Fillable Printable Claim for Mobility Allowance Form - Australia
Fillable Printable Claim for Mobility Allowance Form - Australia
Claim for Mobility Allowance Form - Australia
MA001.1507
Information you need to
know about your claim for
Mobility Allowance
Use this form to claim Mobility Allowance if you are 16 years of age or over and have a disability
and cannot use public transport without extra help. There does not need to be public transport
in your area to qualify. You must also be doing a qualifying activity. Please refer to page 4 for
more information.
Mobility Allowance is not taxable. You do not need to be getting any other income support
payments to qualify for Mobility Allowance.
You cannot be paid Mobility Allowance if you are receiving a funded package of support from the
National Disability Insurance Scheme.
Online Services
Use our online services
You do not need to complete this form if you use our online services. Claiming online is faster.
You can access your Centrelink, Medicare and Child Support Online Services through myGov.
myGov is a fast, simple way to access a range of government services online with one username,
one password, all from one secure location. To create a myGov account, go to my.gov.au
For more information
Go to humanservices.gov.au/mobilityallowance or call us on 132 717 or visit one of our
service centres.
If you need a
translation
of any documents for our business, we can arrange this for you free
of charge.
To speak to us in languages other than English, call 131 202.
Note: Call charges apply – calls from mobile phones may be charged at a higher rate.
If you have a hearing or speech impairment, you can contact the
TTY service
Freecall™ 1800 810 586. A TTY phone is required to use this service.
Information online
– If you would like further information on our services and payments, you can
go to humanservices.gov.au/onlineservices
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Information in other
languages
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Contents
Payments 4
Mobility Allowance 4
Payment information 5
Proof of hours you are working or training 5
Australian residence requirements 6
Someone to deal with us for you 6
Nominees and other arrangements 6
Confirming your identity 7
Changes you must tell us about 9
Other payments, concessions and help 9
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Payments
Mobility Allowance
Mobility Allowance provides assistance to people with disabilities engaged in certain activities and
who cannot use public transport permanently, or for an extended period (12 months or more), without
substantial assistance.
Mobility Allowance is not taxable. You do not need to be getting any other payments from us to qualify
for Mobility Allowance.
Note:
You cannot be paid Mobility Allowance if you are receiving a funded package of support from the
National Disability Insurance Scheme.
You may receive Mobility Allowance if you:
• are aged 16 or over,
and
• have a disability that prevents you from using public transport without substantial assistance (there
does not need to be public transport in your area for you to qualify),
and
• need to travel to and from your home as part of your work, self-employment, training or job seeking.
To qualify for the
standard rate
of Mobility Allowance, you must also be:
• doing at least 32 hours over a 4 week period of voluntary work, paid work, self-employment, training
(including life skills courses),
or
• receiving Newstart, Austudy or Youth Allowance and fulfilling your Mutual Obligation or Activity Test
Requirements associated with these payments,
or
• participating in Disability Management Service with a Disability Employment Services Provider,
or
• looking for work under a Job Plan with an Employment Services Provider (e.g. jobactive
, Disability
Employment Services or Remote Jobs and Communities Programme).
To qualify for the
higher rate
of Mobility Allowance, you must also be:
• receiving Newstart Allowance, Youth Allowance, Parenting Payment or Disability Support Pension,
and
• working 15 hours or more per week for wages at or above the relevant minimum wage,
or
• looking for work of 15 hours or more per week under a Job Plan with an Employment Services Provider
(e.g. jobactive, Disability Employment Services or Remote Jobs and Communities
Programme
),
or
• working for at least 15 hours per week under the Supported Wage System.
In some instances the higher rate may remain payable if you stop receiving Newstart Allowance, Youth
Allowance, Parenting Payment or Disability Support Pension because of income you have earned.
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Payment information
Proof of hours you are
working or training
We will need proof of the hours you are working or training when you claim Mobility Allowance. The
documents listed below might give details of your work and/or training.
If you cannot supply proof of hours, we will send you a form to take to your employer or training
organisation. The form will only be sent to you after we have received your claim.
