10.1.1 The Board may require a member, or a prospective member:

(a) to complete and forward to the Board a questionnaire prepared by the Board concerning his/her health and other matters no later than 14 days after becoming a member or such other period as the Board allows; and/or

(b) to undergo one or more medical examinations and/or tests by an approved medical practitioner or practitioners nominated by the Board within 60 days after becoming a member or such other period as the Board allows;

unless the member:

(A) transferred from the CSS scheme; or

(B) was in receipt of an invalidity pension under the Superannuation Act 1976 on 30 June 1990 and continued to receive that pension until joining the PSS scheme; or

(C) transferred from an approved superannuation scheme and is entitled to a Non-Cash Transfer Multiple (see Rules 5.2.25 and 5.3.25).

10.1.2 The membership status of a new member because of his/her state of health carries over from any concurrent membership that began before the new membership, that is, if the new member:

(a) is a limited benefits member (see Division 2 of this Part) in respect of the concurrent membership, he/she is also a limited benefits member in respect of the new membership until the period of the limited benefits membership in respect of the concurrent period ends; or

(b) is not a limited benefits member (see Division 2 of this Part) in respect of the concurrent membership, he/she is also not a limited benefits member in respect of the new membership.

10.2.1 The Board may determine that a member is, or a prospective member on becoming a member would be, a limited benefits member if, after considering:

(a) any questionnaire and report or reports of medical examinations and/or tests completed under Rule 10.1.1; and

(b) any other matters the Board considers relevant;

it is of the opinion that the person is not of sufficiently sound health to carry out all of the duties his/her position would require without taking excessive sick leave during the three years from the date he/she became a member, unless the member or prospective member has advised the Board that he/she is also a member of the CSS Scheme or the PSS Scheme in respect of a concurrent period that commenced before this period of membership (see Rule 10.1.2).

10.2.2 When the Board has determined under Rule 10.2.1 that a member is a limited benefits member, his/her period of limited benefits membership:

(a) commences on the date of the Board’s notification that he/she is a limited benefits member (see Rules 10.2.4 and 10.2.5);and

(b) ends three years after he/she became a member.

10.2.3 The Board will, as soon as practicable after it has determined under Rule 10.2.1 that a member is a limited benefits member, or a prospective member would be such on becoming a member, notify the person in writing:

(a) that he/she is, or would be, a limited benefits member; and

(b) of the period of limited benefits membership; and

(c) of the condition or conditions that led the Board to form the opinion he/she is not of sufficiently sound health to carry out all of the duties of his/her position without taking excessive sick leave during the three years after becoming a member.

10.2.4 The Board will notify a member who is a limited benefits member because he/she is such in respect of an earlier commencing concurrent membership (see Rule 10.1.2) when the period of limited benefits membership will cease.

10.2.5 If a member is required by the Board to complete and forward a questionnaire or undergo a medical examination or test but does not do so within the period allowed under Rule 10.1.1, he/she is automatically a limited benefits member.

10.2.6 Where a member becomes a limited benefits member under Rules 10.2.5, his/her period of limited benefits membership:

(a) commences on the day following the last day of the period allowed under Rule 10.1.1 to complete and forward the questionnaire or undergo the medical examination or test; and

(b) ends on the earliest of:

(i) the date the Board, following receipt of a completed questionnaire or the participation by the member in a medical examination or test, determines that he/she ceases to be a limited benefits member; or

(ii) three years after he/she became a member.

10.3.1 The Board will take out a policy or policies with a life assurance company or companies in its name to provide additional death and invalidity cover for members. An additional invalidity and death cover policy is to be on the terms and conditions agreed between the Board and the relevant life assurance company.

10.3.2 A member may apply to the Board for additional death and invalidity cover at any time before he/she reaches age 60, provided the amount of cover applied for:

(a) does not exceed the maximum amount of additional cover allowed (see Rule 10.3.8); or

(b) would not result in him/her exceeding his/her maximum benefit, assuming he/she will be entitled to an Additional Cover Multiple under Rule 5.2.9.

10.3.3 The Board may allow the member to choose the policy providing the additional death and invalidity cover if the Board has taken out more than one policy.

10.3.4 A member who applies for additional death and invalidity cover must provide any information and undergo any medical examinations the relevant life assurance company requires for it to determine whether it is prepared to provide the additional death and invalidity cover.

