activity but has serious disability or illness):
regulation 42 (payment of OSCAR subsidy if caregiver has serious disability or illness):
the subpart 7 heading (child disability allowance: certificates and medical examinations) in Part 2:
regulation 49 (child disability allowance: certificates and medical examinations: prescribed health practitioners):
regulations 50 and 51 (child disability allowance: special categories of eligibility for the purposes of section 85(1)(b) of the Act, or for the purposes of section 85(1)(b) and (3) of the Act):
regulation 52 (medical certificates and medical examinations: prescribed health practitioners):
regulation 79 (procedure for deferral of work-test obligations).
Clause 56 amends regulation 108, which is a guide to Part 4 of the Regulations. New regulation 108(e) refers to new subpart 5 of Part 4 (inserted by clause 57).
Clause 57 inserts new subpart 5 of Part 4 (beneficiary required to provide updated medical evidence). New subpart 5 of Part 4 contains new regulation 137, which excludes a beneficiary who is receiving a medical evidence benefit from requirements under new section 205A of the Act, for the purposes of new section 205A(1)(d) of the Act.
Mandatory reviews
Clause 58 amends regulation 165, which is a guide to Part 6 of the Regulations. New regulation 165(aa) refers to new subpart 1A of Part 6 (inserted by clause 59).
Clause 59 replaces subpart 1A of Part 6. New subpart 1A of Part 6 deals with mandatory reviews by MSD (under new subpart 3A of Part 6 of the Act) of a beneficiary’s past or current entitlement to, or the rate of, a specified benefit granted. New subpart 1A of Part 6 contains the following regulations:
new regulation 176A, which designates the kinds of benefits that are specified benefits for the purposes of new subpart 3A of Part 6 of the Act:
new regulation 176B, which states whether a specified benefit is a universal review benefit or an independent review benefit for the purposes of new subpart 3A of Part 6 of the Act:
new regulation 176C, which states a review start deadline for a universal review benefit:
new regulation 176D, which states a review start deadline for an independent review benefit:
new regulation 176E, which states whether a specified benefit is a 3-year rule benefit for the purposes of new subpart 3A of Part 6 of the Act:
new regulation 176F, which states whether a specified benefit is one to which new section 310P of the Act (supplementary benefit rule) applies (see new section 310P(1)(a) of the Act):
new regulation 176G, which prescribes circumstances for the exception under new section 310G(3) of the Act from the requirement for MSD to undertake and complete a review under new section 310A of the Act:
new regulation 176H, which excludes specified benefits stated in new regulation 176H(a) and (b) from an exemption under new section 310H of the Act:
new regulation 176I, which excludes a specified benefit that is special benefit from an extension under new section 310K(4) of the Act.
Part 2Amendments to transitional, savings, and related provisions
Subpart 1—Amendments to Social Security Act 2018
Clause 61 amends Schedule 1, which contains transitional, savings, and related provisions, on 1 July 2026.
Clause 61(1) replaces clause 5(1) of Schedule 1. New clause 5(1) of Schedule 1 makes it clear that entitlement under clause 4 of Schedule 1 to the corresponding assistance, and the rate of benefit that is being or was paid, may be reviewed under—
subpart 3 of Part 6:
new subpart 3A of Part 6.
Clause 61(2) to (4) amends clause 55(2)(a), (5), and (5)(a) of Schedule 1 to include references to reviews under new subpart 3A of Part 6 of the Act.
Clause 61(5) inserts new Part 14 of Schedule 1 (set out in Schedule 1 of the Bill), which contains provisions relating to the amendments made by the Bill (except those that come into force on 4 September 2026 and 30 November 2026).
New Part 14 of Schedule 1 contains the following clauses:
clause 115, which contains definitions for that Part:
clause 116, which sets out the general rule that a new provision that commences on 1 July 2026 applies, on and after commencement, only to—
a benefit, or other assistance, granted before commencement; and
a benefit, or other assistance, granted at or after commencement:
clauses 117 and 118, which set out the exception that new provisions that are mandatory review provisions apply to specified benefits only on and after the application dates set out in clause 117 (and that, until the new provisions apply to specified benefits, those specified benefits remain subject to the corresponding old provisions):
clause 119, which ensures that reviews are not required under the corresponding old provisions for certain beneficiaries:
clause 120, which authorises the making of regulations for transitional and savings purposes.
Clause 62 amends Schedule 1, which contains transitional, savings, and related provisions, on 4 September 2026.
Clause 62 inserts new Part 15 of Schedule 1 (set out in Schedule 2 of the Bill), which contains provisions relating to the amendments made by the Bill that come into force on 4 September 2026.
New Part 15 of Schedule 1 contains the following clauses:
clause 121, which contains definitions, for that Part, of the terms C and C’s 18th birthday (see also new Part 18 of Part 2):
clause 122, which ensures that new subpart 18 of Part 2, and the other new provisions, apply only if C’s 18th birthday occurs on or after 4 September 2026:
clause 123, which ensures that corresponding old provisions continue to apply if C’s 18th birthday occurs before 4 September 2026.
Clause 63 amends Schedule 1, which contains transitional, savings, and related provisions, on 30 November 2026.
Clause 63 inserts new Part 17 of Schedule 1 (set out in Schedule 3 of the Bill), which contains provisions relating to the amendments made by the Bill that come into force on 30 November 2026.
New Part 17 of Schedule 1 contains the following clauses:
clause 128, which contains definitions for the Part:
clause 129, which sets out the general rule that a new provision that commences on 30 November 2026 applies, on and after commencement, only to—
a benefit, or other assistance, granted before commencement; and
a benefit, or other assistance, granted at or after commencement:
clause 130, which relates to the application of the new provisions about updated medical evidence.
Subpart 2—Amendment to Social Security Regulations 2018
Clause 65 amends Schedule 1, which contains transitional, savings, and related provisions.
The amendment inserts new Part 16 of Schedule 1 (set out in Schedule 4 of the Bill), which contains provisions relating to the amendments made by the Bill.
New Part 16 of Schedule 1 contains the following clauses:
clause 30, which contains definitions for the Part:
clause 31, which sets out the general rule that a new provision that commences on 1 July 2026 applies, on and after commencement, only to—
a benefit, or other assistance, granted before commencement; and
a benefit, or other assistance, granted at or after commencement:
clause 32, which sets out the exception that new provisions that are mandatory review provisions apply to specified benefits only on and after the application dates set out in clause 32 (and that, until the new provisions apply to specified benefits, those specified benefits continue to be subject to the corresponding old provisions of the Regulations):
clause 33, which provides for a special first review start deadline for certain independent review benefits that commence before the new mandatory review provisions start to apply to them.
Hon Louise Upston
Social Security (Modernisation) Amendment Bill
Government Bill
313—1
Contents
The Parliament of New Zealand enacts as follows:
1 Title
This Act is the Social Security (Modernisation) Amendment Act 2026.
2 Commencement
Main rule
(1)
This Act comes into force on 1 July 2026.
Exceptions
(2)
However,—
(a)
the sections that make amendments relating to the effect of a child turning 18 years old (see subsection (3)) come into force on 4 September 2026; and
(b)
the sections that make amendments relating to medical evidence (see subsection (4)) come into force on 30 November 2026.
Sections that make amendments relating to child turning 18 years old
(3)
The sections that make amendments relating to the effect of a child turning 18 years old are—
(a)
section 18 (subpart 18 of Part 2 replaced):
(b)
section 41(6) (Schedule 2 amended):
(c)
section 62 (Schedule 1 amended (on 4 September 2026)).
Sections that make amendments relating to medical evidence
(4)
The sections that make amendments relating to medical evidence are—
Amendments to Social Security Act 2018
(1)
section 4 (section 20 amended (jobseeker support: requirements)):
(2)
section 5 (section 22A inserted (jobseeker support: on ground of health condition, injury, or disability: ineligibility if entitlement to supported living payment)):
(3)
section 6 (section 25 amended (jobseeker support: discretionary grant on ground of hardship)):
(4)
section 7 (sections 27 and 28 replaced):
(5)
section 9 (section 34 amended (supported living payment: on ground of restricted work capacity or total blindness: requirements)):
(6)
section 10 (section 37 replaced (supported living payment: on ground of restricted work capacity or total blindness: medical examination)):
(7)
section 11 (section 40 amended (supported living payment: on ground of caring for another person: requirements)):
(8)
section 12 (sections 41 and 42 replaced):
(9)
section 14 (section 78 amended (child disability allowance: discretionary grant)):
(10)
section 15 (sections 80 and 81 replaced):
(11)
section 16 (section 85 amended (disability allowance: discretionary grant)):
(12)
section 17 (section 88 replaced (disability allowance: medical examination)):
(13)
section 19 (section 141 amended (jobseeker support: work capacity determination and work test)):
(14)
section 20 (section 183 amended (what Part 4 does)):
(15)
section 22 (sections 205A to 205I and cross-heading inserted):
(16)
section 25 (section 301 amended (MSD decides whether to grant benefit)):
(17)
section 26 (section 302 amended (immediate provisional grant, and later backdating of other benefit)):
(18)
section 37 (section 418 amended (regulations: general)):
(19)
section 38 (section 434A inserted (regulations: factors affecting benefits: beneficiary required to provide updated medical evidence)):
(20)
section 41(3) to (5) (Schedule 2 amended):
Amendments to Social Security Regulations 2018
(21)
section 44 (regulation 5 amended (guide to Part 2)):
(22)
section 45 (subpart 2 heading in Part 2 amended):
(23)
section 46 (regulation 8 amended (certificates: prescribed health practitioners)):
(24)
section 47 (regulation 11 amended (certificates and medical examinations: prescribed health practitioners)):
(25)
section 48 (regulation 34 amended (payment of childcare subsidy if caregiver not engaged in approved activity but has serious disability or illness)):
(26)
section 49 (regulation 42 amended (payment of OSCAR subsidy if caregiver has serious disability or illness)):
(27)
section 50 (subpart 7 heading in Part 2 amended):
(28)
section 51 (regulation 49 amended (certificates and medical examinations: prescribed health practitioners)):
(29)
section 52 (regulation 50 amended (discretionary grant if life expectancy or continuing disability less than 6 months)):
(30)
section 53 (regulation 51 amended (mandatory grant if disability unexpectedly likely to last, or lasts, for at least 6 months)):
(31)
section 54 (regulation 52 replaced (medical examinations: prescribed health practitioners)):
(32)
section 55 (regulation 79 amended (procedure for deferral of work-test obligations)):
(33)
section 56 (regulation 108 amended (guide to Part 4)):
(34)
section 57 (subpart 5 of Part 4 inserted):
Amendment to Social Security Act 2018
(35)
section 63 (Schedule 1 amended (on 30 November 2026)).
Part 1 Amendments to substantive provisions
Subpart 1—Amendments to Social Security Act 2018
3 Principal Act
This subpart amends the Social Security Act 2018.
Medical evidence
4 Section 20 amended (Jobseeker support: requirements)
In section 20, after “A person is entitled to jobseeker support”
, insert “(subject to sections 22A and 27(6) (entitlement to supported living payment, and medical certificate))”
.
5 New section 22A inserted (Jobseeker support: on ground of health condition, injury, or disability: ineligibility if entitlement to supported living payment)
After section 22, insert:
22A Jobseeker support: on ground of health condition, injury, or disability: ineligibility if entitlement to supported living payment
(1)
Jobseeker support on the ground of a health condition, injury, or disability (see sections 20(b) and 22(c)) cannot be granted to an applicant (A) if A is entitled to a supported living payment on the ground of restricted work capacity under sections 34 to 39 for the reasons set out in subsection (2).
(2)
The reasons mentioned in subsection (1) are that—
(a)
A has restricted work capacity under section 35; and
(b)
the restricting health condition, injury, or disability is expected to continue for at least the prescribed general minimum restricting period for a supported living payment on the ground of restricted work capacity; and
(c)
A meets all other entitlement requirements for that benefit.
6 Section 25 amended (Jobseeker support: discretionary grant on ground of hardship)
After section 25(4), insert:
(5)
This section is subject to section 27(6) (medical certificate).
7 Sections 27 and 28 replaced
Replace sections 27 and 28 with:
27 Jobseeker support: on ground of health condition, injury, or disability: requirement to provide medical certificate
Applicant for benefit must provide medical certificate
(1)
An applicant (A) for jobseeker support on the ground of a health condition, injury, or disability (see sections 20(b) and 22(c)) must—
(a)
provide a medical certificate that complies with this section; and
(b)
include that certificate in A’s application for that benefit.
Beneficiary who is to move to benefit in review must provide medical certificate
(2)
A beneficiary (A) to whom MSD may grant jobseeker support on the ground of health condition, injury, or disability under section 307 or 308 (in a discretionary review under section 304) or under section 310R or 310S (in a mandatory review under section 310A) must—
(a)
provide a medical certificate that complies with this section; and
(b)
do so before MSD grants that benefit in that way.
Requirements for medical certificate
(3)
The medical certificate must—
(a)
be given by a prescribed health practitioner (PHP); and
(b)
certify whether, in the PHP’s opinion, A’s capacity for work is affected by any health condition, injury, or disability; and
(c)
if it certifies that, in the PHP’s opinion, A’s capacity for work is affected by any health condition, injury, or disability, also state—
(i)
the nature of the health condition, injury, or disability (which, if A is at least 27 weeks pregnant, and A has no other health condition, injury, or disability, must include the date that the PHP diagnoses is the date on which A may give birth to a child); and
(ii)
the extent to which A’s capacity for work is affected by the health condition, injury, or disability; and
(iii)
its coverage (see subsection (4)).
Medical certificate’s coverage
(4)
The medical certificate’s coverage (which is also the period before the review for the medical review date in section 205C) means—
(a)
the period for which the health condition, injury, or disability is expected to continue to affect A’s capacity for work; or
(b)
the period after which a PHP should next review A’s capacity for work, if the PHP is unable to identify the period in paragraph (a).
(5)
However, if the health condition is that A is at least 27 weeks pregnant, and A has no other health condition, injury, or disability,—
(a)
the medical certificate’s coverage does not include a period before the review for the medical review date in section 205C; and
(b)
the period in subsection (4)(a)—
(i)
starts when A is 27 weeks pregnant; and
(ii)
ends at the close of the date that MSD is satisfied, from relevant information available to MSD (for example, a notification by A to MSD under section 113 that A has given birth), is the date on which A’s pregnancy ended.
Consequence of not providing medical certificate
(6)
Until MSD has received, from, or on behalf of, A, a medical certificate that complies with this section, MSD must not grant A jobseeker support on the ground of health condition, injury, or disability (as the case requires)—
(a)
in response to A’s application mentioned in subsection (1); or
(b)
in the review mentioned in subsection (2).
How this section interacts with others
(7)
Subsection (6)—
(a)
overrides sections 20, 25, 301, 302, 307, 308, 310R, and 310S; but
(b)
does not limit section 141 (jobseeker support: work capacity determination and work test) (for example, MSD’s duty under section 141(3)(a) to make a determination under section 141 after having had regard to a medical certificate under this section).
28 Jobseeker support: on ground of health condition, injury, or disability: medical examination
This section applies to applicant for, or person receiving, benefit
(1)
This section applies to an applicant for, or a person receiving, jobseeker support on the ground of a health condition, injury, or disability (P) (see sections 20(b) and 22(c)).
MSD may require medical examination by prescribed health practitioner
(2)
MSD may at any time require P to undergo an examination by a prescribed health practitioner (PHP).
(3)
The PHP must be agreed for the purpose between P and MSD or, failing agreement, must be nominated by MSD.
Requirements for medical report
(4)
The PHP must prepare, and must send MSD a copy of, a medical report.
(5)
The medical report must—
(a)
certify whether, in the PHP’s opinion, P’s capacity for work is affected by any health condition, injury, or disability; and
(b)
if it certifies that, in the PHP’s opinion, P’s capacity for work is affected by any health condition, injury, or disability, also state—
(i)
the nature of the health condition, injury, or disability (which, if P is at least 27 weeks pregnant, must include the date that the PHP diagnoses is the date on which A may give birth to a child); and
(ii)
the extent to which P’s capacity for work is affected by the health condition, injury, or disability; and
(iii)
its coverage (see subsection (6)).
Medical report’s coverage
(6)
The medical report’s coverage (which is also the period before the review for the medical review date in section 205C), means—
(a)
the period for which the health condition, injury, or disability is expected to continue to affect P’s capacity for work; or
(b)
the period after which a PHP should next review P’s capacity for work, if the PHP is unable to identify the period in paragraph (a).
(7)
However, if the health condition is that P is at least 27 weeks pregnant, and P has no other health condition, injury, or disability,—
(a)
the medical report’s coverage does not include a period before the review for the medical review date in section 205C; and
(b)
the period in subsection (6)(a)—
(i)
starts when P is 27 weeks pregnant; and
(ii)
ends at the close of the date that MSD is satisfied, from relevant information available to MSD (for example, a notification by P to MSD under section 113 that P has given birth), is the date on which P’s pregnancy ended.
How this section interacts with others
(8)
This section does not limit section 141 (jobseeker support: work capacity determination and work test) (for example, MSD’s duty under section 141(3)(a) to make a determination under section 141 after having had regard to a medical report under this section).
Mandatory reviews
8 Section 33 amended (Expiry of sole parent support, and replacement with jobseeker support, when youngest dependent child turns 14 years old)
Replace section 33(5) with:
(5)
This section does not preclude a review under the following of whether P satisfies the conditions of entitlement to jobseeker support:
(a)
subpart 3 of Part 6 (discretionary review of entitlement to, or rate of, benefit granted):
(b)
subpart 3A of Part 6 (mandatory review of entitlement to, or rate of, specified benefit granted).
Medical evidence
9 Section 34 amended (Supported living payment: on ground of restricted work capacity or total blindness: requirements)
In section 34, after “A person is entitled to the supported living payment”
, insert “(subject to section 36A(7) (medical evidence))”
.
10 Section 37 replaced (Supported living payment: on ground of restricted work capacity or total blindness: medical examination)
Replace section 37 with:
36A Supported living payment: on ground of restricted work capacity or total blindness: requirement to provide medical evidence
Applicant for benefit must provide medical evidence
(1)
A person (P) who applies for a supported living payment on the ground of restricted work capacity or total blindness must—
(a)
provide a medical certificate, or other medical evidence, that complies with this section; and
(b)
include that medical certificate, or other medical evidence, in P’s application for that benefit.
Beneficiary who is to move to benefit in review must provide medical evidence
(2)
A beneficiary (P) to whom MSD may grant a supported living payment on the ground of restricted work capacity or total blindness under section 307 or 308 (in a discretionary review under section 304) or under section 310R or 310S (in a mandatory review under section 310A) must—
(a)
provide a medical certificate, or other medical evidence, that complies with this section; and
(b)
do so before MSD grants that benefit in that way.
Exception: requirements do not apply if benefit payable in Australia
(3)
Subsections (1) and (2) do not apply to a supported living payment on the ground of restricted work capacity or total blindness if that benefit is, or would be, payable in Australia.
Requirements for medical certificate
(4)
The medical certificate must—
(a)
be given by a prescribed health practitioner (PHP); and
(b)
certify whether, in the PHP’s opinion, under section 34(a),—
(i)
P has restricted work capacity because P is permanently and severely restricted in P’s capacity for work because of any health condition, injury, or disability; or
(ii)
P is totally blind; and
(c)
if it certifies that, in the PHP’s opinion, under section 34(a), P has restricted work capacity because P is permanently and severely restricted in P’s capacity for work because of any health condition, injury, or disability, or P is totally blind, also state—
(i)
the nature of the health condition, injury, or disability, or that P is totally blind; and
(ii)
(if P is not totally blind) the extent to which P’s capacity for work is affected by the health condition, injury, or disability; and
(iii)
its coverage (see subsection (5)).