If you are employed:
• recent payslips showing the name of the employer and number of hours you work over a 2 and 4 week
period,
or
• a letter from your employer stating when you started work and how many hours you work over a 2 and
4 week period,
or
• a copy of a recent attendance sheet.
If you are self-employed:
• a letter from your accountant stating the hours you work over a 2 and 4 week period.
If you do voluntary work:
• a letter from a welfare, charitable or community organisation stating how many hours of voluntary work
you do over a 4 week period.
If you participate in a vocational training course:
• an enrolment record which shows the hours you attend over a 4 week period,
or
• a letter from the training organisation stating when you started the course, when it will finish and how
many hours you attend over a 4 week period.
If you participate in an Independent Living or Life Skills Training course:
• a letter from the training organisation stating how many hours of your course over a 4 week period
relate to Independent Living Skills or Life Skills (
do not include
time spent on recreational activities).
If you participate in a Disability Employment Services Program:
• if you currently receive a payment from us, we will verify the details of the program for you.
If you do not receive a payment from us, we will contact you for more information.
If you participate in Remote Jobs and Communities Programme:
• if you currently receive a payment from us, we will verify the details of the programme for you.
If you do not receive a payment from us, we will contact you for more information.
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Payment information
• continued
Australian residence
requirements
There are a number of circumstances that can apply to residence including the examples listed below.
If you require more specific information, call us on 132 717 or visit one of our service centres.
To be eligible for Mobility Allowance, you must be an Australian resident and in Australia when you
lodge your claim. To remain qualified for this payment you must also remain an Australian resident.
You are an Australian resident (as defined by the Social Security Act 1991) if you are living in Australia
and you are either:
• an Australian citizen,
or
• a permanent visa holder,
or
• a protected Special Category visa holder, that is, you arrived in Australia on a New Zealand passport
and you were in Australia on 26 February 2001, or for 12 months in the 2 years immediately before this
date, or were assessed as ‘protected’ before 26 February 2004.
In deciding whether you are living in Australia, we may need to look at the nature of your
accommodation, the nature and extent of family relationships in Australia, the nature and extent of
employment, business or financial ties with Australia, the frequency and duration of travel outside
Australia and any other relevant matters.
Newly arrived residents generally have a 104 week waiting period for Mobility Allowance. This may not
apply to you if you:
• are an Australian citizen,
or
• arrived under a refugee or humanitarian program,
or
• hold a certain visa subclass,
or
• are the partner or dependent child of an Australian citizen or long-term resident,
or
• are the partner or dependent child of a refugee or humanitarian migrant,
or
• were the partner or dependent child of a former refugee or humanitarian migrant at the time they
arrived in Australia,
or
• require Mobility Allowance because of an event which occurred in Australia.
For more information go to humanservices.gov.au/newresidentswaiting
Someone to deal with us for you
Nominees and other
arrangements
Some customers have difficulty managing their affairs often because of a disability or illness, problems
with reading, writing or understanding information or difficulty handling money.
If you need help dealing with us, a Person Permitted to Enquire (PPE) or Nominee Arrangement is
available.
Person Permitted to Enquire arrangements allow you to authorise a person or organisation to make
limited enquiries only about your record.
A Person Permitted to Enquire is not a Nominee Arrangement.
A Nominee Arrangement authorises a person or organisation to enquire, act and make changes on your
behalf and/or receive your payment on your behalf.
If you want to request either of these arrangements, complete the Authorising a person or
organisation to enquire or act on your behalf form (
SS313
). If you do not have this form, go to
humanservices.gov.au/nominees or call us on 132 717.
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Confirming your identity
As a customer you are required to confirm your identity when claiming a payment or service from the
Australian Government Department of Human Services. In most cases, you will only need to confirm
your identity once. You must confirm your identity by providing original documents (not copies) from the
approved list below. We need you to provide the following:
• 1 Commencement of Identity document,
and
• 1 Primary Use in Community document,
and
• 1 Secondary Use in Community document.
Note:
An identity document cannot be used multiple times (e.g. a document used as Commencement of
Identity, cannot be used again as a Primary or Secondary Use in Community document).