10.3.5 If a member applies to the Board for additional death and invalidity cover, or applies to vary existing cover, the Board will ask the relevant life assurance company:

(a) whether it is prepared to provide the additional cover for that member; and, if so

(b) the cost of the additional cover premium, including any extra cost where the member was assessed as not being a standard risk, on:

(i) the date the cover commenced; and

(ii) each subsequent birthday of the member, or other date as specified in the policy.

The Board will provide the information in (a) and (b) from the life assurance company to the member.

10.3.6 The member may vary the amount of additional death and invalidity cover at any time before the cover ceases to be applicable, provided the relevant life assurance company is prepared to provide the additional cover and the new amount:

(a) does not exceed the maximum amount of additional cover allowed (see Rule 10.3.8); or

(b) does not, or will not over time, result in him/her exceeding his/her maximum benefit, assuming he/she will be entitled to an Additional Cover Multiple under Rule 5.2.9.

10.3.7 Variations in the amount of additional death and invalidity cover take effect from:

(a) the date specified in the additional death and invalidity cover policy; or, otherwise,

(b) the member’s next birthday;

unless the Board determines that a variation takes effect on another date.

10.3.8 The maximum amount of additional death and invalidity cover applicable to a member is the amount, expressed as a percentage of his/her relevant salary (see Rule 10.3.9), calculated from the following Table according to his/her age at the time the relevant life assurance company last agreed to provide additional death and invalidity cover.

10.3.9 For the purpose of Rule 10.3.8, the relevant salary on a particular day of a:

(a) regular member is his/her average salary; and

(b) casual member paid on a per diem basis is his/her average salary; and

(c) casual member not paid on a per diem basis is:

(i) the actual basic salary and recognised allowances, if any, received as a casual employee in the preceding 12 months; or

(ii) if the person has not been a casual member for 12 months, the sum of:

(A) the actual basic salary and recognised allowances, if any, received as a casual employee; and

(B) the basic salary and recognised allowances, if any, expected to be received until the completion of 12 months as a casual employee.

10.3.10 A member’s additional death and invalidity cover ceases on the earliest of:

(a) the date he/she reaches age 60; and

(b) the date he/she notifies the Board he/she no longer wishes to have additional death and invalidity cover; and

(c) if the member ceases paying additional cover premiums, the date the Board determines; and

(d) death or invalidity retirement (see Rule 10.3.11).

10.3.11 Where a member with additional death and invalidity cover dies or ceases membership on invalidity retirement, the Board will make a claim against the policy providing the additional cover.

10.3.12 Any amount paid by a life assurance company to the Board in response to a claim against a life policy must be paid into the Fund and thereafter be treated as an employer contribution in relation to the former member in the calculation of benefits.

Division 4

10.4.1 A member with additional death and invalidity cover must pay an additional cover premium on each contribution day, or at alternative times determined by the Board, occurring during the period the cover is applicable.

10.4.2 A member with additional death and invalidity cover is required to pay additional cover premiums at a fortnightly rate of:

(a) if he/she has been assessed as a standard risk by the relevant life assurance company, half the fortnightly premium applicable to his/her cover; or

(b) if he/she has been assessed as not being a standard risk by the relevant life assurance company, the sum of:

(i) half the fortnightly premium that would have been applicable to his/her cover if he/she had been assessed as a standard risk; and

(ii) the amount of any additional fortnightly premium applicable to his/her cover because he/she has been assessed as not being a standard risk;

unless he/she is on leave of absence without pay that is not an excluded period of leave of absence when, if he/she has not notified the Board under Rule 10.3.10(b) that he/she no longer wishes to have additional death and invalidity cover, he/she is required to pay the entire fortnightly premium applicable.

10.4.3 The designated employer of a member with additional death and invalidity cover must pay one half of the fortnightly premium applicable to the member had he/she been assessed as a standard risk each fortnight, unless the member is on leave of absence without pay that is not an excluded period of leave of absence. Payments must be made on each contribution day occurring during the period the cover is applicable, or at the alternative times during the period of cover determined by the Board.

10.4.4 When the additional cover starts, the Board will advise a member with additional death and invalidity cover and his/her designated employer of the fortnightly rate of additional cover premiums required to be paid. The Board will advise the member of any revised rates on each of his/her subsequent birthdays, or other times specified in the additional death and invalidity cover policy.

10.4.5 Additional cover premiums payable by a member and a designated employer must be paid to the Board and the Board must pay all premiums received by it to the relevant life assurance company unless the Board:

(a) directs the designated employer to pay additional cover premiums to the relevant life assurance company; or

(b) directs both the designated employer and the member to pay their respective portions of the additional cover premiums to the relevant life assurance company; or

(c) directs a member who is on leave of absence without pay that is not an excluded period of leave of absence to pay the entire additional cover premium applicable to his/her cover to the relevant life assurance company.