Medical evidence’s coverage
(5)
The coverage of a medical certificate under this section, or of any other medical evidence accepted under this section, means—
(a)
P has restricted work capacity under section 34(a) because P is permanently and severely restricted in P’s capacity for work because of any health condition, injury, or disability that—
(i)
complies with sections 34(a) and 35(1), (2)(a), and (3); and
(ii)
the PHP expects to continue for at least the prescribed general minimum restricting period for supported living payment on the ground of restricted work capacity, but not indefinitely; and
(iii)
means that the prescribed general minimum restricting period for supported living payment on the ground of restricted work capacity is the period before the review for the medical review date (see section 205C); or
(b)
P has restricted work capacity under section 34(a) because P is permanently and severely restricted in P’s capacity for work because of any health condition, injury, or disability that—
(i)
complies with sections 34(a) and 35(1), (2)(a), and (3); and
(ii)
the PHP expects to continue (not for at least the prescribed general minimum restricting period for supported living payment on the ground of restricted work capacity, but) indefinitely; and
(iii)
means that there is no period before the review for the medical review date (see section 205C); or
(c)
P is ineligible for a supported living payment on the ground of restricted work capacity (so that benefit cannot be granted) because—
(i)
the period for which the PHP expects P’s health condition, injury, or disability to continue to affect P’s capacity for work is shorter than the prescribed general minimum restricting period for supported living payment on the ground of restricted work capacity; and
(ii)
section 35(2)(b) does not apply; or
(d)
P is not expected by the PHP to live for the prescribed general minimum restricting period for supported living payment on the ground of restricted work capacity because P’s condition is terminal (see section 35(2)(b)), so there is no period before the review for the medical review date (see section 205C); or
(e)
P is totally blind under section 34(a), so there is no period before the review for the medical review date (see section 205C).
MSD may accept other medical evidence instead of medical certificate
(6)
MSD may accept, instead of a medical certificate that complies with this section, other medical evidence that MSD is satisfied—
(a)
establishes for P what must be certified by, and stated in, a medical certificate that complies with this section; and
(b)
that it is appropriate in the circumstances for MSD to accept instead of a medical certificate that complies with this section.
Consequence of not providing medical evidence
(7)
Until MSD has received, from, or on behalf of, P, a medical certificate or other medical evidence that complies with this section, MSD must not grant P a supported living payment on the ground of restricted work capacity or total blindness (as the case requires)—
(a)
in response to P’s application mentioned in subsection (1); or
(b)
in the review mentioned in subsection (2).
How section interacts with others
(8)
Subsection (7) overrides sections 34, 301, 302, 307, 308, 310R, and 310S.
37 Supported living payment: on ground of restricted work capacity or total blindness: medical examination
This section applies to applicant for, or person receiving, benefit
(1)
This section applies to a person (P) who is an applicant for, or who is receiving, a supported living payment on the ground of restricted work capacity or total blindness.
MSD may require medical examination by prescribed health practitioner
(2)
MSD may at any time require P to undergo an examination by a prescribed health practitioner (PHP).
(3)
The PHP must be agreed for the purpose between P and MSD or, failing agreement, must be nominated by MSD.
Requirements for medical report
(4)
The PHP must prepare, and must send MSD a copy of, a medical report.
(5)
The medical report must—
(a)
certify whether, in the PHP’s opinion,—
(i)
P has restricted work capacity under section 34(a) because P is permanently and severely restricted in P’s capacity for work because of any health condition, injury, or disability; or
(ii)
P is totally blind; and
(b)
if it certifies that, in the PHP’s opinion, P has restricted work capacity under section 34(a) because P is permanently and severely restricted in P’s capacity for work because of any health condition, injury, or disability, or P is totally blind, also state—
(i)
the nature of the health condition, injury, or disability, or that P is totally blind; and
(ii)
(if P is not totally blind) the extent to which P’s capacity for work is affected by the health condition, injury, or disability; and
(iii)
its coverage (see subsection (6)).
Medical report’s coverage
(6)
The coverage of a medical report under this section means—
(a)
P has restricted work capacity under section 34(a) because P is permanently and severely restricted in P’s capacity for work because of any health condition, injury, or disability that—
(i)
complies with sections 34(a) and 35(1), (2)(a), and (3); and
(ii)
the PHP expects to continue for at least the prescribed general minimum restricting period for supported living payment on the ground of restricted work capacity, but not indefinitely; and
(iii)
means that the prescribed general minimum restricting period for supported living payment on the ground of restricted work capacity is the period before the review for the medical review date (see section 205C); or
(b)
P has restricted work capacity under section 34(a) because P is permanently and severely restricted in P’s capacity for work because of any health condition, injury, or disability that—
(i)
complies with sections 34(a) and 35(1), (2)(a), and (3); and
(ii)
the PHP expects to continue (not for at least the prescribed general minimum restricting period for supported living payment on the ground of restricted work capacity, but) indefinitely; and
(iii)
means that there is no period before the review for the medical review date (see section 205C); or
(c)
P is ineligible for a supported living payment on the ground of restricted work capacity (so that benefit cannot be granted) because—
(i)
the period for which the PHP expects P’s health condition, injury, or disability to continue to affect P’s capacity for work is shorter than the prescribed general minimum restricting period for supported living payment on the ground of restricted work capacity; and
(ii)
section 35(2)(b) does not apply; or
(d)
P is not expected by the PHP to live for the prescribed general minimum restricting period for supported living payment on the ground of restricted work capacity because P’s condition is terminal (see section 35(2)(b)), so there is no period before the review for the medical review date (see section 205C); or
(e)
P is totally blind under section 34(a), so there is no period before the review for the medical review date (see section 205C).
11 Section 40 amended (Supported living payment: on ground of caring for another person: requirements)
In section 40(1), after “A person (C) is entitled to the supported living payment”
, insert “(subject to section 41(5) (medical certificate))”
.
12 Sections 41 and 42 replaced
Replace sections 41 and 42 with:
41 Supported living payment: on ground of caring for another person: requirement to provide medical certificate
Applicant for benefit must provide medical certificate
(1)
A person (C) who applies for a supported living payment on the ground of caring for another person (P) must—
(a)
provide a medical certificate that complies with this section; and
(b)
include that certificate in C’s application for that benefit.
Medical certificate for beneficiary who is to move to benefit in review
(2)
If a person (C) who is required to give full-time care and attention at home to another person (P) may be granted by MSD a supported living payment on the ground of caring for another person under section 307 or 308 (in a discretionary review under section 304) or under section 310R or 310S (in a mandatory review under section 310A), C must—
(a)
provide a medical certificate that complies with this section; and
(b)
do so before MSD grants that benefit in that way.
Requirements for medical certificate
(3)
The medical certificate must—
(a)
be given by a prescribed health practitioner (PHP); and
(b)
certify whether, in the PHP’s opinion,—
(i)
P requires C’s full-time care and attention; and
(ii)
were it not for that care and attention, P would have to receive institutional care; and
(c)
if it certifies that, in the PHP’s opinion, P requires C’s full-time care and attention, and were it not for that care and attention, P would have to receive institutional care, state the certificate’s coverage (see subsection (4)).
Medical certificate’s coverage
(4)
The medical certificate’s coverage means—
(a)
the period for which P is expected to require C’s full-time care and attention but for which P would have to receive institutional care, and that is the period before the review for the medical review date (see section 205C); or
(b)
that P is likely to require C’s full-time care and attention indefinitely, which means there is no period before the review for the medical review date (see section 205C).
Consequence of not providing medical certificate
(5)
Until MSD has received, from, or on behalf of, C, a certificate that complies with this section, MSD must not grant C a supported living payment on the ground of caring for another person (as the case requires)—
(a)
in response to C’s application mentioned in subsection (1); or
(b)
in the review mentioned in subsection (2).
How section interacts with others
(6)
Subsection (5) overrides sections 40(1), 301, 302, 307, 308, 310R, and 310S.
42 Supported living payment: on ground of caring for another person: medical examination
This section applies to applicant for, or person receiving, benefit
(1)
This section applies if a supported living payment on the ground of caring for another person (P) has been applied for by, or granted to, a person (C).
MSD may require medical examination by prescribed health practitioner
(2)
MSD may at any time require that P be examined by a prescribed health practitioner (PHP).
(3)
The PHP must be agreed for the purpose between P and MSD or, failing agreement, must be nominated by MSD.
Requirements for medical report
(4)
The PHP must prepare, and must send MSD a copy of, a medical report.
(5)
The medical report must—
(a)
certify whether, in the PHP’s opinion,—
(i)
P requires C’s full-time care and attention; and
(ii)
were it not for that care and attention, P would have to receive institutional care; and
(b)
if it certifies that, in the PHP’s opinion, P requires C’s full-time care and attention, and were it not for that care and attention, P would have to receive institutional care, state the report’s coverage (see subsection (6)).
Medical report’s coverage
(6)
The medical report’s coverage means—
(a)
the period for which P is expected to require C’s full-time care and attention but for which P would have to receive institutional care, and that is the period before the review for the medical review date (see section 205C); or
(b)
that P is likely to require C’s full-time care and attention indefinitely, which means there is no period before the review for the medical review date (see section 205C).
Mandatory reviews
13 Section 75 amended (Winter energy payment: termination on review)
In section 75, after “MSD may terminate a winter energy payment if satisfied, after reviewing the payment under section 304 (see also section 309)”
, insert “or under section 310A (see also section 310T)”
.
Medical evidence
14 Section 78 amended (Child disability allowance: discretionary grant)
After section 78(2), insert:
(3)
Subsection (1) is subject to section 80(5) (medical evidence).
15 Sections 80 and 81 replaced
Replace sections 80 and 81 with:
80 Child disability allowance: requirement to provide medical evidence
Applicant for benefit must provide medical evidence
(1)
A person (A) who applies for a child disability allowance for a child (C) must—
(a)
provide a medical certificate, or other medical evidence, that complies with this section; and
(b)
include that medical certificate, or other medical evidence, in A’s application for that benefit.
Requirements for medical certificate
(2)
The medical certificate must—
(a)
be given by a prescribed health practitioner (PHP); and
(b)
certify whether, in the PHP’s opinion, C is a child with a serious disability within the meaning of section 79; and
(c)
if it certifies that, in the PHP’s opinion, C is a child with a serious disability within that meaning, state the certificate’s coverage (see subsection (3)).
Medical evidence’s coverage
(3)
The coverage of a medical certificate under this section, or of other medical evidence accepted under this section, means—
(a)
the period for which C is expected to be a child with a serious disability within the meaning of section 79, which is the period before the review for the medical review date (see section 205C); or
(b)
that C is likely to be a child with a serious disability within the meaning of section 79 indefinitely, which means there is no period before the review for the medical review date (see section 205C).
MSD may accept other medical evidence instead of medical certificate
(4)
MSD may accept, instead of a medical certificate that complies with this section, other medical evidence that MSD is satisfied—
(a)
establishes for C what must be certified by, and stated in, a medical certificate that complies with this section; and
(b)
that it is appropriate in the circumstances for MSD to accept instead of a medical certificate that complies with this section.
Consequence of not providing medical evidence
(5)
Until MSD has received, from, or on behalf of, A, a medical certificate or other medical evidence that complies with this section, MSD must not grant a child disability allowance for C in response to A’s application mentioned in subsection (1).
How section interacts with others
(6)
Subsection (5) overrides sections 78(1), 301, and 302.
81 Child disability allowance: medical examination
This section applies if child disability allowance applied for or granted
(1)
This section applies if a child disability allowance for a child (C) has been applied for or granted.
MSD may require medical examination by prescribed health practitioner
(2)
MSD may at any time require C to be examined by a prescribed health practitioner (PHP).
(3)
The PHP must be agreed for the purpose between the person who applied for, or who is receiving, the allowance for C and MSD or, failing agreement, must be nominated by MSD.
Requirements for medical report
(4)
The PHP must prepare, and must send MSD a copy of, a medical report.
(5)
The medical report must—
(a)
certify whether, in the PHP’s opinion, C is a child with a serious disability within the meaning of section 79; and
(b)
if it certifies that, in the PHP’s opinion, C is a child with a serious disability within that meaning, state the report’s coverage (see subsection (6)).
Medical report’s coverage
(6)
The medical report’s coverage (which is also the period before the review for the medical review date in section 205C) means—
(a)
the period for which C is expected to be a child with a serious disability within the meaning of section 79, which is the period before the review for the medical review date (see section 205C); or
(b)
that C is likely to be a child with a serious disability within the meaning of section 79 indefinitely, which means there is no period before the review for the medical review date (see section 205C).
Compare: 1964 No 136 s 39C(2)
16 Section 85 amended (Disability allowance: discretionary grant)
(1)
Replace section 85(1) with:
(1)
MSD may grant a disability allowance for a person (in this section called the person) who—
(a)
meets the criteria for eligibility in subsection (2); or
(b)
falls into a special category of eligibility specified in regulations made under section 425.
(1A)
If the person is not a dependent child, or a dependent spouse or partner, of another person, the grant under subsection (1) is made—
(a)
on an application made by, or on behalf of, the person; and
(b)
to the person.
(1B)
If the person is a dependent child, or a dependent spouse or partner, of another person, the grant under subsection (1) is made—
(a)
on an application made by, or on behalf of, the other person; and
(b)
to the other person; and
(c)
on account of the person.
(2)
After section 85(4), insert:
(5)
Subsection (1) is subject to section 87A(4) (medical certificate).
17 Section 88 replaced (Disability allowance: medical examination)
Replace section 88 with:
87A Disability allowance: requirement to provide medical certificate
Applicant for benefit must provide medical certificate
(1)
A person (A) who applies for a disability allowance for a person (P) must—
(a)
provide a medical certificate that complies with this section; and
(b)
include that certificate in A’s application for that benefit.
Requirements for medical certificate
(2)
The medical certificate must—
(a)
be given by a prescribed health practitioner (PHP); and
(b)
certify whether, in the PHP’s opinion, P—
(i)
has a disability that complies with the criteria for eligibility in section 85(2)(a), and has additional expenses of an ongoing kind arising from that disability for the purposes of section 85(2)(d); or
(ii)
falls into a special category of eligibility specified (for the purposes of section 85(1)(b), or of section 85(1)(b) and (3)) in regulations made under section 425; and
(c)
if it certifies that, in the PHP’s opinion, P does meet those criteria or does fall into a special category of eligibility of that kind, state the certificate’s coverage (see subsection (3)).
Medical certificate’s coverage
(3)
The medical certificate’s coverage means—
(a)
the period of less than 6 months for which P’s disability that meets the criteria for eligibility in section 85(2)(a) is likely to continue and that allows a disability allowance to be granted in respect of P because P falls into a special category of eligibility specified in regulations made under section 425 (in which case the medical certificate’s coverage does not include a period before the review for the medical review date in section 205C):
(b)
the period of at least 6 months for which it is a reasonably possible prognosis that P’s disability that meets the criteria for eligibility in section 85(2)(a) is likely to continue, and that allows a disability allowance to be granted in respect of P because P falls into a special category of eligibility specified in regulations made under section 425 (in which case the period before the review for the medical review date in section 205C is 6 months after the date on which any disability allowance is granted in respect of P):
(c)
the period (which is also the period before the review for the medical review date in section 205C), and that is at least 6 months but that is not indefinitely, for which—
(i)
P’s disability that complies with the criteria for eligibility in section 85(2)(a) is likely to continue; and
(ii)
P is likely to have additional expenses of an ongoing kind arising from that disability for the purposes of section 85(2)(d):
(d)
the period, which means there is no period before the review for the medical review date (see section 205C), and that is indefinitely, for which—
(i)
P’s disability that meets the criteria for eligibility in section 85(2)(a) is likely to continue; and
(ii)
P is likely to have additional expenses of an ongoing kind arising from that disability for the purposes of section 85(2)(d):
(e)
any other period that means that P falls into a special category of eligibility specified in regulations made under section 425 (in which case the period before the review for the medical review date in section 205C is 6 months after a disability allowance is granted for P).
Consequence of not providing medical certificate
(4)
Until MSD has received, from, or on behalf of, A, a medical certificate that complies with this section, MSD must not grant a disability allowance to or on account of P in response to A’s application mentioned in subsection (1).
How section interacts with others
(5)
Subsection (4) overrides sections 85(1), 301, and 302.
88 Disability allowance: medical examination
This section applies if disability allowance applied for or granted
(1)
This section applies if a disability allowance for a person (P) has been applied for or granted.
MSD may require medical examination by prescribed health practitioner
(2)
MSD may at any time require P to be examined by a prescribed health practitioner (PHP).
(3)
The PHP must be agreed for the purpose between the person who applied for, or who is receiving, the allowance for P and MSD or, failing agreement, must be nominated by MSD.
Requirements for medical report
(4)
The PHP must prepare, and must send MSD a copy of, a medical report.
(5)
The medical report must—
(a)
certify whether, in the PHP’s opinion, P—
(i)
has a disability that complies with the criteria for eligibility in section 85(2)(a), and has additional expenses of an ongoing kind arising from that disability for the purposes of section 85(2)(d); or
(ii)
falls into a special category of eligibility specified (for the purposes of section 85(1)(b), or of section 85(1)(b) and (3)) in regulations made under section 425; and
(b)
if it certifies that, in the PHP’s opinion, P does meet those criteria or does fall into a special category of eligibility of that kind, state the report’s coverage (see subsection (6)).
Medical report’s coverage
(6)
The medical report’s coverage means—
(a)
the period of less than 6 months for which P’s disability that meets the criteria for eligibility in section 85(2)(a) is likely to continue and that allows a disability allowance to be granted in respect of P because P falls into a special category of eligibility specified in regulations made under section 425 (in which case the medical report’s coverage does not include a period before the review for the medical review date in section 205C):
(b)
the period of at least 6 months for which it is a reasonably possible prognosis that P’s disability that meets the criteria for eligibility in section 85(2)(a) is likely to continue, and that allows a disability allowance to be granted in respect of P because P falls into a special category of eligibility specified in regulations made under section 425 (in which case the period before the review for the medical review date in section 205C is 6 months after the date on which any disability allowance is granted in respect of P):
(c)
the period (which is also the period before the review for the medical review date in section 205C), and that is at least 6 months but that is not indefinitely, for which—
(i)
P’s disability that complies with the criteria for eligibility in section 85(2)(a) is likely to continue; and
(ii)
P is likely to have additional expenses of an ongoing kind arising from that disability for the purposes of section 85(2)(d):
(d)
the period, which means there is no period before the review for the medical review date (see section 205C), and that is indefinitely, for which—
(i)
P’s disability that meets the criteria for eligibility in section 85(2)(a) is likely to continue; and
(ii)
P is likely to have additional expenses of an ongoing kind arising from that disability for the purposes of section 85(2)(d):
(e)
any other period that means that P falls into a special category of eligibility specified in regulations made under section 425 (in which case the period before the review for the medical review date in section 205C is 6 months after a disability allowance is granted for P).
Effect of child turning 18 years old
18 Subpart 18 of Part 2 replaced
In Part 2, replace subpart 18 with:
Subpart 18—Effect of child turning 18 years old
Guide to subpart
103 What this subpart does
Effect on different kinds of benefits
(1)
This subpart sets out how a dependent child (C) turning 18 years old may affect eligibility for, and the appropriate rate of benefit for, the following kinds of benefits (as defined in section 103A):
(a)
a non-discretionary dependent child rate benefit:
(b)
a discretionary dependent child rate benefit:
(c)
a specified children’s benefit.