If you have difficulty in obtaining or providing these documents, you need to contact us as soon as
possible.
Where possible, we will use the documents you provide to confirm your age, residence, income and/
or assets if that is relevant to the payment or service you are applying for. To be eligible for some
payments or services, you may need to provide additional documents.
Who needs to confirm their identity?
Depending on the payment or service you are claiming you may need to confirm your identity by
providing identity documents from the approved list. You will be advised of the identity requirements
for the payment or services you are claiming when you apply. For more information, go to
humanservices.gov.au
If you are required to confirm your identity, you will need to provide one document for EACH of the
following categories:
• Commencement of Identity,
and
• Primary Use in Community,
and
• Secondary Use in Community.
Commencement of Identity
Document Explanation/description
Australian Birth Certificate Original Australian birth certificate, extract or birth card issued in your name/former name.
Australian Visa
Australian visa, current at time of entry to Australia as resident or tourist, issued in your name/former
name.
Australian Citizenship Certificate Australian citizenship certificate issued in your name/former name.
ImmiCard A photo identity card issued in your name/former name by the Department of Immigration and Border
Protection (DIBP) that assists the cardholder to prove their visa/migration status and enrol in services.
Australian Passport (current) Australian passport in your name/former name. Expired passports are not acceptable.
Certificate of Identity Certificate of Identity issued in your name/former name by the Department of Foreign Affairs and Trade
(DFAT) to refugees and non Australian citizens for entry to Australia.
Certificate of Evidence of Resident
Status
Certificate of Evidence of Resident Status issued in your name/former name by the Department of
Immigration and Border Protection (DIBP).
Document of Identity Document of Identity issued in your name/former name by the Department of Foreign Affairs and Trade
(DFAT), to Australian citizens or persons who possess the nationality of a Commonwealth country, for
travel purposes.
Note:
The above documents can also be used to satisfy Primary or Secondary Use in Community (if not
already used as Commencement of Identity).
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Confirming your identity
• continued
Primary Use in Community
Document Explanation/description
Shooter or Firearm Licence Current shooter or firearm licence showing signature and/or photo and same name as claim.
Cannot accept:
minor or junior permit and/or licence.
Australian Driver Licence – Motor
Vehicle
Current state or territory issued driver licence, learner permit or provisional licence showing signature
and/or photo and same name as claim.
Australian Marriage Certificate Marriage certificate issued by a state or territory government agency.
Cannot accept:
church or celebrant issued certificates.
Passport issued outside Australia Current passport issued by a country other than Australia, with a valid entry stamp or visa.
Proof of Age Card Current proof of age or photo identity card issued by a government agency in your name with photo
and/or
signature.
Student ID Card (Persons aged
under 18 years with no other
Primary Use in Community only)
Current secondary student ID card isued in your name with photo and/or signature.
Note:
The above documents can also be used to satisfy Secondary Use in Community (if not already
used as Primary Use in Community)
Secondary Use in Community
Document Explanation/description
Security Licence Current security protection industry or crowd control licence, showing signature and/or photo and
same name as claim.
Bank/Financial Institution Card,
statement or passbook
Current ATM, credit or debit card showing your name and signature. Statement or passbook from
current savings or cheque account showing your name and same address (if applicable) as your claim.
Cannot accept:
cards issued by organisations other than banks, credit unions or building societies,
ATM or internet receipts/statements or account documentation issued by banks/financial institutions
outside Australia.
Child’s Birth Certificate Australian birth certificate for a child showing your name as parent/guardian.
Cannot accept:
sibling’s certificate.
Defence Force Identity Card
Identity card issued by the Australian Defence Force, showing same name as claim, and photo or signature.
Australian Divorce Papers Australian divorce papers in your name/former name (e.g. Decree Nisi, Decree Absolute).
Educational Certificate Educational qualification certificate in your name/former name (school/TAFE/university/Registered
Training Organisation [RTO]).
Certified Academic Transcript Certified academic transcript from an Australian university in your name/former name.