10.5.1 A member may be entitled to a partial invalidity pension if:

(a) he/she was an invalidity pensioner immediately before last becoming a member, or would have been if his/her invalidity pension had not been suspended before that date (see Rules 10.5.3 and 10.5.5); or

(b) for health reasons his/her basic salary and/or recognised allowances decrease, or he/she is working reduced hours or in a lower position or level (see Rules 10.5.7 and 10.5.9).

10.5.2 A partial invalidity pension payable to an eligible employee under the Superannuation Act 1976 immediately before his/her first day of membership is a partial invalidity pension for the purposes of these Rules. Any payment of such pension during the period commencing on his/her first day of membership and ending on the date of his/her election to join the PSS scheme is a payment of partial invalidity pension for the purposes of these Rules.

10.5.3 A member who was an invalidity pensioner immediately before last becoming a member, or would have been if his/her invalidity pension was not suspended before that date, is entitled to a partial invalidity pension if:

(a) he/she was a regular member immediately before becoming an invalidity pensioner; and

(b) his/her basic salary and recognised allowances, if any, on the date he/she last became a member is less than the sum of the:

(i) basic salary payable at whatever salary increment point may have applied to the member immediately before becoming an invalidity pensioner, including, if the Board directs, amounts in respect of the temporary performance of the duties of a higher classified position or office; and

(ii) recognised allowances, if any;

that would have been payable had he/she continued to be a member; and

(c) the decrease in basic salary and/or recognised allowances is a result of him/her resuming employment and working:

(i) reduced hours; and/or

(ii) in a lower position or level;

and

(d) the Board is satisfied the decrease in basic salary and/or recognised allowances is permanent and can properly be attributed to the member’s physical or mental incapacity;

unless the decrease in basic salary and/or recognised allowances is a result of a compensable condition that entitles the member to be paid compensation payments.

10.5.4 The annual rate of partial invalidity pension payable to a member under Rule 10.5.3 is calculated using the formula:

where:

10.5.5 The Board may decide that a member who was an invalidity pensioner immediately before last becoming a member is entitled to partial invalidity pension, even though he/she is not entitled to such a pension under Rule 10.5.3, if it is satisfied that:

(a) although the member’s basic salary and/or recognised allowances did not decrease:

(i) he/she is working reduced hours, or working in a lower position or level; and

(ii) the reduction in hours or lower position or level is permanent and can properly be attributed to the member’s physical or mental incapacity; or

(b) although the member’s basic salary and/or recognised allowances did decrease, the whole of the decrease was not considered to be permanent or properly attributable to his/her physical or mental incapacity, but:

(i) part of the decrease in remuneration is permanent; and

(ii) that part can properly be attributed to the member’s physical or mental incapacity;

unless the reduced hours or lower position or level or the lesser basic salary and/or recognised allowances as appropriate, are a result of a compensable condition that entitles the member to be paid compensation payments.

10.5.6 The annual rate of partial invalidity pension payable to a member under Rule 10.5.5 is an amount determined by the Board having regard to the principles incorporated in this Division, including the principles for calculating partial invalidity pensions, and the need for equity between members

10.5.7 A regular member, other than a limited benefits member, who has not reached his/her maximum retiring age is entitled to a partial invalidity pension if:

(a) his/her basic salary and/or recognised allowances decrease because he/she is working:

(i) reduced hours; and/or

(ii) in a lower position or level; and

(b) the Board is satisfied the decrease in basic salary and/or recognised allowances is permanent and can properly be attributed to physical or mental incapacity;

unless the decrease in basic salary and/or recognised allowances:

(A) is a result of a compensable condition that entitles the member to be paid compensation payments; or

(B) occurred within three years after the earlier of the date the member:

(i) last became a member; or

(ii) first became a limited benefits member in any concurrent period or periods of membership;

and the Board is satisfied the member failed to disclose, at that time, medical or other information that could have reasonably resulted in the Board determining that he/she was a limited benefits member.

For this purpose the member’s basic salary immediately before the decrease includes, if the Board so directs, higher duties allowances received by the member but not otherwise regarded as salary.