Notice about effect of general rules, and providing information on exceptions
(2)
This subpart also requires MSD, at least 20 working days (or, if that period is not possible, as early as practicable) before C’s 18th birthday, to give the beneficiary a notice that—
(a)
explains the effect of the general rules in sections 103B to 103E and of the exceptions to those general rules (which include the exception in section 103F (if C is not financially independent and is continuing education)); and
(b)
asks the beneficiary to provide to MSD, before C’s 18th birthday, any information relevant to whether an exception applies.
Definitions
103A Definitions for this subpart
In this subpart, unless the context otherwise requires,—
C’s 18th birthday means the date on which C turns 18 years old (and, if C was born on 29 February in a leap year, C’s birthday in a non-leap year is, for this definition’s purposes, taken to occur on 1 March of that non-leap year)
Community Costs Programme means the programme—
(a)
approved and established under section 124(1)(d) of the Social Security Act 1964 on 16 October 2006; and
(b)
saved by clause 21 of Schedule 1 of this Act as if it were a special assistance programme approved and established under section 101 of this Act
dependent child rate benefit means a benefit,—
(a)
eligibility for which may, but need not, depend on whether C is a dependent child of the beneficiary (for example, because eligibility depends on the beneficiary having 1 or more dependent children); and
(b)
that is payable at an appropriate rate of benefit that depends on whether C is a dependent child of the beneficiary; and
(c)
that is not a specified children’s benefit; and
(d)
that is either—
(i)
a discretionary dependent child rate benefit; or
(ii)
a non-discretionary dependent child rate benefit
discretionary dependent child rate benefit means a dependent child rate benefit that is any of the following:
(a)
jobseeker support on the ground of hardship (see section 25):
(b)
an emergency benefit:
(c)
a special benefit continued under section 23 of the Social Security (Working for Families) Amendment Act 2004 (as that section is saved by clause 19 of Schedule 1 of this Act):
(d)
any community costs—
(i)
payable as special assistance under the Community Costs Programme; and
(ii)
under that programme subject to this subpart as if that special assistance were a benefit
entitlement period means a period for all of which, or for any part or parts of which, a beneficiary may have entitlement to a benefit, and that,—
(a)
if the benefit is paid in instalments (see section 338) of 1 week’s benefit,—
(i)
starts on a Monday; and
(ii)
ends at the close of the first Sunday after that Monday; and
(b)
if the benefit is paid in instalments (see section 338) of 2 weeks’ benefit,—
(i)
starts on a Wednesday; and
(ii)
ends at the close of the second Tuesday after that Wednesday
exception, to a general rule in section 103B to 103E, means any of the following:
(a)
the exception in section 103F:
(b)
section 326 (after death of beneficiary):
(c)
section 327 (benefits payable to sole parent who stops caring for dependent child due to sudden and uncontrollable circumstances):
(d)
section 328 (supported living payment payable to beneficiary who stops caring for another person):
(e)
section 329 (if child ceases to be entitled to orphan’s benefit or unsupported child’s benefit)
non-discretionary dependent child rate benefit means a dependent child rate benefit that is not a discretionary dependent child rate benefit
specified children’s benefit means any of the following:
(a)
an orphan’s benefit (which, for the purposes of this subpart,—
(i)
includes a clothing allowance in respect of the child under clause 3(a) of Part 4 of Schedule 4; but
(ii)
excludes annual holiday and birthday allowances in respect of the child under clause 3(b) and (c) of Part 4 of Schedule 4):
(b)
an unsupported child’s benefit (which, for the purposes of this subpart,—
(i)
includes a clothing allowance in respect of the child under clause 3(a) of Part 5 of Schedule 4; but
(ii)
excludes annual holiday and birthday allowances in respect of the child under clause 3(b) and (c) of Part 5 of Schedule 4):
(c)
a disability allowance payable to a person for a dependent child:
(d)
a child disability allowance.
General rules
103B Non-discretionary dependent child rate benefit: dependent child excluded for eligibility and for rate of benefit unless exception applies
When this section applies
(1)
This section applies to a child (C) who, immediately before the start of C’s 18th birthday, is—
(a)
a dependent child of a beneficiary receiving a non-discretionary dependent child rate benefit; and
(b)
included as a dependent child of the beneficiary in determining the appropriate rate of benefit for that benefit.
General rule
(2)
MSD must exclude C as a dependent child of the beneficiary in determining—
(a)
whether the beneficiary remains eligible for that benefit; and
(b)
if so, the appropriate rate of benefit for that benefit.
When exclusion of C as dependent child takes effect
(3)
The exclusion of C as a dependent child of the beneficiary takes effect from the start of the first entitlement period wholly after C’s 18th birthday.
Variation of that benefit
(4)
If the exclusion of C as a dependent child of the beneficiary results in the beneficiary being eligible for that benefit at another appropriate rate of benefit (other than one abated to zero or that is nil), MSD must vary that benefit—
(a)
so that it is payable at the other appropriate rate of benefit; and
(b)
with effect when that exclusion takes effect.
Suspension of payment of that benefit if beneficiary ceases to be eligible
(5)
If the exclusion of C as a dependent child of the beneficiary results in the beneficiary ceasing to be eligible for that benefit, or being eligible for that benefit at another appropriate rate of benefit abated to zero or that is nil, MSD must suspend payment of that benefit with effect—
(a)
when the exclusion of C as a dependent child of the beneficiary takes effect; and
(b)
until the earlier of the following:
(i)
MSD determines that an exception applies; or
(ii)
MSD cancels that benefit under subsection (9) or (10).
(6)
On suspending under subsection (5) a main benefit, MSD must also suspend, with effect from when the exclusion of C as a dependent child of the beneficiary takes effect, every other benefit, or special assistance granted under section 100 or 101, if any, that—
(a)
the beneficiary is receiving; and
(b)
is not of a kind excluded from suspension under subsection (7).
(7)
The following are excluded from suspension under subsection (6):
(a)
orphan’s benefit:
(b)
unsupported child’s benefit:
(c)
childcare assistance:
(d)
child disability allowance:
(e)
special assistance paid under the Guaranteed Childcare Assistance Payment Programme.
(8)
On suspending under subsection (5) an accommodation supplement or a disability allowance, MSD must also suspend any temporary additional support that the beneficiary is receiving until whichever of the following occurs first:
(a)
within the 8 weeks after the suspension, the beneficiary notifies MSD under section 113 of a change in the beneficiary’s chargeable income, or allowable costs, or both, the beneficiary has a deficiency of income of $1 or more, and MSD recalculates the amount of that support granted to the beneficiary during the period for which the beneficiary has been granted that support:
(b)
MSD cancels that support with effect at the end of that 8-week period, and as required by this paragraph, because that support has not within that period been recalculated under paragraph (a).
Cancellation of that benefit
(9)
MSD must cancel that benefit, and must also cancel the other benefits and special assistance suspended under subsections (6) and (8), with effect when that exclusion takes effect if—
(a)
that benefit has been suspended under subsection (5); and
(b)
MSD has determined that no exception applies.
(10)
MSD must cancel that benefit, and must also cancel the other benefits and special assistance suspended under subsections (6) and (8), with effect when that exclusion takes effect if, 8 weeks after that benefit has been suspended under subsection (5), MSD has been unable to determine if an exception applies.
103C Discretionary dependent child rate benefit: suspension until MSD determines eligibility, rate of benefit, and if exception applies
When this section applies
(1)
This section applies to a child (C) who, immediately before the start of C’s 18th birthday, is—
(a)
a dependent child of a beneficiary receiving a discretionary dependent child rate benefit; and
(b)
included as a dependent child of the beneficiary in determining the appropriate rate of benefit for that benefit.
General rule
(2)
MSD must suspend that benefit with effect—
(a)
from the start of the first entitlement period wholly after C’s 18th birthday; and
(b)
until the earlier of the following:
(i)
a determination under subsection (5) takes effect:
(ii)
the benefit is cancelled under subsection (6).
(3)
On suspending under subsection (2) a main benefit, MSD must also suspend, with effect from when the exclusion of C as a dependent child of the beneficiary takes effect, every other benefit, or special assistance granted under section 100 or 101, if any, that—
(a)
the beneficiary is receiving; and
(b)
is not of a kind excluded from suspension under subsection (4).
(4)
The following are excluded from suspension under subsection (3):
(a)
orphan’s benefit:
(b)
unsupported child’s benefit:
(c)
childcare assistance:
(d)
child disability allowance:
(e)
special assistance paid under the Guaranteed Childcare Assistance Payment Programme.
Review of eligibility, rate of benefit, and whether exception applies
(5)
Before, on, or after C’s 18th birthday, MSD must promptly review that benefit to determine—
(a)
whether the beneficiary remains eligible for that benefit; and
(b)
if so, the appropriate rate of benefit for that benefit; and
(c)
whether MSD is satisfied that an exception applies.
Cancellation
(6)
MSD must cancel that benefit if, 8 weeks after that benefit is suspended under subsection (2), MSD is unable to determine—
(a)
whether the beneficiary remains eligible for that benefit; and
(b)
if so, the appropriate rate of benefit for that benefit; and
(c)
whether MSD is satisfied that an exception applies.
(7)
If MSD cancels that benefit under subsection (5) or (6), the beneficiary’s entitlement to that benefit ceases with effect from when the suspension of that benefit takes effect under subsection (2)(a).
103D Specified children’s benefit applied for but not granted before 18th birthday: no grant for specified weeks unless exception applies
When this section applies
(1)
This section applies to a child (C) who, immediately before the start of C’s 18th birthday, is one in respect of whom a specified children’s benefit is applied for but not granted.
Exceptions
(2)
However, the general rule in subsection (3) does not apply if MSD is satisfied that an exception applies.
General rule
(3)
MSD must not grant that benefit for a period wholly or in part after the start of the first entitlement period wholly after C’s 18th birthday.
Earlier periods unaffected
(4)
However, MSD may grant that benefit for a period wholly before the start of the first entitlement period wholly after C’s 18th birthday.
Commencement of benefit granted
(5)
A specified children’s benefit granted under subsection (4), or under section 103F(5) or any other exception, commences in accordance with—
(a)
section 311 (commencement of benefits: general); and
(b)
other legislation in or under this Act on commencement of benefits.
103E Specified children’s benefit applied for and granted before 18th birthday: child excluded for eligibility and for rate of benefit unless exception applies
When this section applies
(1)
This section applies to a child (C) who, immediately before the start of C’s 18th birthday, is one in respect of whom a specified children’s benefit is applied for and granted.
General rule
(2)
MSD must exclude C as a child in respect of whom the specified children’s benefit is granted in determining—
(a)
whether the beneficiary remains eligible for that benefit; and
(b)
if so, the appropriate rate of benefit for that benefit.
When exclusion of C as child in respect of whom benefit is granted takes effect
(3)
The exclusion of C as a child in respect of whom the specified children’s benefit is granted takes effect from the start of the first entitlement period wholly after C’s 18th birthday.
Variation of that benefit
(4)
If the exclusion of C as a child in respect of whom the specified children’s benefit is granted results in the beneficiary being eligible for that benefit at another appropriate rate of benefit, MSD must vary that benefit—
(a)
so that it is payable at the other appropriate rate of benefit; and
(b)
with effect when that exclusion takes effect.
Example
Change in appropriate rate of benefit
The eligible caregiver has 3 children in their care in respect of whom an unsupported child’s benefit is granted. The eldest child (C) is excluded on and after C’s 18th birthday. That exclusion affects the appropriate rate of benefit under Part 5 of Schedule 4.
Suspension of payment of that benefit if beneficiary ceases to be eligible
(5)
If the exclusion of C as a child in respect of whom the specified children’s benefit is granted results in the beneficiary ceasing to be eligible for that benefit, MSD must suspend payment of that benefit with effect—
(a)
when the exclusion of C as a child in respect of whom the specified children’s benefit is granted takes effect; and
(b)
until the earlier of the following:
(i)
MSD has determined that an exception applies; or
(ii)
MSD cancels that benefit under subsection (9) or (10).
(6)
On suspending under subsection (5) a disability allowance payable to a person for a dependent child, or a child disability allowance, MSD must also suspend any temporary additional support that the beneficiary is receiving.
(7)
Despite subsection (5), the specified children’s benefit is cancelled, with effect from the start of the first entitlement period wholly after C’s 18th birthday, if—
(a)
that benefit is a disability allowance payable in respect of C; and
(b)
the person to whom the disability allowance in respect of C is payable is not a person to whom, or on whose account, any other disability allowance is payable; and
(c)
no orphan’s benefit or unsupported child’s benefit is payable for C; and
(d)
MSD is not satisfied that an exception applies.
(8)
On cancelling under subsection (7) a disability allowance, MSD must also suspend any temporary additional support that the beneficiary is receiving until whichever of the following occurs first:
(a)
within the 8 weeks after the suspension, the beneficiary notifies MSD under section 113 of a change in the beneficiary’s chargeable income, or allowable costs, or both, the beneficiary has a deficiency of income of $1 or more, and MSD recalculates the amount of that support granted to the beneficiary during the period for which the beneficiary has been granted that support:
(b)
MSD cancels that support with effect at the end of that 8-week period, and as required by this paragraph, because that support has not within that period been recalculated under paragraph (a).
Cancellation of that benefit
(9)
MSD must cancel that benefit, and must also cancel any temporary additional support suspended under subsection (6) or (8), with effect when that exclusion takes effect if—
(a)
that benefit has been suspended under subsection (5); and
(b)
MSD has determined that no exception applies.
(10)
MSD must cancel that benefit, and must also cancel any temporary additional support suspended under subsection (6) or (8), with effect when that exclusion takes effect if, 8 weeks after that benefit has been suspended under subsection (5), MSD has been unable to determine if an exception applies.
Exception if C not financially independent and continuing education
103F MSD may include C as dependent child for eligibility or rate of benefit for determined period
When this section applies
(1)
This section applies to a child (C) to whom section 103B, 103C, 103D, or 103E applies, or to whom subsection (7) applies, if MSD is satisfied, based on all relevant information available to MSD (including any relevant information provided in response to a notice under section 103G) that, on or after C’s 18th birthday, C is—
(a)
not financially independent; and
(b)
enrolled in a programme with a school or tertiary educational establishment; and
(c)
attending that programme to at least the minimum extent required by that school or tertiary educational establishment.
Meaning of determined period
(2)
In this section, determined period, for a benefit, means a period that MSD determines that—
(a)
starts on or after C’s 18th birthday; and
(b)
ends no later than the start of the first entitlement period wholly after the end of 31 December in the year of C’s 18th birthday.
Non-discretionary dependent child rate benefit granted before 18th birthday
(3)
If C is a child to whom section 103B applies, MSD may, for a determined period, for the benefit to which section 103B applies,—
(a)
include C as a dependent child of the beneficiary in determining—
(i)
whether the beneficiary remains eligible for that benefit; and
(ii)
if so, the appropriate rate of benefit for that benefit; and
(b)
in accordance with paragraph (a), continue that benefit (and every other benefit or special assistance suspended) as if it was not, and had never been, suspended under section 103B.
Discretionary dependent child rate benefit granted before 18th birthday
(4)
If C is a child to whom section 103C applies, MSD may, for a determined period, for the benefit to which section 103C applies,—
(a)
include C as a dependent child of the beneficiary in determining—
(i)
whether the beneficiary remains eligible for that benefit; and
(ii)
if so, the appropriate rate of benefit for that benefit; and
(b)
in accordance with paragraph (a), continue that benefit (and every other benefit or special assistance suspended) as if it was not, and had never been, suspended under section 103C.
Specified children’s benefit applied for but not granted before 18th birthday
(5)
If C is a child to whom section 103D applies,—
(a)
MSD may, for a determined period, grant the benefit to which section 103D applies for a period wholly or in part after the start of the first entitlement period wholly after C’s 18th birthday; and
(b)
the benefit that MSD may grant for that period under paragraph (a) commences as provided in section 103D(5).
Specified children’s benefit applied for and granted before 18th birthday
(6)
If C is a child to whom section 103E applies, MSD may, for a determined period, for the benefit to which section 103E applies,—
(a)
include C as a dependent child of the beneficiary in determining—
(i)
whether the beneficiary remains eligible for that benefit; and
(ii)
if so, the appropriate rate of benefit for that benefit; and
(b)
in accordance with paragraph (a), continue that benefit (and any temporary additional support) as if it was not, and had never been, suspended under section 103E.
Dependent child rate benefit, or specified children’s benefit, applied for at or after 18th birthday
(7)
This subsection applies to a child (C) in respect of whom any of the following is applied for at or after the start of C’s 18th birthday:
(a)
a non-discretionary dependent child rate benefit:
(b)
a discretionary dependent child rate benefit:
(c)
a specified children’s benefit.
(8)
If C is a child to whom subsection (7) applies, MSD may, for a determined period,—
(a)
if subsection (7)(a) or (b) applies, include C as a dependent child of the beneficiary in determining—
(i)
whether the beneficiary is eligible for—
(A)
the non-discretionary dependent child rate benefit; or
(B)
the discretionary dependent child rate benefit; and
(ii)
if so, the appropriate rate of benefit for that benefit; or
(b)
if subsection (7)(c) applies, grant the specified children’s benefit.
What happens at end of determined period
(9)
At the end of the determined period, section 103B, 103C, 103D, or 103E, and any provision relevant to how turning 18 years old may affect eligibility for, and the appropriate rate of benefit for, a child to whom subsection (7) applies, applies to C—
(a)
in the same way as it does before the determined period; but
(b)
with effect only from the start of the first entitlement period wholly after the determined period.
Compare: 1964 No 136 s 63A
Notice about effect of general rules, and providing information on exceptions
103G Notifying beneficiary of general rules and exceptions, and asking beneficiary to provide MSD with information relevant to exceptions
MSD must, at least 20 working days (or, if that period is not possible, as early as practicable) before C’s 18th birthday, give the beneficiary a notice that—
(a)
explains the effect of the general rules in sections 103B to 103E and the exceptions; and
(b)
asks the beneficiary to provide to MSD, before C’s 18th birthday, any information relevant to whether an exception applies.
Relationship with other related provisions
103H Relationship with other related provisions
Sections 103 to 103G override any provisions to the contrary in or under this Act, but do not limit—
(a)
section 113 (beneficiary must notify change of circumstances); or
(b)
sections 205A to 205I (failure to provide updated medical evidence for medical evidence benefit); or
(c)
section 290 (offences: false statements, misleading, or attempting to mislead, to receive or continue to receive benefits); or
(d)
section 300 (information gathering, disclosure, and matching); or
(e)
subpart 3 of Part 6 (discretionary review of entitlement to, or rate of, benefit granted); or
(f)
subpart 3A of Part 6 (mandatory review of entitlement to, or rate of, specified benefit granted); or
(g)
Schedule 6 (information gathering, disclosure, and matching) and, in particular, clause 2 (power to obtain information) of that schedule.
Medical evidence
19 Section 141 amended (Jobseeker support: work capacity determination and work test)
In section 141(3)(a),—
(a)
before “certificate”
, insert “medical”
; and
(b)
before “report”
, insert “medical”
.
20 Section 183 amended (What this Part does)
After section 183(2)(l), insert:
(la)
failure to provide updated medical evidence for a medical evidence benefit:
Mandatory reviews
21 Section 198A amended (How section 252 of Accident Compensation Act 2001 affects entitlement to, and rate of, specified supplementary assistance)
In section 198A(3)(a), replace “310B”
with “310A”
.
