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Business Services Wage Assessment Tool Payment Scheme Application
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Business Services Wage Assessment Tool Payment Scheme Application
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Application information

Business Services Wage Assessment Tool Payment Scheme Application
Fields marked with * are required

When to use this form

Use this form if you would like to apply for the Business Services Wage Assessment Tool (BSWAT) Payment Scheme. The BSWAT was developed by the Australian Government for use by Australian Disability Enterprises (ADE) to assess wages of supported employees. The BSWAT Payment Scheme will provide a payment in certain circumstances to eligible supported employees with an intellectual impairment whose wages were assessed and paid using the BSWAT. Registrations for the BSWAT Payment Scheme will close on 30 April 2017. You have until 30 November 2017 to lodge an application.

Do you need help with this form?

If you need help filling out this form you can call the BSWAT Payment Scheme toll free number on 1800 799 515. You can ask someone you trust for help to complete this form, like a family member or a friend. Some people can choose to have a nominee. A nominee is a person you trust to help you make a decision about the BSWAT Payment Scheme. There are rules they will need to follow.

Who can claim this payment?

To be eligible for the BSWAT Payment Scheme you must have: an intellectual impairment, which includes an intellectual disability, autism spectrum disorder, dementia, or impaired intellectual functioning as a consequence of an acquired brain injury been employed by an ADE for at least one day between 1 January 2004 and 28 May 2014 had your wages assessed using the BSWAT, or a training wage while waiting for a BSWAT wage assessment, AND required daily support within an ADE workplace to maintain employment. If you do not meet ALL of the above requirements you ARE NOT eligible for a payment under the BSWAT Payment Scheme.

Deceased Persons

A person recognised by the Secretary of the Department of Social Services as a deceased person’s legal personal representative may apply for the BSWAT Payment Scheme on behalf of a deceased person. If you indicate you are applying for the BSWAT Payment Scheme on behalf of a deceased person, the Department of Social Services will provide you with an additional form so that you can provide further information.

Nominee principles and rules

Under the Business Services Wage Assessment Tool Payment Scheme Act 2015 (the Act) a nominee is bound by the following principles: all adults have an equal right to make decisions that affect their lives and to have those decisions respected persons who may require support in decision making must be provided with access to the support necessary for them to make, communicate and participate in decisions that affect their lives the will, preferences and rights of persons who may require decision making support must direct decisions that affect their lives, and laws and legal frameworks must contain appropriate and effective safeguards in relation to interventions for persons who may require decision-making support, including to prevent abuse and undue influence. If the applicant cannot formulate their own preferences, it is the duty of a nominee to ascertain what the participant would likely want by doing any or all of the following: consider any previous views or wishes expressed by the participant consult with any court-appointed decision maker consult with any participant-appointed decision maker consult with family members, carers or informal supporters of the participant.Under the Business Services Wage Assessment Tool Payment Scheme Rules 2015 (the Rules) a nominee must: support decision making by the participant personally have regard to, and give appropriate weight to, the views of the participant inform the Secretary:
if the nominee has, acquires, or is likely to acquire, any interest, pecuniary or otherwise, that conflicts or could conflict with the performance of the nominee’s duties. (A conflict of interest in relation to a nominee and a participant, means any conflict between the interests of the nominee and the interests of the participant). if the nominee has a conviction for an offence under a law of the Commonwealth, state or territory law involving abuse, violence or fraud if the nominee is so required, any event or change of circumstances in respect of any duties during the period of acting as a nominee, and if the nominee believes that he or she cannot comply with his or her obligations under the Act and the Rules.
become sufficiently familiar with the financial affairs of the participant so that the nominee can discharge his or her duties under the Act and the Rules. avoid or manage any conflict of interest in relation to the nominee and the participant provide support to the participant to express their preference in making decisions in respect of accepting or declining an offer from the BSWAT Payment Scheme communicate to the participant the process, decision and implications of decisions relating to the BSWAT Payment Scheme promote and safeguard the participant’s human rights and act in the way least restrictive of those rights when making decisions relating to the BSWAT Payment Scheme, and recognise and respect the cultural and linguistic circumstances of the participant and ensure an appropriate form of communication for the purposes of communicating about how the BSWAT Payment Scheme is used. If more than one person is appointed as nominee, a further duty of each of them is to consult with the others before doing any act under, or for the purposes of, the Act.Who cannot be a nominee A person cannot be appointed as a nominee if they are:under 18 years of ageemployed by the Australian Government Department of Social Services a recipient of a grant made under Part II of the Disability Services Act 1986 or an employee of such a recipient, ora person who the Secretary has decided must sign a nominee declaration in accordance with section 7.04 of the Rules, but has not done so.However, a person who is employed by the Department of Social Services or a recipient of a grant made under Part ll of the Disability Services Act 1986 (or an employee of such a recipient), may be appointed as a nominee for the participant if: the person is a relative of the participant the person is a court-appointed or participant-appointed decision maker in relation to the participant the person is a nominee in relation to the participant for the purposes of the social security law, or the Secretary determines that there are circumstances which make it inappropriate for a person not to be appointed.