10.5.8 The annual rate of partial invalidity pension payable to a member under Rule 10.5.7 is calculated using the following formula:

where:

10.5.9 The Board may decide that a regular member who is not entitled to a partial invalidity pension under Rule 10.5.7 is entitled to a partial invalidity pension if the Board is satisfied that:

(a) although the member’s basic salary and any recognised allowances did not decrease:

(i) he/she is working reduced hours, or working in a lower position or level; and

(ii) the reduction in hours or lower position or level is permanent and can properly be attributed to the member’s physical or mental incapacity; or

(b) although the member’s basic salary and any recognised allowances did decrease, the whole of the decrease was not considered to be permanent or properly attributable to his/her physical or mental incapacity, but:

(i) part of the decrease is permanent; and

(ii) that part of the decrease can properly be attributed to the member’s physical or mental incapacity;

unless the reduced hours or lower position or level or lesser salary, as appropriate:

(A) is a result of a compensable condition that entitles the member to be paid compensation payments; or

(B) occurred within three years after the earlier of the date the member:

(i) last became a member; or

(ii) first became a limited benefits member in any concurrent period or periods of membership; and

the Board is satisfied the member failed to disclose, at that time, medical or other information that could have reasonably resulted in the Board determining that he/she was a limited benefits member.

10.5.10 The annual rate of partial invalidity pension payable to a member under Rule 10.5.9 is an amount determined by the Board having regard to the principles, including the principles for calculating partial invalidity pensions, incorporated in this Division and the need for equity between members.

10.5.11 The Board may adjust the rate of partial invalidity pension payable if:

(a) the member’s basic salary and recognised allowances, if any, again decrease and the Board is satisfied that the decrease can properly be attributed to physical or mental incapacity of the member; or

(b) while there is no change in the member’s basic salary and recognised allowances, if any:

(i) his/her hours of work reduce or further reduce; or

(ii) he/she changes employment to a lower position or level;

and the Board is satisfied that the change in working circumstances can properly be attributed to physical or mental incapacity of the member; or

(c) the member’s basic salary and recognised allowances, if any, increase, but not to a level equal to, or greater than, the basic salary and recognised allowances, if any, applicable to the duties of the position or office held by the member before whichever is applicable of:

(i) his/her invalidity retirement; or

(ii) the reduction in his/her basic salary and/or recognised allowances, if any, that gave rise to his/her entitlement to partial invalidity pension.

In adjusting the rate of partial invalidity pension the Board will have regard to:

(A) the principles incorporated in this Division, including the principles for calculating partial invalidity pensions; and

(B) the need for equity between members; and

(C) if the member’s basic salary and recognised allowances, if any have again decreased, the appropriateness of:

(i) re-calculating the pension rate; and

(ii) aggregating the total salary decrease using updated values for the initial salary decrease; and

(iii) if the member is, or has been, a permanent part-time employee, the proportion of full time hours worked before each decrease.

10.5.12 Partial invalidity pensions are adjusted at such times as the Board determines.

10.5.13 The Board must take into account the basis of calculation under the Superannuation Act 1976 of a partial invalidity pension which was initially payable under that Act and continued as a partial invalidity pension under these Rules when adjusting rates of partial invalidity pension under Rule 10.5.11.

10.5.14 Partial invalidity pension payments are not payable (see Rule 10.5.15) to a member if he/she fails to:

(a) commence or continue a program of rehabilitation; or

(b) provide medical or other evidence in relation to his/her health and/or ability to resume his/her former duties;

by a date specified by the Board;

unless the Board specifies another, later date by which the member is to undergo that program or provide that evidence because it is satisfied there was sufficient reason for the member’s failure.

10.5.15 The date when payments of partial invalidity pension stop under Rule 10.5.14 is a contribution day determined by the Board that must be a later date than the date specified for the member to undergo the program or provide the evidence.

10.5.16 Payments of partial invalidity pension that have stopped under Rule 10.5.14 again become payable from the date specified by the Board if the member satisfies the Board that he/she will comply with all future Board requirements.

10.5.17 The Board may suspend partial invalidity pension payments in respect of any period the member is on leave without pay that is not sick leave without pay.

10.5.18 A partial invalidity pension ceases on the earlier of: the date:

(a) the member’s basic salary and recognised allowances, if any, equal, or exceed, the basic salary and recognised allowances, if any, applicable to the duties of the position or office held by the member before whichever is applicable of:

(i) his/her invalidity retirement; or

(ii) the reduction in his/her basic salary and/or recognised allowances; or

(b) the Board determines that the circumstances giving entitlement to the partial invalidity pension that did not involve decreased basic salary and/or recognised allowances no longer exist; or

(c) the member ceases membership.

10.6.1 The Board will engage one or more Assessment Panels comprising people with expertise in the assessment of invalidity claims in private sector superannuation schemes, or for those schemes.