Medical evidence
22 New sections 205A to 205I and cross-heading inserted
After section 205, insert:
Factors affecting benefit: failure to provide updated medical evidence for medical evidence benefit
205A Beneficiary required to provide updated medical evidence
When this section applies
(1)
This section applies if—
(a)
a beneficiary is receiving a medical evidence benefit (as defined in section 205C); and
(b)
the coverage (as defined in Schedule 2) of the medical certificate, or other medical evidence, for that benefit includes a period before the review for the medical review date; and
(c)
that benefit therefore has a medical review date (as defined in section 205C); and
(d)
the beneficiary is not excluded from requirements under this section (in the circumstances, and for the relevant period, specified) by regulations made under section 434A(1)(a); and
(e)
the beneficiary’s compliance with requirements under this section has not been deferred under section 205D (for example, in circumstances, and for the relevant period, specified by regulations made under section 434A).
Updated medical evidence required to be provided before medical review date
(2)
The beneficiary must ensure that MSD has received updated medical evidence (as defined in section 205C)—
(a)
for that benefit; and
(b)
from, or on behalf of, the beneficiary; and
(c)
before whichever is applicable of the following dates:
(i)
the medical review date for that benefit:
(ii)
the date to which the beneficiary’s compliance with requirements under this section is deferred under section 205D.
If benefit granted to other person on account of beneficiary
(3)
Subsection (4) applies if the medical evidence benefit is granted—
(a)
for, or in respect of, the beneficiary; and
(b)
on an application made by, or on behalf of, any other person; and
(c)
to any other person on account of the beneficiary.
(4)
A reference in subsection (2), or in any of sections 205B to 205I, to the beneficiary includes a reference to the other person to whom the medical evidence benefit is granted on account of the beneficiary.
Exception
(5)
This section is subject to the exception set out in section 205B.
205B Exception: if medical evidence benefit suspended or not payable
When this section applies
(1)
This section applies only if, on the medical review date (as defined in section 205C), the medical evidence benefit—
(a)
is suspended; or
(b)
is not for the time being payable under this Act.
Requirements only if beneficiary contacts MSD, and subject to modifications
(2)
The beneficiary must ensure that MSD has received updated medical evidence under section 205A only if the beneficiary contacts MSD—
(a)
in the period that—
(i)
starts on the medical review date; and
(ii)
ends on the day on which the benefit is to be cancelled; and
(b)
seeking to have the suspension end and the benefit become payable under this Act, or the benefit otherwise become payable under this Act.
(3)
If the beneficiary contacts MSD as provided in subsection (2),—
(a)
the requirements of section 205A apply (despite anything to the contrary in section 205A or sections 205D to 205I) subject to the modifications set out in this section; and
(b)
MSD must promptly give the beneficiary a notice advising the beneficiary of the effect of those modifications.
Modifications required by this section
(4)
The suspension can end and the benefit can become payable under this Act, or the benefit can otherwise become payable under this Act, only after MSD has received updated medical evidence in line with those requirements.
(5)
If MSD has not received updated medical evidence in line with those requirements by the day on which the benefit is to be cancelled, MSD must cancel the benefit effective from the date of suspension and, in order to receive it again, the beneficiary must apply for it, and be granted it, again.
(6)
Sections 205A(1)(d) and (e) and 205D to 205G do not apply to the benefit or to the beneficiary ensuring that MSD has received updated medical evidence for the benefit.
(7)
The beneficiary must, before a deadline that MSD specifies and that is before the day on which the benefit is to be cancelled, ensure that MSD has received updated medical evidence for the benefit.
205C Definitions
In section 205A, this section, and sections 205D to 205I,—
beneficiary receiving a hospital rate of benefit means a beneficiary whose main benefit under this Act is—
(a)
affected by hospitalisation under section 206(1); and
(b)
paid at a rate of benefit under section 206(2)
beneficiary receiving residential care subsidy means a beneficiary—
(a)
to whom all of the following subparagraphs apply:
(i)
the beneficiary is aged 65 years or over; and
(ii)
the beneficiary is a qualifying person as defined in section 12 of the Residential Care and Disability Support Services Act 2018; and
(iii)
the beneficiary must under section 17 of that Act pay a contribution based on income towards the cost of that beneficiary’s LTR contracted care that is less than the maximum contribution (as defined in section 15(2) of that Act); or
(b)
to whom all of the following subparagraphs apply:
(i)
the beneficiary is aged 50 to 64 years; and
(ii)
the beneficiary is a 50+ single person as defined in section 21 of the Residential Care and Disability Support Services Act 2018; and
(iii)
the beneficiary is under section 22 of that Act liable to make a contribution based on income towards the cost of the person’s LTR contracted care that is less than the maximum contribution (as defined in section 15(2) of that Act)
beneficiary receiving residential support subsidy means a beneficiary who is—
(a)
receiving, in relation to the beneficiary’s disability or long-term chronic health condition, residential care services that are partly funded by the Crown; and
(b)
contributing to the cost of those services by a payment redirected under section 339(1)(a) or (c)(i), or sections 341 and 344, of this Act
hospital or residential care beneficiary means any of the following:
(a)
a beneficiary receiving a hospital rate of benefit:
(b)
a beneficiary receiving residential care subsidy:
(c)
a beneficiary receiving residential support subsidy
medical evidence benefit means any of the following:
(a)
jobseeker support on the ground of health condition, injury, or disability (see section 27):
(b)
a supported living payment on the ground of restricted work capacity or total blindness (see section 36A):
(c)
a supported living payment on the ground of caring for another person (see section 41):
(d)
a child disability allowance for a child (see section 80):
(e)
a disability allowance for a person (see section 87A)
medical review date, for a medical evidence benefit, means the first date after the end of the period before the review (if any) in the coverage of the medical certificate, or other medical evidence, for that benefit, under—
(a)
section 27 or 28:
(b)
section 36A or 37:
(c)
section 41 or 42:
(d)
section 80 or 81:
(e)
section 87A or 88
updated medical evidence, for a medical evidence benefit, means a medical certificate or other medical evidence that is equivalent to, and is satisfactory to and accepted by MSD in the same way as, the medical certificate or other medical evidence that any of the following sections requires MSD to receive before MSD may grant that medical evidence benefit:
(a)
section 27(6):
(b)
section 36A(7):
(c)
section 41(5):
(d)
section 80(5):
(e)
section 87A(4).
205D Deferral of compliance
Deferral under this section and regulations made under section 434A
(1)
Regulations made under section 434A(1)(b) for the purposes of section 205A(1)(e) may, under this subsection, defer compliance with requirements under section 205A by a specified class of beneficiaries for a specified period not exceeding 52 weeks if MSD is satisfied that—
(a)
a specified area (in or outside New Zealand) is affected by any circumstances specified; and
(b)
the specified class of beneficiaries is present in or residing in, and cannot reasonably leave, that specified area.
(2)
Deferral of compliance under subsection (1) in respect of a beneficiary does not affect or limit MSD’s duty under section 205E(1) to, at least 20 working days (or, if that period is not possible, as early as practicable) before the medical review date, give the beneficiary notice of the requirement under section 205A(2).
Deferral under this section: hospital or residential care beneficiary
(3)
Subsection (4) applies only if a beneficiary receiving jobseeker support on the ground of a health condition, injury, or disability, or a supported living payment on ground of restricted work capacity or total blindness, is a hospital or residential care beneficiary.
(4)
For the purposes of section 205A(1)(e), the beneficiary’s compliance with requirements under section 205A is deferred under this section until the first Monday after the beneficiary ceases to be a hospital or residential care beneficiary.
205E Notifying beneficiary of requirement
MSD must notify beneficiary
(1)
MSD must, at least 20 working days (or, if that period is not possible, as early as practicable) before the medical review date, give the beneficiary notice of the requirement under section 205A(2) and that, if they do not comply with it, MSD must suspend, with effect from the end of the day before the relevant deadline stated in section 205G(5),—
(a)
the medical evidence benefit that the beneficiary is receiving; and
(b)
every other benefit, or special assistance granted under section 100 or 101, if any, that—
(i)
the beneficiary is receiving; and
(ii)
is required to be suspended under section 205G(2) or (3).
Exception if medical evidence benefit suspended or not payable
(2)
Subsection (1) does not apply if, when MSD must give notice under that subsection, the medical evidence benefit—
(a)
is suspended; or
(b)
is not for the time being payable under this Act, for example, under—
(i)
section 217 (benefit not payable during custody in prison or on remand); or
(ii)
section 219 (general rule: benefit not payable while beneficiary absent from New Zealand).
If benefit becomes payable, MSD must take reasonable steps to advise
(3)
Subsection (4) applies, despite subsections (1) and (2), if—
(a)
the suspension ends and the medical evidence benefit becomes payable under this Act; or
(b)
the medical evidence benefit otherwise becomes payable under this Act.
(4)
MSD must, as soon as practicable, take reasonable steps to notify the beneficiary of the requirement under section 205A(2).
Exception if beneficiary is hospital or residential care beneficiary
(5)
Subsection (1) does not apply if the beneficiary is a hospital or residential care beneficiary.
If beneficiary, or child or other person for whom benefit granted, has died
(6)
Subsection (1) does not apply if the medical evidence benefit ends under sections 326 to 329 because either of the following people has died:
(a)
the beneficiary who was receiving that benefit:
(b)
a child, or other person, for whom, or on account of whom, that benefit was granted.
205F MSD may extend deadline for providing updated medical evidence
Deadline that may be extended
(1)
This section applies to the deadline under section 205A(2) (under which the beneficiary (B) must ensure that MSD has received updated medical evidence for that benefit from, or on behalf of, the beneficiary, and before whichever is applicable of the following dates:
(a)
the medical review date for that benefit:
(b)
the date to which B’s compliance with requirements under section 205A is deferred under section 205D).
MSD may extend deadline: general
(2)
MSD may, before, at, or after that deadline, extend that deadline by up to 40 working days if—
(a)
B contacts MSD before that deadline; and
(b)
MSD is satisfied that B has a good and sufficient reason for not being able to provide the updated medical evidence before that deadline.
Greater maximum extension in specified circumstances
(3)
MSD may under subsection (2) extend that deadline by more than 40 working days but not more than 52 weeks if B is paid the benefit for B’s absences from New Zealand longer than 4 weeks in any 52-week period—
(a)
under section 219(3) and regulations made under section 436; and
(b)
because MSD is satisfied that payment of the benefit complies with the relevant qualifying circumstances set out in subsection (4).
(4)
The relevant qualifying circumstances for subsection (3) are that—
(a)
B’s return to New Zealand from an absence in respect of which the benefit is paid has been prevented by new circumstances that—
(i)
were not reasonably foreseeable at the time when B last left New Zealand; and
(ii)
are outside B’s control; and
(b)
MSD is satisfied that the extension of the absence is not longer than is necessitated by the new circumstances.
MSD may extend deadline: exceptional late extension
(5)
MSD may, after that deadline, extend that deadline by up to 40 working days after the medical evidence benefit is suspended under section 205G, if—
(a)
B was a hospital or residential care beneficiary; and
(b)
B contacts MSD after that deadline; and
(c)
MSD is satisfied that B had a good and sufficient reason for not being able to provide the updated medical evidence before that deadline.
205G Consequences if beneficiary fails to comply with requirement
Suspension of benefits and special assistance
(1)
If the beneficiary fails to comply with a requirement under section 205A(2), MSD must suspend, with effect from the end of the day before the relevant deadline stated in subsection (5), the medical evidence benefit that the beneficiary is receiving.
(2)
On suspending under subsection (1) a child disability allowance or a disability allowance, MSD must also suspend, with effect from the end of the day before the relevant deadline stated in subsection (5), any temporary additional support that the beneficiary is receiving.
(3)
On suspending under subsection (1) a medical evidence benefit other than a child disability allowance or a disability allowance, MSD must also suspend, with effect from the end of the day before the relevant deadline stated in subsection (5), every other benefit, or special assistance granted under section 100 or 101, if any, that—
(a)
the beneficiary is receiving; and
(b)
is not of a kind excluded from suspension under subsection (4).
Kinds of benefits, or special assistance, excluded from suspension
(4)
The following are excluded from suspension under subsection (3):
(a)
orphan’s benefit:
(b)
unsupported child’s benefit:
(c)
childcare assistance:
(d)
child disability allowance:
(e)
special assistance paid under the Guaranteed Childcare Assistance Payment Programme.
Relevant deadline
(5)
The relevant deadline mentioned in subsections (1) to (3) and (7) is—
(a)
the deadline under section 205A(2); or
(b)
if MSD has granted the beneficiary an extended deadline under section 205F, the extended deadline.
Exception to suspension: resumption if extension under section 205F(5)
(6)
However, every benefit and special assistance must be resumed from when it was suspended under subsection (1), (2), or (3) if the beneficiary—
(a)
was a hospital or residential care beneficiary; and
(b)
is granted an extension under section 205F(5).
Cancellation of benefit and special assistance
(7)
MSD must cancel a benefit or special assistance with effect from when the benefit or special assistance is suspended under subsection (1), (2), or (3) if—
(a)
the benefit or special assistance is suspended under subsection (1), (2), or (3); and
(b)
the beneficiary fails to comply with a requirement under section 205A(2) within 8 weeks starting at the relevant deadline stated in subsection (5).
205H Recognised medical certificate or no relevant change in applicable medical circumstances
Medical evidence benefit to which this section applies
(1)
This section applies to a medical evidence benefit only if it is—
(a)
jobseeker support on the ground of health condition, injury, or disability (see section 27); or
(b)
a supported living payment on the ground of restricted work capacity (see section 36A).
This section applies if recognised medical certificate
(2)
This section applies if the updated medical evidence that MSD received for the medical evidence benefit is a medical certificate that is—
(a)
equivalent to, and satisfactory to and accepted by MSD in the same way as, the medical certificate that section 27 or 36A requires MSD to receive before MSD may grant that benefit; and
(b)
issued on a date stated in it, and by a prescribed health practitioner who is, or who falls within a class or description that is, recognised by MSD for the purposes of this paragraph; and
(c)
received by MSD—
(i)
using an electronic means recognised by MSD for the purposes of this paragraph; and
(ii)
within 20 working days after the date on which it is issued; and
(iii)
before the relevant deadline under section 205G(5).
Publishing recognition of prescribed health practitioners and electronic means
(3)
MSD must ensure that details of, and of any variation or revocation of, any recognition by MSD of prescribed health practitioners or electronic means for the purposes of subsection (2)(b) or (c), are published as soon as practicable—
(a)
in the Gazette; and
(b)
on an internet site that—
(i)
is maintained by, or on behalf of, the responsible department; and
(ii)
is publicly available free of charge.
Section also applies if relevant change in applicable medical circumstances
(4)
This section also applies if MSD is satisfied from the updated medical evidence that MSD received for the medical evidence benefit that no relevant change in the applicable medical circumstances has occurred since whichever is the last to occur of the following dates:
(a)
the date on which that benefit commenced:
(b)
the date on which MSD last completed consideration of updated medical evidence that MSD received for that benefit.
Beneficiary remains entitled to medical evidence benefit and rate of benefit
(5)
If this section applies under subsection (2) or (4), the beneficiary remains entitled to receive the following that the beneficiary received immediately before the medical review date:
(a)
the medical evidence benefit:
(b)
the rate of the medical evidence benefit.
205I Other specified provisions not limited
(1)
Sections 205A to 205H do not limit—
(a)
subpart 18 of Part 2 (effect of child turning 18 years old); or
(b)
section 113 (beneficiary must notify change of circumstances); or
(c)
section 219 (general rule: benefit not payable while beneficiary absent from New Zealand); or
(d)
the exceptions, or other contrary or related provisions, contained in regulations made under section 436 (regulations: factors affecting benefits: absence from New Zealand); or
(e)
section 290 (offences: false statements, misleading, or attempting to mislead, to receive or continue to receive benefits); or
(f)
section 300 (information gathering, disclosure, and matching); or
(g)
subpart 3 of Part 6 (discretionary review of entitlement to, or rate of, benefit granted); or
(h)
subpart 3A of Part 6 (mandatory review of entitlement to, or rate of, specified benefit granted); or
(i)
sections 325 to 330 (ending of benefits); or
(j)
Schedule 6 (information gathering, disclosure, and matching) and, in particular, clause 2 (power to obtain information) of that schedule.
(2)
This section does not limit regulations made under section 434A(1)(a) excluding a beneficiary who is receiving a medical evidence benefit from requirements under section 205A because all or any provisions specified in subsection (1)(a) to (j) apply to the beneficiary.
Mandatory reviews
23 Section 296 amended (What this Part does)
Replace section 296(b) with:
(b)
discretionary reviews by MSD of a beneficiary’s past or current entitlement to a benefit or rate of benefit:
(ba)
mandatory reviews by MSD of a beneficiary’s past or current entitlement to a specified benefit or rate of specified benefit:
24 Section 298 amended (MSD must inquire into claim for benefit)
Replace section 298(4) with:
(4)
Subsection (3) does not limit—
(a)
subsection (1); or
(b)
subpart 3 (discretionary review of entitlement to, or rate of, benefit granted); or
(c)
subpart 3A (mandatory review of entitlement to, or rate of, specified benefit granted).
Medical evidence
25 Section 301 amended (MSD decides whether to grant benefit)
In section 301, insert as subsection (2):
(2)
This section is subject to—
(a)
section 27(6) (which prevents MSD granting jobseeker support on the ground of a health condition, injury, or disability until MSD has received, from, or on behalf of, the applicant, a medical certificate that complies with section 27); and
(b)
section 36A(7) (which prevents MSD granting a supported living payment on the ground of restricted work capacity or total blindness until MSD has received, from, or on behalf of, the applicant, a medical certificate or other medical evidence that complies with section 36A); and
(c)
section 41(5) (which prevents MSD granting a supported living payment on the ground of caring for another person until MSD has received, from, or on behalf of, the applicant, a medical certificate that complies with section 41); and
(d)
section 80(5) (which prevents MSD granting a child disability allowance for a child until MSD has received, from, or on behalf of, the applicant, a medical certificate or other medical evidence that complies with section 80); and
(e)
section 87A(4) (which prevents MSD granting a disability allowance to or on account of a person until MSD has received, from, or on behalf of, the applicant, a medical certificate that complies with section 87A).
26 Section 302 amended (Immediate provisional grant, and later backdating of other benefit)
After section 302(3), insert:
(4)
This section is subject to—
(a)
section 27(6) (which prevents MSD granting jobseeker support on the ground of a health condition, injury, or disability until MSD has received, from, or on behalf of, the applicant, a medical certificate that complies with section 27); and
(b)
section 36A(7) (which prevents MSD granting a supported living payment on the ground of restricted work capacity or total blindness until MSD has received, from, or on behalf of, the applicant, a medical certificate or other medical evidence that complies with section 36A); and
(c)
section 41(5) (which prevents MSD granting a supported living payment on the ground of caring for another person until MSD has received, from, or on behalf of, the applicant, a medical certificate that complies with section 41); and
(d)
section 80(5) (which prevents MSD granting a child disability allowance for a child until MSD has received, from, or on behalf of, the applicant, a medical certificate or other medical evidence that complies with section 80); and
(e)
section 87A(4) (which prevents MSD granting a disability allowance to or on account of a person until MSD has received, from, or on behalf of, the applicant, a medical certificate that complies with section 87A).
Mandatory reviews, and when benefit ends after death of beneficiary
27 Subpart 3 heading in Part 6 amended
In Part 6, in the subpart 3 heading, replace “Review”
with “Discretionary review”
.
28 Section 304 amended (Review of entitlement and rate payable)
Repeal section 304(3) and (4) and the heading above section 304(3).
