Library wiki
AFCA published IP determinations — Total and partial are separate benefits — AFCA applies the PDS as written
AFCA does not grade medical severity as ‘total’ or ‘partial’. It asks which definition the person met in each month: hours actually worked, important income-producing duties, and earnings against pre-disability income. Working more than the hours threshold usually takes the file out of total and into partial — if the earnings drop and duty test are also met. Not working, but still able to do the important duties, fails total. A graded return is often residual, not recovery and not a failed total claim. Where the PDS deems a ≤10-hour week to be a 100% loss, AFCA applies that deeming.
Where it is defined
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Ombud precedent
AFCA does not grade medical severity as ‘total’ or ‘partial’. It asks which definition the person met in each month: hours actually worked, important income-producing duties, and earnings against pre-disability income. Working more than the hours threshold usually takes the file out of total and into partial — if the earnings drop and duty test are also met. Not working, but still able to do the important duties, fails total. A graded return is often residual, not recovery and not a failed total claim. Where the PDS deems a ≤10-hour week to be a 100% loss, AFCA applies that deeming.