10.6.2 The Board may refer an invalidity case to an Assessment Panel for consideration and recommendation.

10.6.3 Where the Board has referred a case to an Assessment Panel, the Board:

(a) will provide the Panel with the medical and other evidence it considers necessary; and

(b) may require the member or former member, as the Panel requests, to:

(i) undergo a medical examination or examinations; and

(ii) provide any information.

10.6.4 Where the Board has referred a case to an Assessment Panel, the Assessment Panel is to make a recommendation with supporting reasons to the Board:

(a) if the Board has indicated to the Assessment Panel that it has to decide whether to approve the invalidity retirement of a member, whether that member is totally and permanently incapacitated; or

(b) if the Board has indicated to the Assessment Panel that the Board has to decide whether to pay a preserved benefit under Rule 8.1.1, whether the former member is:

(i) suffering from a terminal medical condition; or

(ii) totally and permanently incapacitated; or

(c) if the Board has indicated to the Assessment Panel that the Board has to decide whether to regard a former member as having ceased membership on invalidity retirement under Rule 8.5.2, whether the former member was totally and permanently incapacitated on his/her last day of membership; and

(d) on any other matters the panel considers relevant or the Board requires.

10.6.5 An Assessment Panel may seek advice from any medical practitioner or specialist in connection with any case referred to it by the Board.

10.6.6 An Assessment Panel is to provide its recommendation to the Board within two years, or such further period as the Board determines, of:

(a) in the case of a member on sick leave with or without pay, the date the member commenced sick leave because of the condition which is the basis of the request to the Board to approve his/her invalidity retirement; or

(b) in the case of a member on compensation leave, the date the Board was asked to approve his/her invalidity retirement; or

(c) in the case of a former member seeking payment of his/her preserved benefit on invalidity grounds, the date the Board was asked to approve the payment; or

(d) in the case of a former member applying to be regarded as having ceased membership on invalidity retirement for the purposes of Rule 8.5.2, the date the member’s application was received;

10.7.1 Following receipt of a request to approve the retirement of a member on invalidity grounds, the Board may approve his/her invalidity retirement if, after considering:

(a) the report or reports of one or more medical practitioners submitted with the request; and

(b) any other matters the Board considers relevant;

it is satisfied there is no reasonable doubt the member is totally and permanently incapacitated.

10.7.2 If the Board considers there is reasonable doubt that the member is totally and permanently incapacitated, the Board must:

(a) require the member to undergo a medical examination by a Commonwealth Medical Officer or other approved medical practitioner within six months, or other period specified by the Board, of him/her last commencing related sick leave or compensation leave before the request to approve the retirement was submitted; and

(b) refer the issue whether the member is totally and permanently incapacitated and the report of the medical examination to an Assessment Panel;

before deciding a request to approve the retirement of the member on invalidity grounds.

10.7.3 The Board may again refer the issue whether the member is totally and permanently incapacitated to an Assessment Panel for further consideration and recommendation within a period set by the Board and must consider the recommendation of that Assessment Panel when making its decision.

10.7.4 If a recommendation of an Assessment Panel indicates that a program of rehabilitation may prevent a member’s total and permanent incapacity, the Board may:

(a) consult with Comcare, or other appropriate body, with a view to implementing such a program; and

(b) arrange for, and meet the cost of, that program if it considers that the program would be cost-effective in reducing the likelihood of the member’s invalidity retirement.

10.7.5 The Board must decide whether or not to approve the invalidity retirement of a member, other than a member already entitled to invalidity benefits under Rule 10.7.1. When making its decision the Board must consider:

(a) the recommendation, or recommendations, of the Assessment Panel; and

(b) if a program of rehabilitation was put in place under Rule 10.7.4, the effectiveness of the program; and

(c) where the member is on compensation leave (or is suffering from a compensable condition), the assessment of the member’s medical condition by Comcare, or other appropriate body; and

(d) the practicality of either:

(i) the member’s employer providing a job the member would be reasonably qualified for, or reasonably could be qualified for after retraining; and/or

(ii) the member obtaining such a job with another employer.

10.7.6 The Board may defer a decision whether or not to approve the invalidity retirement of a member after it has considered the matters in Rule 10.7.5.

10.7.7 The Board must advise its decision under Rule 10.7.1 or 10.7.5 to the member and his/her employer. The advice is to include a statement of the reasons for the decision and a copy of the recommendation made by the Assessment Panel, if any.