29 Section 304A amended (Grounds for review of whether person’s information share child support payment is or was their weekly income)
Replace section 304A(1)(f) with:
(f)
the person to whom the payment was made has died, and their benefit—
(i)
is specified in any of paragraphs (a) to (i) of the definition of specified main benefit in section 326(5); and
(ii)
will end, or has ended, under section 326(2) or (4):
30 Section 305 amended (Information for review)
Replace section 305(3) with:
(3)
This section does not limit—
(a)
section 28 (jobseeker support: on ground of health condition, injury, or disability: medical examination); or
(b)
section 37 (supported living payment: on ground of restricted work capacity or total blindness: medical examination); or
(c)
section 42 (supported living payment: on ground of caring for another person: medical examination); or
(d)
section 81 (child disability allowance: medical examination); or
(e)
section 88 (disability allowance: medical examination); or
(f)
subpart 18 of Part 2 (effect of child turning 18 years old); or
(g)
section 113 (beneficiary must notify change of circumstances); or
(h)
sections 205A to 205I (failure to provide updated medical evidence for medical evidence benefit); or
(i)
section 290 (offences: false statements, misleading, or attempting to mislead, to receive or continue to receive benefits); or
(j)
section 300 (information gathering, disclosure, and matching); or
(k)
subpart 3A of Part 6 (mandatory review of entitlement to, or rate of, specified benefit granted); or
(l)
Schedule 6 (information gathering, disclosure, and matching) and, in particular, clause 2 (power to obtain information) of that schedule.
31 New section 310AA inserted (Part 7 gives rights to seek review or appeal against decision)
After section 310, insert:
310AA Part 7 gives rights to seek review or appeal against decision
(1)
Rights to seek a review of, or to appeal against, a decision on a review under this subpart are given by the following subparts of Part 7:
(a)
subpart 2 (reviews by benefits review committee):
(b)
subpart 3 (appeals to appeal authority):
(c)
subpart 4 (appeals to courts):
(d)
subpart 5 (appeals to medical board).
(2)
Subsection (1) is by way of explanation only.
32 Subpart 3A of Part 6 replaced
Replace subpart 3A of Part 6 with:
Subpart 3A—Mandatory review of entitlement to, or rate of, specified benefit granted
MSD must undertake and complete review
310A MSD must review specified benefit
Specified benefit to which this section applies
(1)
This section applies to a specified benefit—
(a)
as that term is defined in section 310D; and
(b)
granted to, or in respect of, a beneficiary; and
(c)
that is being paid, or was paid, to the beneficiary.
MSD must review specified benefit (unless exception or exemption applies)
(2)
MSD must review the specified benefit—
(a)
for the purpose, and within the limits, stated in sections 310E and 310F; and
(b)
unless MSD is not required to review the specified benefit because of an exception, or exemption, under section 310G or 310H; and
(c)
with MSD also reviewing every other specified benefit granted to, or in respect of, the beneficiary, if the specified benefit is a universal review benefit under section 310D; and
(d)
without MSD also reviewing any other specified benefit granted to, or in respect of, the beneficiary (except as provided in subsection (3)), if the specified benefit is an independent review benefit under section 310D; and
(e)
so that MSD starts to undertake the review by the review start deadline (as defined in section 310D); and
(f)
after advising the beneficiary of, and the beneficiary providing, the information required for the review under sections 310I to 310M; and
(g)
with the effect of, and decision on, the review stated in sections 310N to 310U; and
(h)
with the review and appeal rights mentioned in section 310V applying in respect of a decision on the review; and
(i)
unless MSD has received information that satisfies MSD that either of the following people has died:
(i)
the beneficiary who was receiving the specified benefit:
(ii)
a child, or other person, for whom, or on account of whom, the specified benefit was granted.
Exceptions
(3)
Despite subsection (2)(d), an independent review benefit that is an orphan’s benefit, or an unsupported child’s benefit, received by a beneficiary for a child must be reviewed under section 310A together with any disability allowance the beneficiary is receiving for the child.
(4)
This section is subject to the exception set out in section 310C.
310B Notice if specified benefit suspended or not payable
When this section applies
(1)
This section applies only if, at least 20 working days before the review start deadline for a review under section 310A, MSD considers that, at that deadline, the specified benefit will be—
(a)
suspended; or
(b)
not for the time being payable under this Act, other than not for the time being payable under—
(i)
section 217 (benefit not payable during custody in prison or on remand); or
(ii)
section 219 (general rule: benefit not payable while beneficiary absent from New Zealand).
Notice about effect of section 310C
(2)
MSD must, by giving a notice at least 20 working days before the review start deadline, advise the beneficiary of the effect of section 310C.
310C If specified benefit suspended or not payable
When this section applies
(1)
This section applies only if, at the review start deadline, the specified benefit—
(a)
is suspended; or
(b)
is not for the time being payable under under this Act.
Review only if beneficiary contacts MSD, and subject to modifications
(2)
MSD must review the specified benefit under section 310A only if the beneficiary contacts MSD—
(a)
in the period that—
(i)
starts with the review start deadline; and
(ii)
ends on the day on which the benefit is to be cancelled; and
(b)
seeking to have the suspension end and the benefit become payable under this Act, or the benefit otherwise become payable under this Act.
(3)
If the beneficiary contacts MSD as provided in subsection (2),—
(a)
MSD must review the specified benefit under section 310A (despite anything to the contrary in this subpart) subject to the modifications set out in this section; and
(b)
MSD must promptly give the beneficiary a notice advising the beneficiary of the effect of those modifications.
Modifications for review required by this section
(4)
The suspension can end and the benefit can become payable under this Act, or the benefit can otherwise become payable under this Act, only after a review of the specified benefit required by subsection (3)(a).
(5)
If the beneficiary does not comply with subsection (8), MSD must cancel the benefit and, to be again entitled to the benefit, the beneficiary must apply for it again and establish that the beneficiary is eligible for it.
(6)
Exceptions or exemptions under section 310G or 310H do not apply to that review.
(7)
Sections 310I to 310L do not apply to that review.
(8)
The beneficiary must, before a deadline that MSD specifies and that is before the day on which the benefit is to be cancelled, provide MSD with—
(a)
the information that MSD notifies the beneficiary that MSD requires for the review; and
(b)
the answers to questions that MSD notifies the beneficiary that MSD requires for the review.
310D Definitions for subpart
In this subpart, unless the context otherwise requires,—
3-year rule benefit means a specified benefit stated to be a 3-year rule benefit by regulations made under section 438A(1)(a) (see section 438A(1A)(c))
automated electronic system means an automated electronic system used under subpart 5A
disruption, to a system under the responsible department’s control (for example, an automated electronic system), includes, without limitation, a disruption to disclosure to MSD of all or any information used in or by the system
independent review benefit means a specified benefit stated to be an independent review benefit by regulations made under section 438A(1)(a) (see section 438A(1A)(a))
review start deadline, for a review under section 310A of a specified benefit, means the review start deadline—
(a)
for that review of that specified benefit; and
(b)
stated, or otherwise provided for, by regulations made under section 438A(1)(a) (see section 438A(1A)(b) and (1B))
specified benefit—
(a)
means a kind of benefit designated by regulations made under section 438A(1)(a) to be a specified benefit for the purposes of this subpart (however, childcare assistance under subpart 12 of Part 2 payable to the same beneficiary may be designated only as a single specified benefit); but
(b)
if those regulations designate a kind of benefit to be a specified benefit for the purposes of this subpart only if it meets prescribed conditions, means that kind of benefit only if it meets the prescribed conditions (see regulations made under section 438A(1)(b))
universal review benefit means a specified benefit stated to be a universal review benefit by regulations made under section 438A(1)(a) (see section 438A(1A)(a)).
Purpose of review
310E Review of entitlement and rate payable
Review under subpart
(1)
A review under section 310A of a specified benefit is to ascertain all or any of the following:
(a)
whether the beneficiary is, or remains, entitled to receive the benefit, or the rate of benefit, that is being paid to the beneficiary; or
(b)
whether the beneficiary was not entitled to receive the benefit, or the rate of benefit, that was paid to the beneficiary.
Exception
(2)
This section is subject to section 310F.
310F Review excludes whether a person’s information share child support payment is or was all or any of their weekly income
(1)
MSD cannot review under section 310A whether a person’s information share child support payment is or was all or any of their weekly income under Part 3A of Schedule 3.
(2)
However, this section does not affect or limit—
(a)
section 113 (beneficiary must notify change of circumstances); or
(b)
MSD for the purposes of a review under section 310A treating a person’s information share child support payment as all or any of their weekly income under Part 3A of Schedule 3; or
(c)
MSD reviewing under subpart 3 (discretionary review of entitlement to, or rate of, benefit granted) whether a person’s information share child support payment is or was all or any of their weekly income under Part 3A of Schedule 3.
Exceptions to, and exemption from, review
310G Exceptions to review
If exception applies, MSD is not required to undertake or complete review
(1)
If an exception under subsection (2) or (3) applies, MSD is not required to undertake or complete a review that MSD would, but for this section, be required to undertake and complete under section 310A.
Exception: disruption to system used to undertake review
(2)
The exception under this subsection applies if—
(a)
the specified benefit is neither of the following:
(i)
childcare assistance:
(ii)
a special benefit continued under section 23 of the Social Security (Working for Families) Amendment Act 2004 (as that section is saved by clause 19 of Schedule 1) and payable to a beneficiary who is ordinarily resident in New Zealand; and
(b)
at any time or times, or at all times, at least 20 working days before the review start deadline, there is a disruption to a system used to undertake the review.
Exception: 1 or more prescribed circumstances apply to beneficiary
(3)
The exception under this subsection applies if, at any time or times, or at all times, at least 20 working days before the review start deadline, 1 or more of the prescribed circumstances apply to the beneficiary.
(4)
In this section, prescribed circumstances means any circumstances that are—
(a)
circumstances (within or outside New Zealand) in which MSD is not required under this section to undertake a mandatory review that MSD would, but for this section, be required to undertake under section 310A; and
(b)
prescribed for the purposes of the exception in subsection (3) by regulations made under section 438A(1)(c).
310H Exemption from review
If exemption applies, MSD is not required to undertake or complete review
(1)
If an exemption under this section applies, MSD is not required to undertake or complete a review that MSD would, but for this section, be required to undertake and complete under section 310A.
When MSD may grant exemption
(2)
MSD may, before, at, or after the review start deadline for the specified benefit, grant an exemption under this section only if—
(a)
the beneficiary contacts MSD before that deadline; and
(b)
MSD is satisfied that the specified benefit is not excluded from an exemption under this section by regulations made under section 438A(1)(d); and
(c)
MSD is satisfied that, owing to the beneficiary’s circumstances, the review should not be undertaken or completed.
Information for review
310I MSD must advise beneficiary of information required
MSD must, by giving a notice under section 310J by at least 20 working days before the review start deadline for a review under section 310A, advise the beneficiary of—
(a)
the information that MSD requires for the review:
(b)
the questions for which MSD requires answers for the review.
310J MSD must give notice to beneficiary
In requiring information or answers under section 310I or 310K(3), MSD must give the beneficiary a notice advising the beneficiary of the following matters:
Requirement to undertake and complete mandatory review
(a)
that MSD must review the specified benefit under section 310A:
Information or answers required under section 310K(1)
(b)
any information that MSD under section 310K(1) requires the beneficiary to provide for the review:
(c)
any questions that MSD under section 310K(1) requires the beneficiary to answer for the review:
Information or answers required under section 310K(3)
(d)
any information that MSD under section 310K(3) requires the beneficiary to provide for the review:
(e)
the way in which that information must be provided:
(f)
any questions that MSD under section 310K(3) requires the beneficiary to answer for the review:
(g)
the way in which those questions must be answered:
Deadline for information or answers required under section 310I
(h)
the deadline for providing the information or answers required under section 310K(1) or (3):
Consequence of failure to comply with section 310K
(i)
that the beneficiary’s benefit and special assistance will be suspended under section 310L if the beneficiary fails to provide the information or answer the questions by—
(i)
the deadline under section 310K(1) or (3); or
(ii)
an extended deadline under section 310K(4).
310K Beneficiary’s duty to provide information for review
Notified information or answers to be provided by review start deadline
(1)
The beneficiary must, before the review start deadline for a review under section 310A, provide MSD with—
(a)
the information that MSD has notified the beneficiary under section 310J that MSD requires for the review:
(b)
the answers to questions that MSD has notified the beneficiary under section 310J that MSD requires for the review.
MSD may require further information or answers
(2)
Subsection (3) applies if, after the beneficiary provides information or answers in response to a notification described in subsection (1), MSD determines that the beneficiary’s circumstances have changed since whichever is the last to occur of the following dates:
(a)
the date on which the specified benefit commenced:
(b)
the date on which the specified benefit was last reviewed under section 304 or 310A.
(3)
MSD may, by giving a notice under section 310J, require the beneficiary to provide information or answers—
(a)
in a way that MSD specifies; and
(b)
by a reasonable deadline that MSD specifies.
MSD may extend deadline for providing notified information or answers
(4)
MSD may, before, at, or after the deadline under subsection (1), extend that deadline by up to 20 working days only if—
(a)
the beneficiary contacts MSD before that deadline; and
(b)
MSD is satisfied that the specified benefit is not excluded from an extension under this subsection by regulations made under section 438A(1)(e); and
(c)
MSD is satisfied that the beneficiary has a good and sufficient reason for not being able to provide the information, or answer the questions, in the specified way before that deadline.
310L Consequences if beneficiary fails to comply with duty
Universal review benefit: suspension of all benefits and special assistance
(1)
If the beneficiary fails to comply with a requirement under section 310K(1) or (3) in respect of a specified benefit that is a universal review benefit, MSD must suspend, with effect from the end of the day before the relevant deadline stated in subsection (5), every benefit, and every special assistance granted under section 100 or 101, that—
(a)
the beneficiary is receiving; and
(b)
is not of a kind listed in subsection (6).
(2)
However, subsection (1)(b) does not prevent a specified benefit from being suspended under subsection (1) if that specified benefit is—
(a)
itself the subject of the review under section 310A; and
(b)
of a kind listed in subsection (6).
Independent review benefit: suspension of only independent review benefit
(3)
If the beneficiary fails to comply with a requirement under section 310K(1) or (3) in respect of a specified benefit that is an independent review benefit, MSD must suspend, with effect from the end of the day before the relevant deadline stated in subsection (5), only that independent review benefit.
(4)
However, MSD must suspend, with effect from the end of the day before the relevant deadline stated in subsection (5), only the benefits and special assistance specified in paragraphs (a) and (b) if—
(a)
the independent review benefit mentioned in subsection (3) is an orphan’s benefit, or an unsupported child’s benefit, received by a beneficiary for a child; and
(b)
the beneficiary is receiving for, or on behalf of, the child, any other benefit, or special assistance, that is not—
(i)
a child disability allowance; or
(ii)
childcare assistance; or
(iii)
special assistance paid under the Guaranteed Childcare Assistance Payment Programme.
Relevant deadline
(5)
The relevant deadline mentioned in subsections (1), (3), (4), and (8) is—
(a)
the deadline under section 310K(1) if—
(i)
MSD has not required information under section 310K(3); and
(ii)
MSD has not granted the beneficiary an extended deadline under section 310K(4):
(b)
the deadline under section 310K(3) if MSD has required information under section 310K(3):
(c)
the extended deadline if MSD has granted the beneficiary an extended deadline under section 310K(4).
Benefits or special assistance that must not be suspended
(6)
The kinds of benefits or special assistance mentioned in subsection (1)(b) are—
(a)
a child disability allowance:
(b)
an orphan’s benefit:
(c)
an unsupported child’s benefit:
(d)
a youth payment:
(e)
a young parent payment:
(f)
childcare assistance:
(g)
New Zealand superannuation (other than New Zealand superannuation that is being paid at a rate specified in clause 1 of Part 2 of Schedule 1 of the New Zealand Superannuation and Retirement Income Act 2001):
(h)
a veteran’s pension:
(i)
special assistance paid under the Guaranteed Childcare Assistance Payment Programme.
Cancellation of benefit or special assistance
(7)
MSD must cancel, effective from the date that it is suspended, a benefit, or any special assistance granted under section 100 or 101, if—
(a)
the benefit, or the special assistance, is suspended under subsection (1), (3), or (4); and
(b)
the beneficiary fails to comply with a requirement under section 310K(1) or (3) within the relevant period in subsection (8).
Relevant period
(8)
The relevant period mentioned in subsection (7) is,—
(a)
if the suspended benefit or special assistance is not New Zealand superannuation or a veteran’s pension to which subsection (9), (10), or (11) applies, 8 weeks starting at the relevant deadline stated in subsection (5):
(b)
if the suspended benefit or special assistance is New Zealand superannuation or a veteran’s pension to which subsection (9), (10), or (11) applies, 2 years (each of 365 days) starting at the relevant deadline stated in subsection (5) (even if that deadline is on 29 February in a leap year).
New Zealand superannuation with 2-year relevant period
(9)
This subsection applies to New Zealand superannuation—
(a)
payable at a non-standard couple rate under Part 3 (see clauses 4 and 7 to 10) of Schedule 1AA of the New Zealand Superannuation and Retirement Income Act 2001; and
(b)
payable to a beneficiary who is not absent from New Zealand, or payable—
(i)
to a beneficiary who is absent from New Zealand; and
(ii)
as provided in any of sections 22 to 25 of the New Zealand Superannuation and Retirement Income Act 2001.
(10)
This subsection applies to New Zealand superannuation—
(a)
payable at any rate under the New Zealand Superannuation and Retirement Income Act 2001; and
(b)
payable to a beneficiary who is absent from New Zealand, and as provided in—
(i)
sections 26 to 35 of the New Zealand Superannuation and Retirement Income Act 2001; or
(ii)
a reciprocity agreement adopted under section 380; and
(c)
not payable to a beneficiary who is ordinarily resident in—
(i)
Australia; or
(ii)
the United Kingdom of Great Britain and Northern Ireland.
Veteran’s pension with 2-year relevant period
(11)
This subsection applies to a veteran’s pension—
(a)
payable to a beneficiary who is—
(i)
absent from New Zealand; and
(ii)
not ordinarily resident in Australia; and
(b)
payable as provided in—
(i)
sections 181 to 196 of the Veterans’ Support Act 2014; or
(ii)
a reciprocity agreement adopted under section 380; and
(c)
not payable to a beneficiary who is ordinarily resident in—
(i)
Australia; or
(ii)
the United Kingdom of Great Britain and Northern Ireland.
310M Other specified provisions not limited
Sections 310I to 310L and 310N to 310U do not limit—
(a)
section 28 (jobseeker support: on ground of health condition, injury, or disability: medical examination); or
(b)
section 37 (supported living payment: on ground of restricted work capacity or total blindness: medical examination); or
(c)
section 42 (supported living payment: on ground of caring for another person: medical examination); or
(d)
section 81 (child disability allowance: medical examination); or
(e)
section 88 (disability allowance: medical examination); or
(f)
subpart 18 of Part 2 (effect of child turning 18 years old); or
(g)
section 113 (beneficiary must notify change of circumstances); or
(h)
sections 205A to 205I (failure to provide updated medical evidence for medical evidence benefit); or
(i)
section 290 (offences: false statements, misleading, or attempting to mislead, to receive or continue to receive benefits); or
(j)
section 300 (information gathering, disclosure, and matching); or
(k)
subpart 3 of Part 6 (discretionary review of entitlement to, or rate of, benefit granted); or
(l)
sections 325 to 330 (ending of benefits); or
(m)
Schedule 6 (information gathering, disclosure, and matching) and, in particular, clause 2 (power to obtain information) of that schedule.
Effect of, and decision on, review
310N No relevant change in beneficiary’s circumstances
When this section applies
(1)
This section applies if MSD is satisfied because of the review under section 310A that no relevant change in the beneficiary’s circumstances has occurred since whichever is the last to occur of the following dates:
(a)
the date on which the specified benefit commenced:
(b)
the date on which the specified benefit was last reviewed under section 304 or 310A.