For more information

Go to www.dss.gov.au/bswat/paymentscheme or call the BSWAT Payment Scheme Helpdesk on toll free number 1800 799 515. You can also send an email to bswatpayments@dss.gov.au If you have a hearing or speech impairment, you can contact the TTY service on 1800 555 677 then ask for 1800 799 515. Internet relay users can visit the National Relay Service website and ask for 1800 799 515. A TTY phone is required to use these services.

Applicant details

Business Services Wage Assessment Tool Payment Scheme Application
Fields marked with * are required

Permanent address

Permanent address
Postal address

Contact details

Centrelink Reference Number

Do you know your Centrelink Reference Number? *
Are you applying on behalf of a deceased person? *
To apply on behalf of a deceased person, you need to complete a different application form. You do not need to finish filling out this online form.Instead you need to complete the ‘Application for a Deceased Person’s Legal Personal Representative Form’.Find the printable version of this application form, and follow the links to access the form.This form needs to be completed by the deceased person’s Legal Personal Representative and returned by emailing bswatpayments@dss.gov.au or posting to: Department of Social Services
BSWAT Payment Scheme
GPO Box 9820
HOBART TAS 7001

Employment details

Business Services Wage Assessment Tool Payment Scheme Application
Fields marked with * are required
Where possible, provide information about any Australian Disability Enterprise that you have worked at since 2001.

Employment details:

Type of Nominee

Business Services Wage Assessment Tool Payment Scheme Application
Fields marked with * are required

Please read this before answering the following questions

If you do not have a Department of Human Services nominee, or you would like to nominate another person to act on your behalf for the BSWAT Payment Scheme, you can nominate someone else. The person you nominate cannot be: under 18 years of age employed by the Department of Social Services, or a recipient of a grant made under Part II of the Disability Services Act 1986 or an employee of such a recipient. However, a person who is employed by the Department of Social Services or a recipient of a grant made under Part ll of the Disability Services Act 1986 (or an employee of such a recipient), may be appointed as a nominee for the participant if: the person is a relative of the participant the person is a court-appointed or participant-appointed decision maker in relation to the participant the person is a nominee in relation to the participant for the purposes of the social security law, or the Secretary determines that there are circumstances which make it inappropriate for a person not to be appointed.
Have you spoken to the person you would like to nominate and have they agreed to undertake this role? *
Please read this before answering the following questions
You must read the ‘Nominee principles and rules’ on the Application information page before you continue. If you have a person who helps you make decisions about money, or a person who supports you when you deal with the Australian Government Department of Human Services, you may want to ask that person to help you apply for the BSWAT Payment Scheme.
Does someone help you make decisions about money? *
Do you have a court-appointed decision maker? *
Would you like this person to support you with your claim for the BSWAT Payment Scheme? *
Do you have an authorised Department of Human Services nominee? *
Would you like this person to be your nominee for the BSWAT Payment Scheme claim? *

Nominee details

Business Services Wage Assessment Tool Payment Scheme Application
Fields marked with * are required
Do you wish to appoint a nominee to help you and be your representative for the BSWAT Payment Scheme? *

To be completed by the nominee.