10.8.1 Where a request to pay a preserved benefit on invalidity grounds under Rule 8.1.1 has been received, the Board may approve the payment if, after considering:

(a) the report or reports of one or more medical practitioners submitted with the request; and

(b) any other matters the Board considers relevant;

it is satisfied there is no reasonable doubt the preserved benefit member is:

(c) totally and permanently incapacitated; or

(d) suffering from a terminal medical condition.

10.8.2 If the Board considers there is reasonable doubt that the preserved benefit member is totally and permanently incapacitated, the Board must:

(a) require the preserved benefit member to undergo a medical examination by a Commonwealth Medical Officer or other approved medical practitioner within six months, or other period specified by the Board, of the date the Board was asked to approve the payment; and

(b) refer the issue whether the preserved benefit member is totally and permanently incapacitated and the report of the medical examination to an Assessment Panel;

before considering a request to pay the preserved benefit on invalidity grounds.

10.8.3 The Board must decide whether or not to pay a preserved benefit to a preserved benefit member, other than a preserved benefit member entitled to his/her preserved benefit under Rule 10.8.1. When making its decision the Board must consider the recommendation of the Assessment Panel.

10.8.4 The Board must advise its decision under Rule 10.8.1 or 10.8.3 to the former member. The advice is to include a statement of the reasons for the decision and a copy of the recommendation made by the Assessment Panel, if any.

10.9.1 Where an application under Rule 8.5.2 to regard a preserved benefit member as having retired on invalidity grounds as at the date of ceasing membership has been received, the Board may approve that application, if, after considering:

(a) the report or reports of one or more medical practitioners submitted with the request; and

(b) any other matters the Board considers relevant;

it is satisfied there is no reasonable doubt the preserved benefit member was totally and permanently incapacitated on his/her last day of membership.

10.9.2 If the Board considers there is reasonable doubt that the preserved benefit member was totally and permanently incapacitated on his/her last day of membership, the Board must:

(a) require the preserved benefit member to undergo a medical examination by a Commonwealth Medical Officer or other approved medical practitioner within six months, or other period specified by the Board, of the date the application under rule 8.5.2 was received; and

(b) refer the issue whether the preserved benefit member was totally and permanently incapacitated on his/her last day of membership and the report of the medical examination to an Assessment Panel;

before considering a request to regard a preserved benefit member as having retired on invalidity grounds as at the date of ceasing membership.

10.9.3 The Board must decide whether or not to regard a preserved benefit member as having retired on invalidity grounds as at the date of ceasing membership, other than a preserved benefit member already so regarded under Rule 10.9.1. When making its decision the Board must consider the recommendation of the Assessment Panel.

10.9.4 The Board must advise its decision under Rule 10.9.1 or 10.9.3 to the former member. The advice is to include a statement of the reasons for the decision and a copy of the recommendation made by the Assessment Panel, if any.

10.10.1 The Board may pay pre-assessment payments to a member who has been off work for a continuous period of 28 days or more because of a serious medical condition, unless he/she:

(a) is a limited benefits member; or

(b) is on compensation leave.

10.10.2 Before deciding whether to pay pre-assessment payments to a member, the Board must obtain a report from:

(a) a Commonwealth Medical Officer; or

(b) an approved medical practitioner;

whether there is a likelihood the member will be totally and permanently incapacitated because of the condition causing his/her absence from work.

10.10.3 If a report from a Commonwealth Medical Officer or other approved medical practitioner indicates that a program of rehabilitation may prevent a member’s total and permanent incapacity, the Board may:

(a) consult with Comcare or other appropriate body with a view to implementing such a program; and

(b) arrange for, and meet the cost of, that program if it considers that the program would be cost-effective in reducing the likelihood of the member’s invalidity retirement.

10.10.4 The Board must pay pre-assessment payments to a member if, after considering the report obtained under Rule 10.10.2, it is satisfied there is a real likelihood the member will be totally and permanently incapacitated.

10.10.5 The Board must notify a member that he/she is not entitled to pre-assessment payments if, after considering the report obtained under Rule 10.10.2, the Board is satisfied it is likely that the member will be able to work again in a job for which he/she is, or could after retraining be, reasonably qualified.

10.10.6 Pre-assessment payments are not payable during the first six months of the member being off work while the member is in receipt of sick leave full pay or sick leave half pay.