When change in circumstances is relevant change
(2)
For the purposes of this section and section 310O, a change in the beneficiary’s circumstances is a relevant change only if—
(a)
the change affects the beneficiary’s entitlement to receive a specified benefit; or
(b)
the change affects the rate of a specified benefit the beneficiary receives.
Beneficiary remains entitled to specified benefit and rate of benefit
(3)
The decision on the review must be that the beneficiary remains entitled to receive the following that the beneficiary received immediately before MSD undertook the review:
(a)
the specified benefit:
(b)
the rate of the specified benefit.
Exception: special benefit or emergency benefit
(4)
However, subsection (3) does not apply if the specified benefit is—
(a)
a special benefit—
(i)
continued under section 23 of the Social Security (Working for Families) Amendment Act 2004 (as that section is saved by clause 19 of Schedule 1 of this Act); and
(ii)
payable to a beneficiary who is ordinarily resident in New Zealand; or
(b)
an emergency benefit—
(i)
granted—
(A)
under section 63 (discretionary grant on ground of hardship); or
(B)
under section 64 (grant during epidemic in New Zealand); and
(ii)
granted with no expiry date, or with an expiry date that is later than 52 weeks after the commencement of the benefit; and
(iii)
payable to a beneficiary who is ordinarily resident in New Zealand.
Exception: 3-year rule benefits and supplementary benefit rule
(5)
This section is subject to sections 310O and 310P.
310O Exception: 3-year rule benefit
When this section applies
(1)
This section applies if MSD is satisfied because of the review under section 310A of a 3-year rule benefit, and because of all relevant information available to MSD, that subsection (2), (3), or (4) applies to that benefit.
Benefit is any 3-year rule benefit
(2)
This subsection applies to a 3-year rule benefit if—
(a)
the 3-year rule benefit is any 3-year rule benefit; and
(b)
the declared income of the beneficiary and the beneficiary’s spouse or partner (if any) has not changed in the last 3 calendar years.
Benefit is accommodation supplement
(3)
This subsection applies to a 3-year rule benefit if—
(a)
the 3-year rule benefit is accommodation supplement; and
(b)
the following have not changed in the last 3 calendar years:
(i)
declared accommodation costs (as defined in section 65AAA):
(ii)
declared weekly qualifying accommodation costs (as referred to in section 68(1)(b), and as defined in clause 7 of Part 7 of Schedule 4 for the purposes of that Part).
Benefit is disability allowance
(4)
This subsection applies to 3-year rule benefit if—
(a)
the 3-year rule benefit is disability allowance; and
(b)
the beneficiary’s additional expenses of an ongoing kind arising from the beneficiary’s disability (for the purposes of section 85(2)(d) of the Act) have not changed in the last 3 calendar years.
MSD must consider whether to request further information or answers
(5)
If this section applies, MSD must consider whether to require further information or answers under section 310K(3).
310P Exception: supplementary benefit rule
When this section applies
(1)
This section applies if MSD is satisfied because of the review under section 310A of a specified benefit, and because of all relevant information available to MSD, that the beneficiary is not receiving a main benefit under this Act and—
(a)
the specified benefit is one to which this section applies (see regulations made under section 438A(1)(a) and (1A)(d)); and
(b)
the declared income of the beneficiary and the beneficiary’s spouse or partner (if any) for the review is no income.
MSD must consider whether to request further information or answers
(2)
If this section applies, MSD must consider whether to require further information or answers under section 310K(3).
310Q No entitlement, or entitlement only at different rate
When this section applies
(1)
This section applies if MSD is satisfied because of the review under section 310A that the beneficiary—
(a)
was not or is not entitled (at all, rather than on another eligibility ground for that benefit) to receive a specified benefit; or
(b)
was or is entitled to receive a specified benefit at a different rate.
What MSD may do
(2)
MSD may suspend, cancel, or vary the rate of benefit of, the specified benefit from a date MSD reasonably determines.
MSD must also suspend or cancel other benefits or special assistance beneficiary is receiving
(3)
Subsection (4) applies if—
(a)
MSD suspends or cancels the specified benefit under subsection (2); and
(b)
the specified benefit is—
(i)
a main benefit; and
(ii)
a universal review benefit; and
(c)
the beneficiary is also receiving benefits or special assistance—
(i)
other than the specified benefit; and
(ii)
not of a kind listed in section 310L(6).
(4)
MSD must suspend or cancel the benefits or special assistance to which subsection (3)(c) applies with the specified benefit suspended or cancelled under subsection (2).
MSD must also continue or vary other benefits or special assistance beneficiary is receiving
(5)
Subsection (6) applies if—
(a)
MSD varies the specified benefit under subsection (2); and
(b)
the specified benefit is a universal review benefit; and
(c)
the beneficiary is also receiving benefits or special assistance—
(i)
other than the specified benefit; and
(ii)
not of a kind listed in section 310L(6).
(6)
MSD must continue or vary the benefits or special assistance to which subsection (5)(c) applies (if the beneficiary was or is entitled to receive them) with the specified benefit varied under subsection (2).
MSD must also suspend or cancel other benefits or special assistance beneficiary is receiving
(7)
Subsection (8) applies if—
(a)
MSD suspends or cancels the specified benefit under subsection (2); and
(b)
the specified benefit is—
(i)
an independent review benefit; and
(ii)
an orphan’s benefit, or an unsupported child’s benefit, received by a beneficiary for a child; and
(c)
the beneficiary is also receiving for, or on behalf of, the child, any other benefit, or special assistance, that is not—
(i)
a child disability allowance; or
(ii)
childcare assistance; or
(iii)
special assistance paid under the Guaranteed Childcare Assistance Payment Programme.
(8)
MSD must suspend or cancel the benefits or special assistance to which subsection (7)(c) applies with the specified benefit suspended or cancelled under subsection (2).
MSD must also continue or vary other benefits or special assistance beneficiary is receiving
(9)
Subsection (10) applies if—
(a)
MSD varies the specified benefit under subsection (2); and
(b)
the specified benefit is—
(i)
an independent review benefit; and
(ii)
an orphan’s benefit, or an unsupported child’s benefit, received by a beneficiary for a child; and
(c)
the beneficiary is also receiving for, or on behalf of, the child, any other benefit, or special assistance, that is not—
(i)
a child disability allowance; or
(ii)
childcare assistance; or
(iii)
special assistance paid under the Guaranteed Childcare Assistance Payment Programme.
(10)
MSD must continue or vary the benefits or special assistance to which subsection (9)(c) applies (if the beneficiary was or is entitled to receive them) with the specified benefit varied under subsection (2).
310R Benefit on another eligibility ground more appropriate
When this section applies
(1)
This section applies if MSD is satisfied because of the review under section 310A that the beneficiary—
(a)
was granted a specified benefit on a stated eligibility ground for that benefit; and
(b)
is more appropriately entitled to receive that specified benefit on another eligibility ground for that specified benefit.
What MSD may do
(2)
MSD may cancel the specified benefit as granted on the stated eligibility ground, and grant the beneficiary that specified benefit on the other eligibility ground commencing from the date of cancellation.
310S Another benefit more appropriate
When this section applies
(1)
This section applies if MSD is satisfied because of the review under section 310A that the beneficiary is more appropriately entitled to receive another benefit.
What MSD may do
(2)
MSD may cancel the specified benefit, and grant the beneficiary the other benefit commencing from the date of cancellation.
310T Termination of winter energy payment
After the review under section 310A, MSD may terminate a winter energy payment under section 75.
310U Certain specified benefits granted, or granted at rate, not taking into account certain insurance payments
When this section applies
(1)
This section applies if MSD is satisfied because of the review under section 310A that the beneficiary has been granted a specified benefit, or has been granted a specified benefit at a rate, that does not take into account certain insurance payments specified in regulations made under section 439.
Insurance payment reduced by amount of costs incurred in obtaining it
(2)
For the purposes of this section, the amount of an insurance payment must, to the extent MSD so determines, be reduced by the amount of any costs incurred by an applicant for a specified benefit or a beneficiary in obtaining receipt of that payment.
What MSD may do
(3)
MSD may, in accordance with those regulations, suspend, cancel, or vary the rate of, the specified benefit, from a date MSD determines.
Review of, or appeal against, decision on review
310V Part 7 gives rights to seek review or appeal against decision
(1)
Rights to seek a review of, or to appeal against, a decision on a review under this subpart are given by the following subparts of Part 7:
(a)
subpart 2 (reviews by benefits review committee):
(b)
subpart 3 (appeals to appeal authority):
(c)
subpart 4 (appeals to courts):
(d)
subpart 5 (appeals to medical board).
(2)
Subsection (1) is by way of explanation only.
33 Section 325 amended (General rule if person’s entitlement to benefit ceases)
In section 325(2), before “sections 326 to 330,”
, insert “subpart 18 of Part 2 (effect of child turning 18 years old),”
.
34 Section 326 replaced (After death of beneficiary receiving specified benefit)
Replace section 326 with:
326 After death of beneficiary
Specified main benefit if surviving spouse or partner, or child, not entitled to lump sum accident compensation payment
(1)
Subsection (2) applies to a person and a benefit only if,—
(a)
when the person died, the person was receiving the benefit; and
(b)
the benefit is a specified main benefit (as defined in subsection (5)); and
(c)
the person leaves a spouse or partner, or a child, not entitled to a lump sum accident compensation payment (as defined in subsection (5)).
(2)
If this subsection applies to a person and a benefit, that benefit of the person ends 28 days after the date of the person’s death.
Specified main benefit, or any other benefit, that does not end under subsection (2)
(3)
Subsection (4) applies to a person and a benefit only if,—
(a)
when the person died, the person was receiving the benefit; and
(b)
the benefit is—
(i)
a specified main benefit (as defined in subsection (5)); or
(ii)
any other benefit (for example, an accommodation supplement, or temporary additional support); and
(c)
the benefit does not end under subsection (2).
(4)
If this subsection applies to a person and a benefit, that benefit of the person ends on a date that is—
(a)
set by MSD; and
(b)
not later than 28 days after the date of the person’s death.
Definitions
(5)
In this section,—
lump sum accident compensation payment means a lump sum payment under—
(a)
section 56 of the Accident Rehabilitation and Compensation Insurance Act 1992; or
(b)
section 444 of the Accident Insurance Act 1998; or
(c)
section 382 of the Accident Compensation Act 2001
specified main benefit means—
Main benefit under other Act
(a)
New Zealand superannuation:
(b)
a veteran’s pension:
Main benefit under this Act
(c)
jobseeker support:
(d)
sole parent support:
(e)
a supported living payment on the ground of restricted work capacity or total blindness under section 34:
(f)
a supported living payment on the ground of caring for another person under section 40:
(g)
a youth payment:
(h)
a young parent payment:
(i)
an emergency benefit related to a benefit specified in any of paragraphs (c) to (h).
35 Section 334 amended (Exceptions for specified benefit based on prescribed circumstances)
In section 334(4), after “any review under section 304”
, insert “or 310A”
.
Use of automated electronic systems
36 Section 363A amended (Use of automated electronic systems to make decisions, exercise powers, comply with obligations, and take related actions)
(1)
In section 363A(2), insert in its appropriate alphabetical order:
administrative programme means a programme—
(a)
of social assistance; and
(b)
not in or under legislation; and
(c)
that the responsible department administers (alone or jointly with other departments)
(2)
In section 363A(2) replace the definition of specified provision with:
specified provision means either or both of the following:
(a)
a specified provision as defined in clause 11 of Schedule 3:
(b)
all, or a part, of an administrative programme.
(3)
Repeal section 363A(3) and the heading above section 363A(3).
(4)
Replace section 363A(6)(a) with:
(a)
approved by MSD, in consultation with—
(i)
the Privacy Commissioner appointed under the Privacy Act 2020; and
(ii)
the Human Rights Commission continued by section 4 of the Human Rights Act 1993; and
(iii)
any other person, body, or organisation that MSD considers appropriate; and
(5)
After section 363A(6), insert:
(6A)
The standard must include provisions that address the following topics:
(a)
accuracy and reliability:
(b)
bias and discrimination:
(c)
legal and policy considerations:
(d)
fraud considerations:
(e)
transparency:
(f)
human oversight:
(g)
compliance and assurance.
Medical evidence
37 Section 418 amended (Regulations: general)
In section 418(1)(a), replace “sections 27, 28, 37, 41, 42, 80, 81, 88, 134, 164, 167, and 379”
with “sections 27, 28, 36A, 37, 41, 42, 80, 81, 87A, 88, 134, 164, 167, and 379”
.
38 New section 434A inserted (Regulations: factors affecting benefits: beneficiary required to provide updated medical evidence)
After section 434, insert:
434A Regulations: factors affecting benefits: beneficiary required to provide updated medical evidence
(1)
The Governor-General may, by Order in Council, make regulations for all or any of the following purposes:
(a)
excluding a beneficiary who is receiving a medical evidence benefit from requirements under section 205A, for the purposes of section 205A(1)(d):
(b)
deferring compliance with requirements under section 205A—
(i)
for the purposes of section 205A(1)(e); and
(ii)
under section 205D(1).
(2)
Regulations made under subsection (1)(a) may exclude the beneficiary from those requirements under section 205A—
(a)
in circumstances specified in those regulations; and
(b)
for a period that, for each particular circumstances specified,—
(i)
is specified in those regulations; and
(ii)
starts on the benefit’s medical review date; and
(iii)
does not exceed 52 weeks.
(3)
Regulations made under this section are secondary legislation (see Part 3 of the Legislation Act 2019 for publication requirements).
Mandatory reviews
39 Section 438A amended (Regulations: requirement regarding specified benefits)
(1)
In the heading to section 438A, replace “requirement regarding specified benefits”
with “mandatory reviews of entitlement to, or rate of, specified benefit granted”
.
(2)
Replace section 438A(1) with:
(1)
The Governor-General may, by Order in Council, make regulations for all or any of the following purposes:
(a)
designating the kinds of benefit that are specified benefits for the purposes of subpart 3A of Part 6 (see section 310D) (however, childcare assistance under subpart 12 of Part 2 payable to the same beneficiary may be designated only as a single specified benefit):
(b)
providing that a kind of benefit is designated to be a specified benefit for those purposes only if it meets prescribed conditions (see the definition of specified benefit in section 310D):
(c)
prescribing circumstances (within or outside New Zealand) for the purposes of the exception under section 310G(3) from the requirement for MSD to undertake and complete a review under section 310A (see the definition of prescribed circumstance in section 310G(4)):
(d)
providing that a specified benefit is excluded from an exemption under section 310H:
(e)
providing that a specified benefit is excluded from an extension under section 310K(4).
(1A)
Regulations made under subsection (1)(a) designating a kind of benefit as a specified benefit for the purposes of subpart 3A of Part 6 must also state the following for that specified benefit and those purposes:
(a)
whether it is a universal review benefit or an independent review benefit (see the definitions of those terms in section 310D):
(b)
a review start deadline (see the definition of that term in section 310D):
(c)
whether it is a 3-year rule benefit (see the definition of that term in section 310D):
(d)
whether it is a specified benefit to which section 310P applies (see section 310P(1)(a)).
(1B)
Regulations made under subsections (1)(a) and (1A)(b) may also, for a specified benefit that commences before subpart 3A of Part 6 starts to apply to a specified benefit of that kind, provide that the first review start deadline for a review under section 310A of that specified benefit is a date determined by MSD that is no later than 52 weeks after that specified benefit commences.
(1C)
A condition prescribed under subsection (1)(b) may require that a kind of benefit is granted—
(a)
on a prescribed eligibility ground for that kind of benefit:
(b)
at a prescribed rate of benefit for that kind of benefit:
(c)
to, or in respect of, a beneficiary in prescribed circumstances.
(1D)
A condition prescribed under subsection (1)(b) may also require that a kind of benefit is payable only to a beneficiary—
(a)
ordinarily resident in New Zealand; or
(b)
ordinarily resident in an overseas country.
(1E)
Regulations made under subsection (1)(c) may, without limitation, provide that the prescribed circumstances—
(a)
apply to a beneficiary for the purposes of section 310G(3) only if the beneficiary is being paid, or was paid, a specified benefit stated in the regulations; or
(b)
do not apply to a beneficiary for the purposes of section 310G(3) if the beneficiary is being paid, or was paid, a specified benefit stated in the regulations.
40 Section 439 amended (Regulations: certain benefits granted, or granted at rate, not taking into account certain insurance payments)
(1)
In section 439(1), replace “section 310”
with “sections 310 and 310U”
.
(2)
In section 439(2)(a), after “benefits or kinds of benefits”
, insert “, or specified benefits or kinds of specified benefits,”
.
(3)
In section 439(2)(b), after “the benefit”
, insert “or specified benefit”
.
Definitions
41 Schedule 2 amended
(1)
In Schedule 2, insert in its appropriate alphabetical order:
administrative programme is defined in section 363A(2) for the purposes of subpart 5A of Part 6
(2)
In Schedule 2, replace the definition of automated electronic system with:
automated electronic system—
(a)
is defined in section 304A for the purposes of that section; and
(b)
is defined in section 310D for the purposes of subpart 3A of Part 6
(3)
In Schedule 2, insert in their appropriate alphabetical order:
beneficiary receiving a hospital rate of benefit is defined in section 205C for the purposes of sections 205A to 205I
beneficiary receiving residential care subsidy is defined in section 205C for the purposes of sections 205A to 205I
beneficiary receiving residential support subsidy is defined in section 205C for the purposes of sections 205A to 205I
coverage, of any medical certificate, medical evidence, or medical report is defined—
(a)
in section 27(4) for a medical certificate under section 27; and
(b)
in section 28(6) for a medical report under section 28; and
(c)
in section 36A(5) for—
(i)
a medical certificate under section 36A; and
(ii)
other medical evidence under section 36A(6); and
(d)
in section 37(6) for a medical report under section 37; and
(e)
in section 41(4) for a medical certificate under section 41; and
(f)
in section 42(6) for a medical report under section 42; and
(g)
in section 80(3) for—
(i)
a medical certificate under section 80; and
(ii)
other medical evidence under section 80(4); and
(h)
in section 81(6) for a medical report under section 81; and
(i)
in section 87A(3) for a medical certificate under section 87A; and
(j)
in section 88(6) for a medical report under section 88
hospital or residential care beneficiary is defined in section 205C for the purposes of sections 205A to 205I
medical evidence benefit is defined in section 205C for the purposes of sections 205A to 205I
medical review date is defined in section 205C for the purposes of sections 205A to 205I
prescribed general minimum restricting period for supported living payment on the ground of restricted work capacity means the minimum period (that a person’s health condition, injury, or disability that restricts the person’s capacity for work is expected to continue for at least) that is—
(a)
referred to in section 35(2)(a); and
(b)
set out in regulations made under section 418(1)(b)
updated medical evidence is defined in section 205C for the purposes of sections 205A to 205I
(4)
In Schedule 2, definition of prescribed health practitioner, after “prescribed health practitioner”
, insert “or PHP”
.