Mortgage Papers Legally drawn mortgage papers for an Australian residence in your name/former name.
Name Change Legal change of name certificate or deed poll certificate.
Veterans’ Affairs Card Current Department of Veterans’ Affairs card issued in your name.
Tenancy Agreement or Lease
Current formal residential tenancy agreement or lease in your name and showing same address as claim.
Motor Vehicle Registration Current motor vehicle registration showing your name, same address as claim and proof of payment.
Foreign Government issued
Documents
Documents issued by a country other than Australia (comparable to Australian issued documents),
including foreign birth, marriage and education certificates, lapsed foreign passports, foreign driver
licences and overseas national identity cards.
Australian Government
(Commonwealth, state or territory)
issued photo ID Card
Current Commonwealth, state or territory issued photo identification card issued in your name.
Rates Notice Paid rates notice in your name and showing same address as claim, less than 12 months old.
Utility Account A paid utility account (e.g. gas, water, electricity or phone) in your name and showing receipt number
and same address as claim, less than 12 months old.
Student ID Card Current student ID card issued in your name with photo and/or signature (secondary/TAFE/university/
Registered Training Organisation [RTO]).
Electoral Enrolment Proof of electoral enrolment card issued in your name and same address as claim.
Aviation Security Identity Card (ASIC)
Current aviation security identity card showing same name as claim, photo and/or signature.
Maritime Security Identification Card
Current maritime security identification card showing same name as claim, photo and/or signature.
Police Identity Card Current police identity card showing same name as claim, photo and/or signature.
Prison release certificate A prison release certificate in your name with a photo and/or signature.
Note:
Certificates that do not meet this criteria cannot be used.
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Changes you must tell us about
You can tell us about changes to your circumstances through online services if you have a myGov or
Centrelink online account. For more information, see ‘Online Services’ on page 1.
Travelling outside Australia
If you receive Mobility Allowance, you should tell us if you are going overseas and you:
• will be away for longer than 6 weeks,
or
• will cease meeting your Mutual Obligation or Activity Test Requirements within 6 weeks of your
departure,
or
• you will be ceasing your qualifying activity for Mobility Allowance within 6 weeks of your departure.
There is further information available at humanservices.gov.au/paymentsoverseas about how
your payment or concession card may be affected or whether you should contact us about leaving or
returning to Australia. You can also contact us if you want to find out more information.
Other payments, concessions and help
Advance Payments
If you are eligible for Mobility Allowance you can receive an advance on your payments. This equals
13 fortnightly payments.
It is only paid once every 12 months and
no part of the advance can be repaid or returned
in order
to resume fortnightly payments. When the 6 month advance period ends, you automatically go back to
fortnightly payments.
Carer Payment and
Carer Allowance
If someone provides constant care in your home they may be able to claim Carer Payment
through us.
If someone provides daily care either in your home or the carer’s home, they may be able to claim Carer
Allowance. For more information, go to humanservices.gov.au/carers
Information you need to know about your claim for Carer Payment and Carer Allowance (
Ci002
)
(
Information Booklet
) is a booklet with information about claiming Carer Payment or Carer Allowance.
For a copy, go to humanservices.gov.au
Child Dental Benefits Schedule
You may also be eligible for assistance under the Child Dental Benefits Schedule. For more information,
go to humanservices.gov.au/childdental
Community Engagement
Officers
Community Engagement Officers may be able to visit you if you are homeless, living in a hostel or
refuge, suffering from a mental illness, or fleeing from domestic violence. Community Engagement
Officers can tell you about payments and services and help you access these services. They provide
services in locations like rehabilitation centres, psychiatric hospitals, prisons, hostels, drop-
in centres.
Education Entry Payment
Education Entry Payment is an additional amount to help with the cost of study. For more information,
go to humanservices.gov.au/educationentry or call us on 132 717 or visit one of our service centres.
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Other payments, concessions and help
• continued
Employment Services
Providers
If you are a job seeker with a disability, illness or injury, that makes it hard for you to find and maintain
employment, there are a number of services which may be able to assist you.