10.10.7 If the member does not receive sick leave pay at any time during the first six months of being off work, pre-assessment payments are payable during that period at the fortnightly rate calculated using the formula below, provided that the rate is greater than zero:

Half Salary - ( Partial Invalidity Pension + Other Compensation Payments)

where:

and Superannuation Salary is the sum of the annual basic salary and recognised allowances, if any, applicable to the member on his/her first day off work, proportionately adjusted by the Board in the same manner as in Rule 5.4.2 for a permanent part-time employee, or as in Rule 5.5.2 for a casual member, to take account of:

(a) his/her work pattern over the lesser of his/her:

(i) previous 78 contribution due days; or

(ii) number of contribution due days; and

(b) any hours not worked in which a partial invalidity pension or compensation payment was applicable to the member.

Partial Invalidity Pension is the fortnightly amount of any partial invalidity pension payable to the member; and

Other Compensation Payments is the fortnightly amount of any compensation payments payable to the member in relation to a condition that is not the condition causing the member to be off work.

10.10.8 Pre-assessment payments after the first six months of the member being off work are payable, if greater than zero, at:

(a) the fortnightly rate determined under Rule 10.10.7 less the fortnightly amount of any sick leave pay payable to the member; or, if greater,

(b) the fortnightly rate of maximum invalidity pension that would have been payable had he/she been retired on invalidity grounds six months after his/her first day off work, less the sum of:

(i) the fortnightly amount of sick leave pay payable to the member, if any; and

(ii) the fortnightly amount of partial invalidity pension payable to the member, if any; and

(iii) the fortnightly amount of compensation payments payable to the member, if any, in relation to a condition that is not the condition causing the member to be off work.

10.10.9 Pre-assessment payments are payable on and fortnightly from the contribution day occurring on, or next following:

(a) the earlier of the date from which:

(i) the member has been off work for a continuous period of six months; or

(ii) the member has no sick leave credits applicable; or

(b) where pre-assessment payments are payable as a result of a second or subsequent assessment of the member, the date the Board determines.

10.10.10 The Board will deduct member contributions and, if the member has additional death and invalidity cover, the additional premiums required to be paid by the member under Division 4 of this Part from the fortnightly pre-assessment payment.

10.10.11 Pre-assessment payments cease on the contribution day specified by the Board that is after the earliest of the date:

(a) the Board notifies the member and his/her employer whether it has approved his/her invalidity retirement; and

(b) the member returns to work; and

(c) the member ceases membership; and

(d) the Board required the member to:

(i) commence or continue a program of rehabilitation; or

(ii) undergo a medical examination and/or provide medical evidence;

and he/she failed to do so, unless the Board has set another later date to commence or continue that program or undergo that examination because it is satisfied there was sufficient reason for the member’s non-compliance.

10.10.12 Pre-assessment payments that have been ceased under paragraph (d) of Rule 10.10.11 again become payable from the date specified by the Board where the member satisfies the Board he/she will comply with all future Board requirements relating to a program of rehabilitation, or medical examination or production of medical evidence.

10.11.1 An invalidity pensioner who:

(a) is under age 65; and

(b) became, or last became, an invalidity pensioner before age 60; and

(c) begins to receive personal earnings;

must give to the Board particulars in writing of these personal earnings and an estimate of expected personal earnings during the next 12 months. A person acting on the invalidity pensioner’s behalf may provide this information.

10.11.2 The Board may require an invalidity pensioner who:

(a) is under age 65; and

(b) became, or last became, an invalidity pensioner before age 60;

to give in writing, within the period specified by the Board which must end before the invalidity pensioner attains age 65, either or both:

(A) such information as the Board requires relating to any employment, or work on the pensioner’s own account, in which the pensioner has been engaged during a period specified by the Board; or

(B) particulars of the pensioner’s personal earnings and an estimate of the expected personal earnings during the next 12 months.

A person acting on the invalidity pensioner’s behalf may give this information.

10.11.3 An invalidity pensioner may:

(a) revise an estimate of his/her expected personal earnings for the next 12 months; and

(b) give the Board updated particulars of his/her personal earnings.

A person acting on the invalidity pensioner’s behalf may give this information.

10.11.4 The Board must estimate the annual rate of personal earnings of an invalidity pensioner after considering information provided to the Board relating to his/her employment, past earnings and expected future earnings.

10.11.5 Where an invalidity pensioner fails to provide information required by the Board under Rule 10.11.2, the Board may suspend his/her pension with effect from a date specified, provided that:

(a) the Board is satisfied there was no reasonable excuse for the failure to provide the information; and

(b) the date of suspension is not earlier than the day after the expiry of the period within which provision of the information was required.

10.11.6 The Board must notify in writing the invalidity pensioner, or the person acting on his/her behalf, of the suspension.