(5)
In Schedule 2, replace the definition of relevant deadline with:
relevant deadline—
(a)
is defined in section 205G(5) for the purposes of section 205G(1) to (3) and (7); and
(b)
is defined in section 310L(5) for the purposes of section 310L(1), (3), (4), and (8)
(6)
In Schedule 2, insert in their appropriate alphabetical order:
C’s 18th birthday is defined in section 103A for the purposes of subpart 18 of Part 2
Community Costs Programme is defined in section 103A for the purposes of subpart 18 of Part 2
dependent child rate benefit is defined in section 103A for the purposes of subpart 18 of Part 2
determined period is defined in section 103F(2) for the purposes of section 103F
discretionary dependent child rate benefit is defined in section 103A for the purposes of subpart 18 of Part 2
entitlement period is defined in section 103A for the purposes of subpart 18 of Part 2
exception, to a general rule in section 103B to 103E, is defined in section 103A for the purposes of subpart 18 of Part 2
non-discretionary dependent child rate benefit is defined in section 103A for the purposes of subpart 18 of Part 2
specified children’s benefit is defined in section 103A for the purposes of subpart 18 of Part 2
(7)
In Schedule 2, replace the definition of disruption with:
disruption,—
(a)
to an automated electronic system, is defined in section 304A for the purposes of that section; and
(b)
to a system under the responsible department’s control, is defined in section 310D for the purposes of subpart 3A of Part 6
(8)
In Schedule 2, insert in their appropriate alphabetical order:
Guaranteed Childcare Assistance Payment Programme means—
(a)
the Guaranteed Childcare Assistance Payment Programme—
(i)
approved and established under section 124(1)(d) of the Social Security Act 1964 on 20 August 2012; and
(ii)
saved by clause 21 of Schedule 1 of this Act as if it were approved and established under section 101 of this Act; and
(b)
any later special assistance programme approved and established under section 101 that, with or without modification, replaces, or that corresponds to, the programme specified in paragraph (a)
independent review benefit is defined in section 310D for the purposes of subpart 3A of Part 6
lump sum accident compensation payment is defined in section 326(5) for the purposes of section 326
(9)
In Schedule 2, repeal the definition of mandatory review deadline.
(10)
In Schedule 2, replace the definition of prescribed circumstances with:
prescribed circumstances—
(a)
is defined in section 310G(4) for the purposes of section 310G; and
(b)
is defined in section 334(5) for the purposes of section 334
(11)
In Schedule 2, insert in their appropriate alphabetical order:
relevant change is defined in section 310N(2) for the purposes of sections 310N and 310O
relevant deadline is defined in section 310L(5) for the purposes of section 310L(1), (3), (4), and (8)
relevant period is defined in section 310L(8) for the purposes of section 310L(7)
review start deadline, for a review under section 310A of a specified benefit, is defined in section 310D for the purposes of subpart 3A of Part 6
(12)
In Schedule 2, definition of specified benefit, paragraph (ab), replace “310A”
with “310D”
.
(13)
In Schedule 2, insert in their appropriate alphabetical order:
specified main benefit is defined in section 326(5) for the purposes of section 326
universal review benefit is defined in section 310D for the purposes of subpart 3A of Part 6
Mandatory reviews, and when benefit ends after death of beneficiary
42 Schedule 3 amended
(1)
In Schedule 3, clause 11, replace the definition of specified provision with:
specified provision means any provision that is all or a part of any legislation that the responsible department administers (alone or jointly with other departments) by doing either or both of the following:
(a)
leading advice to the Minister on its policy and effect, and on any proposed amendments to it:
(b)
exercising or performing powers, duties, or functions under it
Example
Specified provision
A provision in, or made under, any of the following:
this Act (for example, a schedule of this Act):
the New Zealand Superannuation and Retirement Income Act 2001:
Part 6 of the Veterans’ Support Act 2014
(2)
In Schedule 3, clause 15A(3), replace “section 326(2) or (3)”
with “section 326(2) or (4)”
.
(3)
In Schedule 3, clause 15B(4)(a), after “a review under section 304”
, insert “or 310A”
.
(4)
In Schedule 3, replace clause 15H(1)(a) with:
(a)
the person has died, and their benefit—
(i)
is specified in any of paragraphs (a) to (i) of the definition of specified main benefit in section 326(5); and
(ii)
will end, or has ended, under section 326(2) or (4); and
Subpart 2—Amendments to Social Security Regulations 2018
43 Principal regulations
This subpart amends the Social Security Regulations 2018.
Medical evidence
44 Regulation 5 amended (Guide to Part 2)
(1)
In regulation 5(b), (c), and (g), before “certificates”
, insert “medical”
.
(2)
In regulation 5(h), after “prescribes health practitioners for”
, insert “medical certificates and”
.
45 Subpart 2 heading in Part 2 amended
In Part 2, in the subpart 2 heading, before “certificates”
, insert “medical”
.
46 Regulation 8 amended (Certificates: prescribed health practitioners)
In the heading to regulation 8, replace “Certificates”
with “Medical certificates”
.
47 Regulation 11 amended (Certificates and medical examinations: prescribed health practitioners)
(1)
In the heading to regulation 11, replace “Certificates”
with “Medical certificates”
.
(2)
Before regulation 11(1), insert:
Restricted work capacity or total blindness: medical certificate about applicant
(1AAA)
A health practitioner who is any of the following, acting within their scope of practice, is prescribed for the purposes of section 36A of the Act:
(a)
a medical practitioner:
(b)
a psychologist:
(c)
a nurse practitioner.
(3)
In the heading to regulation 11(2), before “certificate”
, insert “medical”
.
48 Regulation 34 amended (Payment of childcare subsidy if caregiver not engaged in approved activity but has serious disability or illness)
In regulation 34(b), before “certificate”
, insert “medical”
.
49 Regulation 42 amended (Payment of OSCAR subsidy if caregiver has serious disability or illness)
In regulation 42(b), before “certificate”
, insert “medical”
.
50 Subpart 7 heading in Part 2 amended
In Part 2, in the subpart 7 heading, before “certificates”
, insert “medical”
.
51 Regulation 49 amended (Certificates and medical examinations: prescribed health practitioners)
In the heading to regulation 49, replace “Certificates”
with “Medical certificates”
.
52 Regulation 50 amended (Discretionary grant if life expectancy or continuing disability less than 6 months)
In regulation 50(2), replace “to a person”
with “for a person”
.
53 Regulation 51 amended (Mandatory grant if disability unexpectedly likely to last, or lasts, for at least 6 months)
Replace regulation 51(2) and (3) with:
(2)
This regulation applies if an application for a disability allowance for a person (P) has been declined only on the ground that P’s disability is likely to last less than 6 months, and MSD is later satisfied (by, or on behalf of, P)—
(a)
that P’s disability is likely to last, or has continued, for 6 months or more; and
(b)
that P would otherwise have been eligible under section 85(1)(a) of the Act to be granted a disability allowance from the date of the original application.
(3)
MSD must grant a disability allowance for P commencing on the date of the original application.
54 Regulation 52 replaced (Medical examinations: prescribed health practitioners)
Replace regulation 52 with:
52 Medical certificates and medical examinations: prescribed health practitioners
A health practitioner who is either of the following, acting within their scope of practice, is prescribed for the purposes of sections 87A and 88 of the Act:
(a)
a medical practitioner:
(b)
a nurse practitioner.
Compare: 1964 No 136 s 69C(3)
55 Regulation 79 amended (Procedure for deferral of work-test obligations)
In regulation 79(3)(a), before “certificate”
, insert “medical”
.
56 Regulation 108 amended (Guide to Part 4)
After regulation 108(d), insert:
(e)
subpart 5 (regulation 137) deals with factors affecting benefits: a beneficiary who is required to provide updated medical evidence:
57 New subpart 5 of Part 4 inserted
After regulation 136, insert:
Subpart 5—Factors affecting benefits: beneficiary required to provide updated medical evidence
137 When beneficiary excluded from requirements
What this regulation does
(1)
This regulation excludes a beneficiary who is receiving a medical evidence benefit from requirements under section 205A of the Act, for the purposes of section 205A(1)(d) of the Act.
When beneficiary excluded
(2)
A beneficiary who is receiving a medical evidence benefit is excluded from requirements under section 205A of the Act if—
(a)
the coverage (as defined in Schedule 2 of the Act) of the medical certificate, or other medical evidence, for that benefit includes a period before the review for the medical review date; and
(b)
that benefit therefore has a medical review date (as defined in section 205C of the Act); and
(c)
payment of that benefit continues for an ending of benefits period that is mentioned in subclause (3); and
(d)
the medical review date falls in that ending of benefits period.
Relevant ending of benefits periods
(3)
Subclause (2)(c) applies only to an ending of benefits period under a section of the Act that is, and in the limited circumstances (if any) that are, specified in any of the following paragraphs:
(a)
section 326 (after death of beneficiary):
(b)
section 327 (benefits payable to sole parent who stops caring for dependent child due to sudden and uncontrollable circumstances), but only if the medical evidence benefit is paid in respect of the dependent child who has left the sole parent’s care:
(c)
section 328 (supported living payment payable to beneficiary who stops caring for another person):
(d)
section 330 (supported living payment on ground of restricted work capacity or total blindness and cancelled on medical grounds).
Mandatory reviews
58 Regulation 165 amended (Guide to Part 6)
Replace regulation 165(aa) with:
(aa)
subpart 1A (regulations 176A to 176I) deals with mandatory reviews by MSD of a beneficiary’s past or current entitlement to a specified benefit or rate of specified benefit:
59 Subpart 1A of Part 6 replaced
Replace subpart 1A of Part 6 with:
Subpart 1A—Mandatory review of entitlement to, or rate of, specified benefit granted
Specified benefits
176A Benefits designated as specified benefits
What this regulation does
(1)
This regulation designates the kinds of benefits that are a specified benefit for the purposes of subpart 3A of Part 6 of the Act (see the definition of specified benefit in section 310D of the Act).
Kinds of benefits designated (including prescribed conditions for designation)
(2)
Each of the following subclauses sets out—
(a)
a kind of benefit designated by this regulation; and
(b)
any prescribed conditions for designation.
Supported living payment
(3)
This subclause designates a supported living payment—
(a)
granted—
(i)
under section 34 of the Act on the ground of restricted work capacity or total blindness; or
(ii)
under section 40 of the Act on the ground of caring for another person; and
(b)
payable to a beneficiary who is ordinarily resident in New Zealand.
Supported living payment—overseas
(4)
This subclause designates a supported living payment—
(a)
granted—
(i)
under section 34 of the Act on the ground of restricted work capacity or total blindness; or
(ii)
under section 40 of the Act on the ground of caring for another person; and
(b)
payable to a beneficiary who is ordinarily resident in a country other than any of the following:
(i)
New Zealand:
(ii)
Australia:
(iii)
the United Kingdom of Great Britain and Northern Ireland; and
(c)
payable as provided in a reciprocity agreement—
(i)
with the Government of the country in which the beneficiary is ordinarily resident; and
(ii)
adopted by an order made under section 380 of the Act.
Orphan’s benefit
(5)
This subclause designates an orphan’s benefit payable to a beneficiary who is ordinarily resident in New Zealand.
Orphan’s benefit—overseas
(6)
This subclause designates an orphan’s benefit—
(a)
payable to a beneficiary who is ordinarily resident in a country other than New Zealand; and
(b)
payable as provided in a reciprocity agreement—
(i)
with the Government of the country in which the beneficiary is ordinarily resident; and
(ii)
adopted by an order made under section 380 of the Act.
Unsupported child’s benefit
(7)
This subclause designates an unsupported child’s benefit payable to a beneficiary who is ordinarily resident in New Zealand.
Emergency benefit
(8)
This subclause designates an emergency benefit—
(a)
granted—
(i)
under section 63 of the Act (discretionary grant on ground of hardship); or
(ii)
under section 64 of the Act (grant during epidemic in New Zealand); and
(b)
granted with no expiry date, or with an expiry date that is later than 52 weeks after the commencement of the benefit; and
(c)
payable to a beneficiary who is ordinarily resident in New Zealand.
Accommodation supplement
(9)
This subclause designates an accommodation supplement—
(a)
granted under section 65 of the Act; and
(b)
not received by a person who is receiving—
(i)
a youth payment; or
(ii)
a young parent payment; and
(c)
payable to a beneficiary who is ordinarily resident in New Zealand.
Childcare assistance (childcare subsidy or OSCAR subsidy)
(10)
This subclause designates childcare assistance (a childcare subsidy, an out-of-school care and recreation subsidy (OSCAR subsidy), or both)—
(a)
payable under subpart 6 of Part 2 of these regulations; and
(b)
payable to a beneficiary who is ordinarily resident in New Zealand.
Disability allowance
(11)
This subclause designates a disability allowance—
(a)
granted under section 85 of the Act; and
(b)
not received by—
(i)
a person to whom subclause (12) applies; or
(ii)
a person who is receiving—
(A)
a youth payment; or
(B)
a young parent payment; and
(c)
payable to a beneficiary who is ordinarily resident in New Zealand.
(12)
This subclause applies to a person who—
(a)
is receiving jobseeker support or sole parent support; and
(b)
has been notified or advised under section 335 of the Act that their entitlement to that benefit will cease unless they reapply for that benefit and it is regranted; and
(c)
has informed MSD, in the 44 weeks before the date of the notification or advice mentioned in paragraph (b), of the person’s additional expenses of an ongoing kind arising from the person’s disability (for the purposes of section 85(2)(d) of the Act).
Special benefit
(13)
This subclause designates a special benefit—
(a)
continued under section 23 of the Social Security (Working for Families) Amendment Act 2004 (as that section is saved by clause 19 of Schedule 1 of the Act); and
(b)
payable to a beneficiary who is ordinarily resident in New Zealand.
Widow’s benefit—overseas
(14)
This subclause applies to widow’s benefit—
(a)
granted or continued under clause 55 of Schedule 1, and Part 10 of Schedule 4, of the Act; and
(b)
payable to a beneficiary who is ordinarily resident in a country other than any of the following:
(i)
New Zealand:
(ii)
the United Kingdom of Great Britain and Northern Ireland; and
(c)
payable as provided in a reciprocity agreement—
(i)
with the Government of the country in which the beneficiary is ordinarily resident; and
(ii)
adopted by an order made under section 380 of the Act.
New Zealand superannuation
(15)
This subclause designates New Zealand superannuation—
(a)
payable at a non-standard couple rate under Part 3 (see clauses 4 and 7 to 10) of Schedule 1AA of the New Zealand Superannuation and Retirement Income Act 2001; and
(b)
payable to a beneficiary who is not absent from New Zealand; or
(c)
payable—
(i)
to a beneficiary who is absent from New Zealand; and
(ii)
as provided in any of sections 22 to 25 of the New Zealand Superannuation and Retirement Income Act 2001.
New Zealand superannuation—overseas
(16)
This subclause designates New Zealand superannuation—
(a)
payable at any rate under the New Zealand Superannuation and Retirement Income Act 2001; and
(b)
payable to a beneficiary who is absent from New Zealand, and as provided in—
(i)
sections 26 to 35 of the New Zealand Superannuation and Retirement Income Act 2001; or
(ii)
a reciprocity agreement adopted under section 380 of the Act; and
(c)
not payable to a beneficiary who is ordinarily resident in—
(i)
Australia; or
(ii)
the United Kingdom of Great Britain and Northern Ireland.
Veteran’s pension—overseas
(17)
This subclause designates a veteran’s pension—
(a)
payable to a beneficiary who is—
(i)
absent from New Zealand; and
(ii)
not ordinarily resident in Australia; and
(b)
payable as provided in—
(i)
sections 181 to 196 of the Veterans’ Support Act 2014; or
(ii)
a reciprocity agreement adopted under section 380 of the Act; and
(c)
not payable to a beneficiary who is ordinarily resident in—
(i)
Australia; or
(ii)
the United Kingdom of Great Britain and Northern Ireland.
Review with, or apart from, other specified benefits
176B Universal review benefit or independent review benefit
What this regulation does
(1)
This regulation states whether a specified benefit is a universal review benefit or an independent review benefit for the purposes of subpart 3A of Part 6 of the Act (see the definitions of those terms in section 310D of the Act).
Universal review benefit
(2)
Each of the following specified benefits is a universal review benefit:
(a)
supported living payment (see regulation 176A(3)):
(b)
emergency benefit (see regulation 176A(8)):
(c)
accommodation supplement (see regulation 176A(9)):
(d)
disability allowance (see regulation 176A(11)):
(e)
New Zealand superannuation (see regulation 176A(15)).
Independent review benefit
(3)
Each of the following specified benefits is an independent review benefit:
(a)
supported living payment—overseas (see regulation 176A(4)):
(b)
orphan’s benefit (see regulation 176A(5)):
(c)
orphan’s benefit—overseas (see regulation 176A(6)):
(d)
unsupported child’s benefit (see regulation 176A(7)):
(e)
childcare assistance (see regulation 176A(10)):
(f)
special benefit (see regulation 176A(13)):
(g)
widow’s benefit—overseas (see regulation 176A(14)):
(h)
New Zealand superannuation—overseas (see regulation 176A(16)):
(i)
veteran’s pension—overseas (see regulation 176A(17)).
Review start deadlines stated
176C Review start deadline: universal review benefit
Deadline: 52 weeks after last review date
(1)
The review start deadline for a review under section 310A of the Act of a universal review benefit is 52 weeks after the last review date.
Last review date: if any universal review benefit is main benefit
(2)
If a universal review benefit granted to, or in respect of the beneficiary, is a main benefit, the last review date is whichever is the last to occur of the following dates:
(a)
the date on which that main benefit commenced:
(b)
the date on which that main benefit was last reviewed under section 304 or 310A of the Act.
Last review date: if universal review benefit is supplementary benefit
(3)
If no universal review benefit granted to, or in respect of the beneficiary, is a main benefit, the last review date is whichever is the last to occur of the following dates:
(a)
the earliest of the dates on which the beneficiary’s 1 or more specified benefits that are supplementary benefits commenced:
(b)
the last of the dates on which the beneficiary’s 1 or more specified benefits that are supplementary benefits was or were last reviewed under section 310A of the Act.
(4)
In subclause (3), a supplementary benefit means—
(a)
an accommodation supplement; or
(b)
a disability allowance.
176D Review start deadline: independent review benefit
Deadline: general rule: 52 weeks after last review date
(1)
The review start deadline for a review under section 310A of the Act of any of the following is 52 weeks after the last review date:
(a)
supported living payment—overseas (see regulation 176A(4)):
(b)
orphan’s benefit (see regulation 176A(5)):
(c)
orphan’s benefit—overseas (see regulation 176A(6)):
(d)
unsupported child’s benefit (see regulation 176A(7)):
(e)
childcare assistance (see regulation 176A(10)):
(f)
widow’s benefit—overseas (see regulation 176A(14)):
(g)
New Zealand superannuation—overseas (see regulation 176A(16)):
(h)
veteran’s pension—overseas (see regulation 176A(17)).
Last review date: general
(2)
The last review date of the benefit mentioned in any of paragraphs (a) to (f) of subclause (1) is whichever is the last to occur of the following dates:
(a)
the date on which that benefit commenced:
(b)
the date on which that benefit was last reviewed under section 310A of the Act:
(c)
if that benefit is either of the following, the date on which MSD last confirmed whether the information MSD holds regarding the beneficiary’s circumstances is correct:
(i)
orphan’s benefit (see regulation 176A(5)):
(ii)
unsupported child’s benefit (see regulation 176A(7)).
Last review date: New Zealand superannuation—overseas, and veteran’s pension—overseas
(3)
The last review date of the benefit mentioned in either of paragraphs (g) and (h) of subclause (1) is whichever is the last to occur of the following dates:
(a)
the date on which that benefit commenced to be payable to a beneficiary who is absent from New Zealand, and as provided in—
(i)
sections 26 to 35 of the New Zealand Superannuation and Retirement Income Act 2001; or
(ii)
sections 181 to 196 of the Veterans’ Support Act 2014; or
(iii)
a reciprocity agreement adopted under section 380 of the Act; or
(b)
the date on which that benefit was last reviewed under section 310A of the Act.
Exception: deadline: special benefit
(4)
The review start deadline for a review under section 310A of the Act of a special benefit (see regulation 176A(13)) is—
(a)
13 weeks after the last review date (if it is the last review date in subclause (5)(a) or (6)(a)); or
(b)
26 weeks after the last review date (if it is the last review date in subclause (5)(b) or (6)(b), (c), or (d)).