If you do not have a current assessment of your work capacity you will generally need an assessment
before you can access these services.
The aim of Employment Services Providers is to provide the most appropriate level of service based
on your individual needs. They can match your skills to vacancies and help with general job search
assistance to improve your employment prospects and your job search techniques.
For more information about Employment Services Providers for people with a disability, illness or injury,
go to humanservices.gov.au (select People with Disability) or employment.gov.au or call 136 268.
jobactive
jobactive is a national network of employment service organisations.
Disability Employment Services
Disability Employment Services help people with a disability, injury or health condition get ready to
look for, find and keep a job. Disability Employment Services provides a range of support to meet your
individual needs.
Remote Jobs and Communities Programme
Remote Jobs and Communities Programme provides participation and employment services for people
living in remote areas of Australia.
Australian Disability Enterprises
Australian Disability Enterprises are organisations that provide paid employment in a supported
environment for people with disabilities who have high support needs.
Essential Medical
Equipment Payment
If you use, or provide care for someone that is using, essential medical equipment or medically required
heating/cooling in your current residence, you may be eligible for the Essential Medical Equipment
Payment. For more information about how to claim, go to humanservices.gov.au/emep or call us
on 132 468.
Financial Information
Service Officers
Financial Information Service (FIS) Officers can give you free, independent information. This will help
you understand investments and how they work, and help you make better financial decisions.
Health Care Card
If you get Mobility Allowance, you will automatically get a Health Care Card.
A Health Care Card provides you access to pharmaceutical medications listed under the Pharmaceutical
Benefits Scheme at a reduced cost. You
may
also receive other concessions provided by state and
territory governments.
Indigenous Services Staff
Indigenous Services Staff are located in most service centres. Some service centres also have
interpreters who speak Aboriginal or Torres Strait Islander languages and teams who visit and help
remote communities.
Remote Area Allowance
Remote Area Allowance was introduced as an additional assistance for customers in remote areas.
It recognises that many customers who do not pay tax, or very little tax, do not get the full benefit of tax
zone rebates. Remote Area Allowance makes a contribution towards some of the costs associated with
living in particularly remote areas.
Social Workers
We have professional social workers in our service centres and Smart Centres throughout Australia.
Social workers can offer you personal counselling and support in difficult times, such as domestic and
family violence, severe financial hardship, homelessness, loss and bereavement. They can refer you to
other services and programs like housing, health, emergency relief, legal and/or counselling services
and support groups.
MA001.1507
Claim for
Mobility Allowance
In your claim pack, you should have the following:
• Claim for Mobility Allowance
form (MA001)
• Medical Report Mobility Allowance
form (MA002)
Forms in your
claim pack
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Filling in this form
• Please use black or blue pen.
• Print in BLOCK LETTERS.
• Mark boxes like this
with a or .
• Where you see a box like this
Go to 5
skip to the question number shown.
You do not need to answer the questions in between.
What else you may
need to provide
You may need to provide identity documents. For a list of acceptable documents refer to
Confirming your identity
in the Notes Booklet.
Use this form to claim Mobility Allowance if you are 16 years of age or over and have a
disability and cannot use public transport without extra help. There does not need to be
public transport in your area to qualify. You must also be doing a qualifying activity.
Please refer to page 4 of the Notes Booklet for more information.
Mobility Allowance is not taxable. You do not need to be getting any other income support
payments to qualify for Mobility Allowance.
You cannot be paid Mobility Allowance if you are receiving a funded package of support
from the National Disability Insurance Scheme.
When to use this form
Returning your form
Check that all required questions are answered and that the form is signed and dated.
Return this form and any supporting documents to us within 14 days so we can process
your application or claim. If you cannot do this within 14 days, contact us for extra time.
If extra time is required, you must contact us at the earliest possible date to make an
arrangement.
You can return this form and any supporting documents:
• online – submit your documents online. For more information about how to access an Online
Account or how to lodge documents online, go to
www.
humanservices.gov.au/submitdocumentsonline
• by post
• in person – if you are unable to submit this form and any supporting documents online or
by post, you can provide them in person to one of our service centres.