Name of nominee
Nominee’s address
Nominee’s postal address
Nominee’s contact details

Declaration

Business Services Wage Assessment Tool Payment Scheme Application
Fields marked with * are required

IMPORTANT INFORMATION

Privacy and your personal information The Australian Government Department of Social Services and the Australian Government Department of Human Services will collect your personal information for the purpose of assessing your eligibility to receive an offer under the Business Services Wage Assessment Tool Payment Scheme Act 2015. If this information is not collected, your eligibility cannot be assessed. The Department of Social Services and the Department of Human Services may also hold, use or disclose your personal information in the performance of its functions and administering its legislation, where you have given consent, or where otherwise permitted by the Privacy Act 1988. A disclosure may be made to an organisation contracted by the Australian Government Department of Social Services to assess your application. The Department of Social Services privacy policy is available at www.dss.gov.au/privacy-policy and the Department of Human Services privacy policy is available at www.humanservices.gov.au/privacy These policies contain contact details and important information about your privacy, including information about how you can access and seek correction of information we hold about you, how you may complain about a breach of the Privacy Act 1988 and how the Departments will deal with any privacy complaint. You can also contact the Privacy Commissioner using the contact details available at www.oaic.gov.au
Statement
the information held by the Australian Government Department of Human Services being used to assess my eligibility for the Business Services Wage Assessment Tool Payment Scheme and to calculate an offer under the Scheme. the information held by the Australian Government Department of Social Services being used to assess my eligibility for the Business Services Wage Assessment Tool Payment Scheme and to calculate an offer under the Scheme.
the information held by the Australian Government Department of Social Services being used for the purposes of research or analysis, including: calculation and payment of wages to individuals who have an intellectual impairment, and/orthe management, operation or administration of the Act or Rules.
the assessment of my application under the Business Services Wage Assessment Tool Payment Scheme may be undertaken by the Australian Government Department of Social Services and/or an organisation contracted by the Australian Government Department of Social Services.
Declaring person:

Nominee Declaration

Business Services Wage Assessment Tool Payment Scheme Application
Fields marked with * are required

Information for nominees

The nominee principles and rules outlined on application information page applies to nominees appointed under the Business Services Wage Assessment Tool Payment Scheme. As a nominee, you agree to comply with the principles, rules and duties of nominees as set out in the Act and the Rules.
IMPORTANT INFORMATION
Privacy and your personal information The Department of Social Services and Department of Human Services will collect your personal information for the purposes of appointing you as a nominee for the applicant under the BSWAT Payment Scheme. If this information is not collected, you may not be appointed as a nominee for the applicant. The Department of Social Services and the Department of Human Services may also hold, use or disclose your personal information in the performance of its functions and administering its legislation, where you have given consent, or where otherwise permitted by the Privacy Act 1988. A disclosure may be made to an organisation contracted by the Australian Government Department of Social Services to assess the application. The Department of Social Services privacy policy is available at www.dss.gov.au/privacy-policy and the Department of Human Services privacy policy is available at www. humanservices.gov.au/privacy These policies contain contact details and important information about your privacy, including information about how you can access and seek correction of information we hold about you, how you may complain about a breach of the Privacy Act 1988 and how the Departments will deal with any privacy complaint. You can also contact the Privacy Commissioner using the contact details available at www.oaic.gov.au
Nominee Statement
being appointed as a nominee for the applicant under the Business Services Wage Assessment Tool Payment Scheme.
my personal information being held, used and disclosed by the Australian Government Department of Social Services and the Australian Government Department of Human Services for the purposes described above.
I have read and understand the information contained in this form. There is nothing that would preclude me from being appointed as a nominee. I understand and will act as a nominee for the applicant in accordance with the functions and responsibilities outlined under the Business Services Wage Assessment Tool Payment Scheme Act 2015 and the Business Services Wage Assessment Tool Payment Scheme Rules 2015.
YOUR DEPARTMENT NAME HERE