(5)
The last review date of the benefit mentioned in subclause (4), if it commenced at or after the start of 30 November 2026 (which is the time that subpart 3A of Part 6 of the Act started to apply to special benefit), is whichever is the last to occur of the following dates:
(a)
the date on which that benefit commenced:
(b)
the date (on which that benefit was last required to be reviewed under section 310A of the Act, regardless of whether, and if so, when, it was so reviewed, and) that is 26 weeks after the end of—
(i)
the 13-week period in subclause (4)(a); or
(ii)
the last 26-week period in subclause (4)(b).
(6)
The last review date of the benefit mentioned in subclause (4), if it commenced before the start of 30 November 2026 (which is the time that subpart 3A of Part 6 of the Act started to apply to a special benefit), is whichever is the last to occur of the following dates:
(a)
the date on which that benefit commenced:
(b)
the date on which that benefit was last reviewed (as a periodic review) under section 304 of the Act—
(i)
before the start of 30 November 2026; and
(ii)
at, or about 13 weeks after, the time that benefit commenced; or
(c)
the date on which that benefit was last reviewed under section 304 of the Act—
(i)
before the start of 30 November 2026; and
(ii)
at, or about 26 weeks after, the last previous periodic review of that benefit under section 304 of the Act; or
(d)
the date (on which that benefit was last required to be reviewed under section 310A of the Act, regardless of whether and, if so, when, it was so reviewed) that is 26 weeks after the end of—
(i)
the 13-week period in subclause (4)(a); or
(ii)
the last 26-week period in subclause (4)(b).
Duty to consider requiring further information or answers
176E 3-year rule benefits
What this regulation does
(1)
This regulation states whether a specified benefit is a 3-year rule benefit for the purposes of subpart 3A of Part 6 of the Act (see the definition of that term in section 310D of the Act).
3-year rule benefits
(2)
Each of the following specified benefits is a 3-year rule benefit:
(a)
supported living payment (see regulation 176A(3)):
(b)
supported living payment—overseas (see regulation 176A(4)):
(c)
emergency benefit (see regulation 176A(8)):
(d)
accommodation supplement (see regulation 176A(9)):
(e)
childcare assistance (see regulation 176A(10)):
(f)
disability allowance (see regulation 176A(11)):
(g)
special benefit (see regulation 176A(13)):
(h)
widow’s benefit—overseas (see regulation 176A(14)):
(i)
New Zealand superannuation (see regulation 176A(15)).
176F Benefits to which supplementary benefit rule applies
A specified benefit is one to which section 310P of the Act applies (see section 310P(1)(a) of the Act) if it is any of the following:
(a)
accommodation supplement (see regulation 176A(9)):
(b)
childcare assistance (see regulation 176A(10)):
(c)
disability allowance (see regulation 176A(11)):
(d)
special benefit (see regulation 176A(13)).
Exceptions to review
176G Circumstances prescribed for exception to review
What this regulation does
(1)
This regulation prescribes circumstances (within or outside New Zealand) for the exception under section 310G(3) of the Act from the requirement for MSD to undertake and complete a review under section 310A of the Act (see the definition of prescribed circumstances in section 310G(4) of the Act).
Circumstances prescribed
(2)
This regulation prescribes each of the following circumstances:
(a)
the beneficiary—
(i)
is a patient in hospital care within the meaning of section 4(1) of the Health and Disability Services (Safety) Act 2001; and
(ii)
has been in hospital for a period of more than 13 weeks:
(b)
the beneficiary is in residential disability care or rest home care within the meaning of section 4(1) of the Health and Disability Services (Safety) Act 2001:
(c)
the beneficiary resides in, or is present in and cannot reasonably leave, an area in respect of which a state of local emergency or state of national emergency is in force under Part 4 of the Civil Defence Emergency Management Act 2002:
(d)
the beneficiary resides in, or is present in and cannot reasonably leave, an area outside New Zealand in respect of which a broadly equivalent foreign local or national state of emergency is in force:
(e)
the beneficiary resides in, or is present in and cannot reasonably leave, an area that is or may be affected by an outbreak of a quarantinable disease in respect of which an epidemic notice has been given, and is in force, under section 5(1) of the Epidemic Preparedness Act 2006:
(f)
the beneficiary resides in, or is present in and cannot reasonably leave, an area outside New Zealand in respect of which broadly equivalent foreign legislative measures, or administrative measures, for a quarantinable disease are in force or in operation.
Prescribed circumstances do not apply to 1 or more specified benefits
(3)
Circumstances prescribed by subclause (2)(a) and (b) do not apply to a beneficiary for the purposes of section 310G(3) of the Act if the beneficiary is being paid, or was paid, a specified benefit that is either of the following:
(a)
an orphan’s benefit (see regulation 176A(5)):
(b)
an unsupported child’s benefit (see regulation 176A(7)).
(4)
Circumstances prescribed by subclause (2)(a) to (f) do not apply to a beneficiary for the purposes of section 310G(3) of the Act if the beneficiary is being paid, or was paid, a specified benefit that is either of the following:
(a)
childcare assistance (see regulation 176A(10)):
(b)
a special benefit (see regulation 176A(13)).
Exclusions from exemptions to review
176H Specified benefits excluded from exemptions
Each of the following specified benefits is excluded from an exemption under section 310H of the Act (see section 310H(2)(b) of the Act):
(a)
childcare assistance (see regulation 176A(10)):
(b)
a special benefit (see regulation 176A(13)).
Extensions to deadline for providing notified information or answers
176I Specified benefit excluded from extensions
A specified benefit is excluded from an extension under section 310K(4) of the Act (see section 310K(4)(b) of the Act) if that specified benefit is special benefit (see regulation 176A(13)).
Part 2 Amendments to transitional, savings, and related provisions
Subpart 1—Amendments to Social Security Act 2018
60 Principal Act
This subpart amends the Social Security Act 2018.
61 Schedule 1 amended (on 1 July 2026)
(1)
In Schedule 1, replace clause 5(1) with:
(1)
Entitlement to the corresponding assistance, and the rate of benefit that is being or was paid, may be reviewed under—
(a)
subpart 3 of Part 6 (discretionary review of entitlement to, or rate of, benefit granted):
(b)
subpart 3A of Part 6 (mandatory review of entitlement to, or rate of, specified benefit granted).
(2)
In Schedule 1, clause 55(2)(a), after “the widow or widower continues to meet the conditions of entitlement to that benefit in those provisions”
, insert “(and compliance with those conditions can be assessed, without limitation, in a review under subpart 3 or 3A of Part 6)”
.
(3)
In Schedule 1, clause 55(5), delete “and to a review under subpart 3 of Part 6”
.
(4)
In Schedule 1, clause 55(5)(a), after “the person continues to meet the conditions of entitlement to that benefit in those provisions”
, insert “(and compliance with those conditions can be assessed, without limitation, in a review under subpart 3 or 3A of Part 6)”
.
(5)
In Schedule 1,—
(a)
insert the Part set out in Schedule 1 of this Act as the last Part; and
(b)
make all necessary consequential amendments.
62 Schedule 1 amended (on 4 September 2026)
In Schedule 1,—
(a)
insert the Part set out in Schedule 2 of this Act as the last Part; and
(b)
make all necessary consequential amendments.
63 Schedule 1 amended (on 30 November 2026)
In Schedule 1,—
(a)
insert the Part set out in Schedule 3 of this Act as the last Part; and
(b)
make all necessary consequential amendments.
Subpart 2—Amendment to Social Security Regulations 2018
64 Principal regulations
This subpart amends the Social Security Regulations 2018.
65 Schedule 1 amended
In Schedule 1,—
(a)
insert the Part set out in Schedule 4 of this Act as the last Part; and
(b)
make all necessary consequential amendments.
Schedule 1 New Part 14 inserted into Schedule 1 of Social Security Act 2018
s 61(5)
Part 14 Provisions relating to Social Security (Modernisation) Amendment Act 2026 amendments commencing on 1 July 2026
115 Definitions for this Part
In this Part, unless the context otherwise requires,—
amendment Act means the Social Security (Modernisation) Amendment Act 2026
new provision means a provision of this Act as that provision is amended, inserted, or replaced, at the start of 1 July 2026, by a provision—
(a)
of the amendment Act; and
(b)
that commences under section 2(1) of the amendment Act.
116 Application of new provisions: general
General rule
(1)
A new provision applies, on and after commencement, only to—
(a)
a benefit, or other assistance, granted before commencement; and
(b)
a benefit, or other assistance, granted at or after commencement.
Exception
(2)
This clause is subject to clause 117.
117 Application of new provisions that are mandatory review provisions
Clause applies only to new provisions that are mandatory review provisions
(1)
This clause applies only to new provisions that relate to mandatory reviews under subpart 3A of Part 6 (as inserted by the amendment Act).
Specified benefits affected only on and after 1 July 2026
(2)
The new provisions apply only on and after 1 July 2026 to the following:
(a)
an orphan’s benefit (see regulation 176A(5) of the Social Security Regulations 2018):
(b)
an unsupported child’s benefit (see regulation 176A(7) of the Social Security Regulations 2018).
Specified benefits affected only on and after 1 October 2026
(3)
The new provisions apply only on and after 1 October 2026 to any specified benefit (see regulation 176A(3), (4), (6), (8), (9), (11), (12), and (14) to (17) of the Social Security Regulations 2018) that is not—
(a)
a specified benefit to which subclause (2) applies; or
(b)
a specified benefit to which subclause (4) applies; or
(c)
a specified benefit to which subclause (5) applies.
Specified benefits affected only on and after 30 November 2026
(4)
The new provisions apply only on and after 30 November 2026 to a special benefit (see regulation 176A(13) of the Social Security Regulations 2018).
Specified benefits affected only on and after 6 September 2027
(5)
The new provisions apply only on and after 6 September 2027 to childcare assistance (see regulation 176A(10) of the Social Security Regulations 2018).
References to Social Security Regulations 2018
(6)
Subclauses (2) to (5) apply only to provisions of the Social Security Regulations 2018 as those provisions are inserted—
(a)
on 1 July 2026; and
(b)
by the amendment Act.
118 Position before specified benefits affected by amendments
(1)
Until the new provisions apply under clause 117 to specified benefits, those specified benefits continue to be subject to the following provisions as in force immediately before 1 July 2026:
(a)
subpart 3A of Part 6 this Act:
(b)
related provisions of this Act:
(c)
related provisions of the Social Security Regulations 2018.
(2)
This clause is subject to clause 119.
119 Reviews not required under old provisions for certain beneficiaries
MSD is not required by the provisions specified in clause 118(1)(a) to (c) to undertake or complete a mandatory review in respect of a beneficiary who, immediately before 1 July 2026,—
(a)
was receiving—
(i)
disability allowance and a youth payment; or
(ii)
disability allowance and a young parent payment; and
(b)
under the provisions specified in clause 118(1)(a) to (c),—
(i)
had an exception, exemption, or extension under which their mandatory review deadline was on or after 1 July 2026; or
(ii)
had received a notice informing them that their mandatory review deadline was on or after 1 July 2026; or
(iii)
had been required by MSD to provide information or answers by a deadline that was on or after 1 July 2026.
120 Regulations for transitional and savings purposes
Power to make regulations on recommendation of Minister
(1)
The Governor-General may, by Order in Council made on the recommendation of the Minister, make regulations prescribing transitional provisions, savings provisions, or both, related to amendments made by the amendment Act to this Act.
Regulations must be for specified transitional or savings purposes
(2)
The regulations must be for either or both of the following purposes:
(a)
facilitating, or ensuring the orderliness of, the transition to those amendments being brought into operation:
(b)
ensuring that existing rights or obligations continue as part of, or despite, that transition.
Requirements for recommendation of Minister
(3)
The Minister must not recommend the making of regulations made under subclause (1) unless satisfied that those regulations—
(a)
are reasonably necessary for either or both of the purposes in subclause (2)(a) and (b); and
(b)
are consistent with the amendments made by the amendment Act to this Act.
Provisions prescribed may be in addition to or instead of specified clauses
(4)
The transitional provisions or savings provisions prescribed by regulations made under subclause (1) may be provisions in addition to or instead of all or any of the following provisions as inserted by the amendment Act:
(a)
clauses 115 to 119 of this Part (provisions relating to amendments commencing on 1 July 2026):
(b)
Part 15 (provisions relating to amendments commencing on 4 September 2026):
(c)
Part 17 (provisions relating to amendments commencing on 30 November 2026).
What prescribed transitional provisions or savings provisions may do
(5)
The transitional provisions or savings provisions prescribed by regulations made under subclause (1) may do all or any of the following:
(a)
provide that, for a transitional period, in any circumstances, or subject to any conditions, specified in the regulations, 1 or more provisions (including definitions) of this Act do not apply, or apply with modifications or additions:
(b)
provide that, for a transitional period, in any circumstances, or subject to any conditions, specified in the regulations, 1 or more provisions repealed, amended, or revoked by those amendments are to continue to apply, or apply with modifications or additions, as if they had not been repealed, amended, or revoked:
(c)
provide for any other matter necessary for either or both of the purposes in subclause (2)(a) and (b).
Secondary legislation
(6)
Regulations made under this clause are secondary legislation (see Part 3 of the Legislation Act 2019 for publication requirements).
Power ends at, and any regulations made are revoked at, start of third anniversary of commencement
(7)
Regulations made under this clause cannot be made after, and are revoked by this clause at, the start of the third anniversary of the commencement of the amendments to which those regulations relate.
Schedule 2 New Part 15 inserted into Schedule 1 of Social Security Act 2018
s 62
Part 15 Provisions relating to Social Security (Modernisation) Amendment Act 2026 amendments commencing on 4 September 2026
121 Definitions for this Part
In this Part, unless the context otherwise requires,—
C means a child who, immediately before C’s 18th birthday, was—
(a)
a child in respect of whom an orphan’s benefit, unsupported child’s benefit, or child disability allowance has been applied for or granted (whether that benefit was applied for or granted before, on, or after 4 September 2026); or
(b)
included as a dependent child of the beneficiary in determining and paying the appropriate rate of any other benefit (whether that other benefit was applied for or granted before, on, or after 4 September 2026)
C’s 18th birthday has the same meaning as in section 103A (as inserted on 4 September 2026).
122 New provisions apply only if C’s 18th birthday occurs on or after 4 September 2026
(1)
This clause applies only if C’s 18th birthday occurs on or after 4 September 2026.
(2)
The following provisions, as inserted on 4 September 2026 (see section 2(2)(a) and (3) of the Social Security (Modernisation) Amendment Act 2026), apply to C on and after 4 September 2026:
(a)
subpart 18 of Part 2:
(b)
related provisions of this Act.
123 Old provisions apply if C’s 18th birthday before 4 September 2026
(1)
This clause applies if C’s 18th birthday occurs before 4 September 2026.
(2)
The following provisions, as in force immediately before 4 September 2026, continue to apply to C on and after 4 September 2026:
(a)
subpart 18 of Part 2:
(b)
related provisions of this Act.
Schedule 3 New Part 17 inserted into Schedule 1 of Social Security Act 2018
s 63
Part 17 Provisions relating to Social Security (Modernisation) Amendment Act 2026 amendments commencing on 30 November 2026
128 Definitions for this Part
In this Part, unless the context otherwise requires,—
amendment Act means the Social Security (Modernisation) Amendment Act 2026
new provision means a provision of this Act as that provision is amended, inserted, or replaced, at the start of 30 November 2026, by a provision—
(a)
of the amendment Act; and
(b)
that commences under section 2(2)(b) of the amendment Act.
129 Application of new provisions: general
General rule
(1)
A new provision applies, on and after commencement, only to—
(a)
a benefit, or other assistance, granted before commencement; and
(b)
a benefit, or other assistance, granted at or after commencement.
Exceptions
(2)
This clause is subject to clause 130.
130 Application of new provisions about updated medical evidence
Clause applies only to new provisions about updated medical evidence
(1)
This clause applies only to the new provisions that are—
(a)
sections 205A to 205I (as inserted by the amendment Act); and
(b)
about a failure to provide updated medical evidence for a medical evidence benefit.
Application to medical evidence benefit granted before commencement
(2)
Those new provisions apply to a medical evidence benefit granted before commencement only on and after the first day after MSD is satisfied that the medical evidence benefit ceases to be supported by medical evidence—
(a)
required under this Act as in force before commencement; and
(b)
provided to MSD before commencement.
Schedule 4 New Part 16 inserted into Schedule 1 of Social Security Regulations 2018
s 65
Part 16 Provisions relating to Social Security (Modernisation) Amendment Act 2026
30 Definitions for this Part
In this Part, unless the context otherwise requires,—
amendment Act means the Social Security (Modernisation) Amendment Act 2026
new provision means a provision of these regulations as that provision is amended, inserted, or replaced, at the start of 1 July 2026, by a provision—
(a)
of the amendment Act; and
(b)
that commences under section 2(1) of the amendment Act.
31 Application of new provisions: general
General rule
(1)
A new provision applies, on and after commencement, only to—
(a)
a benefit, or other assistance, granted before commencement; and
(b)
a benefit, or other assistance, granted at or after commencement.
Exceptions
(2)
This clause is subject to the exceptions in clauses 32 and 33.
32 Application of new provisions that are mandatory review provisions
Clause applies only to new provisions that are mandatory review provisions
(1)
This clause applies only to new provisions that relate to mandatory reviews under subpart 3A of Part 6 (as inserted by the amendment Act).
Specified benefits affected only on and after 1 July 2026
(2)
The new provisions apply only on and after 1 July 2026 to the following:
(a)
an orphan’s benefit (see regulation 176A(5)):
(b)
an unsupported child’s benefit (see regulation 176A(7)).
Specified benefits affected only on and after 1 October 2026
(3)
The new provisions apply only on and after 1 October 2026 to any specified benefit (see regulation 176A) that is not—
(a)
a specified benefit to which subclause (2) applies; or
(b)
a specified benefit to which subclause (4) applies; or
(c)
a specified benefit to which subclause (5) applies.
Specified benefits affected only on and after 30 November 2026
(4)
The new provisions apply only on and after 30 November 2026 to a special benefit (see regulation 176A(13)).
Specified benefits affected only on and after 6 September 2027
(5)
The new provisions apply only on and after 6 September 2027 to childcare assistance (see regulation 176A(10)).
References to these regulations
(6)
Subclauses (2) to (5) apply only to provisions of these regulations as those provisions are inserted by the amendment Act.
Position before specified benefits affected by amendments
(7)
Until the new provisions apply under this clause to specified benefits, those specified benefits continue to be subject to provisions of these regulations as in force immediately before 1 July 2026 that are related to the following provisions as in force immediately before 1 July 2026:
(a)
subpart 3A of Part 6 of the Act:
(b)
related provisions of the Act.
33 Special first review start deadline for certain independent review benefits that commence before new provisions start to apply to them
(1)
This clause applies to a specified benefit—
(a)
of a kind specified in regulation 176D(1)(a), (c), and (e) to (h); and
(b)
that commences before regulation 176D(1) starts to apply under clause 32 to a specified benefit of that kind.
(2)
The first review start deadline for a review under section 310A of the Act of a specified benefit to which this clause applies is a date determined by MSD that is no later than 52 weeks after the specified benefit commences.
(3)
After the review mentioned in subclause (2) is completed, the date on which it was completed becomes the last review date under regulation 176D(2)(b) or (3)(b) of a specified benefit to which this clause applies.
"Related Legislation
"Related Legislation
"Related Legislation
Versions
Social Security (Modernisation) Amendment Bill
RSS feed link copied, you can now paste this link into your feed reader.