10.11.7 Where a pension is suspended under Rule 10.11.5 and the invalidity pensioner or the person acting on his/her behalf, subsequently provides the required information, the Board will revoke the suspension from such date as the Board determines.

10.11.8 If an invalidity pension has been suspended under Rule 10.11.5 for a period of 12 months the Board may cancel the entitlement to invalidity pension, unless the invalidity pensioner had reached age 64 before his/her pension was last suspended. The Board must notify in writing the invalidity pensioner, or the person acting on his/her behalf, of the cancellation.

10.11.9 The annual pension rate payable to an invalidity pensioner is to be reduced (see Rule 10.11.10) or the pension suspended (see Rule 10.11.11) during any period when the invalidity pensioner’s Earnings exceed his/her Notional Income. For this purpose:

Earnings are the sum of:

(a) the annual pension rate that would have been payable if:

(i) the invalid pensioner had chosen to take his/her whole invalidity benefit accrual as a pension; and

(ii) that rate had not been reduced or suspended by any earlier applications of this Rule; and

(b) his/her annual personal earnings rate, as estimated by the Board under Rule 10.11.4; and

Notional Income is the greater of:

(a) $23,597, increased on 1 July 1991, and each subsequent 1 July, in accordance with the increases, if any, applying to pensions under Rule 9.6.1; or

(b) 75% of the annual rate of salary determined by the Board as that which would have been payable to the pensioner had he/she continued to be a member.

10.11.10 The annual rate of pension payable to an invalidity pensioner must, if the annual rate of pension is greater than the lesser of:

(a) the annual personal earnings estimated under Rule 10.11.4; or

(b) the amount by which Earnings exceed Notional Income, as calculated under Rule 10.11.9;

be reduced by the lesser of those amounts.

10.11.11 The annual pension payable to an invalidity pensioner must be suspended if the lesser of:

(a) annual personal earnings estimated under Rule 10.11.4; or

(b) the amount by which Earnings exceed Notional Income, as calculated under Rule 10.11.9;

is equal to or greater than the annual rate of pension.

10.11.12 The Board will specify when the reduction or suspension takes effect, not being a date earlier than the date the next payment of pension to the invalidity pensioner is payable, and notify the invalidity pensioner accordingly.

10.11.13 The Board may, at its discretion, pay arrears of pension where an invalidity pension has been reduced or suspended under Rule 10.11.9 if

(a) a later calculation under that Rule results in:

(i) a higher rate of invalidity pension; or

(ii) lifting the suspension and re-commencement of payments of an invalidity pension; and

(b) that higher rate or payment of re-commenced pension would have been payable before the date the pension is increased or the suspension lifted.

10.11.14 No recovery of overpaid pension will be made if a calculation under Rule 10.11.9 results in a lower rate of invalidity pension or suspension of an invalidity pension and that lower rate or suspension would have applied during a period in respect of which invalidity pension has already been paid.

10.12.1 If:

(a) the Board becomes aware that a member, who:

(i) is not classified as a limited benefits member, and

(ii) has not reached age 60; and

(iii) has been a member for less than three years in his/her current period of membership;

failed to give information he/she was required to give, or gave false or misleading information in connection with a medical questionnaire or examination under Rule 10.1.1; and

(b) the Board is of the opinion the member would have been a limited benefits member under Rule 10.2.1 if he/she had given that information or had not given false or misleading information;

the member is a limited benefits member during the period:

(A) commencing on the date he/she last became a member; and

(B) ending on the earlier of the date three years after he/she last became a member or on the date on which the member first became a limited benefits member in any concurrent period or periods of membership.

10.12.2 Where:

(a) the Board becomes aware that a former member, who:

(i) ceased membership before age 60 on invalidity retirement or death; and

(ii) had been a member for less than three years; and

(iii) was not a limited benefits member on his/her last day of membership;

failed to give information he/she was required to give, or gave false or misleading information in connection with a medical questionnaire or examination under Rule 10.1.1; and

(b) the Board is of the opinion the former member would have been a limited benefits member under Rule 10.2.1 if he/she had given that information or had not given false or misleading information;

the former member is to be treated as a limited benefits member on his/her last day of membership and the Board must adjust the benefit entitlement of, or in respect of, the former member and recover any payments made in excess of the adjusted entitlement.

10.12.3 The Board will notify a person in writing that he/she:

(a) is a limited benefits member under Rule 10.12.1 and the period of the limited benefits membership; or

(b) is to be treated as a limited benefits member under Rule 10.12.2.