Australian Government Department of Employment Application for Internal Review of a FEG decision under Section 38 Decisions made by the Department of Employment about eligibility for assistance and the amount of any assistance paid under the Fair Entitlements Guarantee Act 2012 (the FEG Act) are able to be reviewed. A person may lodge an application for internal review at any time after the department has made a decision in respect of their claim. The review mechanisms are: Section 37 Review – where the department, at its own initiative, commences a review of a FEG decision Section 38 Review – where a person seeks an internal review of a FEG decision because they disagree with the outcome. Such an application must be made within 28 days of the date of the decision under review; and Section 41 Review – where a person seeks an external review of an internal review decision made under section 38. As noted in the Reviewing a FEG Decision fact sheet, where a person has queries or concerns about their FEG decision, it is recommend that they contact the department in the first instance to discuss these concerns. Based on the information provided, it may be possible to resolve any concerns without lodging an application for internal review, particularly where the department agrees to initiate its own review of the decision (which could result in a quicker resolution of the issues). Usually, the best way to contact the department to discuss concerns about a FEG decision is to send an email to FEG@employment.gov.au or to telephone the FEG Hotline on 1300 135 040. When should I use this form? This form should be used only for those circumstances where a person is seeking an internal review of a FEG decision under section 38 (whether or not their concerns have been discussed with the department). On receipt of an application for internal review under section 38, the department will then conduct a review of its decision. In conducting the review, the department will independently investigate: the issues raised in the review application any supporting information or documents provided in the application; and any relevant information already held by the department, including information received from the insolvency practitioner. How long do I have to apply for an internal review? An application for internal review under section 38 must be lodged within 28 days of the date of the decision notice relating to the decision being reviewed. This period may be extended by the the department if a person seeks additional time to lodge their review within the 28 day period. What information should I include? An application for internal review under section 38 must include any information or documents that will be relied upon to support the reasons for seeking an internal review. Additional information will be particularly important in cases where a person disagrees with the information an insolvency practitioner has provided to the department from the books and records of their former employer. However, it is not necessary to provide additional copies of documents that have been previously provided to the department, or copies of documents that the department has referred to in its previous decision. March 2014 The below list includes examples of the types of documents that may help the department to assess an application for internal review under section 38. It will not be necessary to provide all of these documents in every case and only documents that are relevant to the issues raised in review application are required. For example, if a review is being sought on the amount of unpaid wages owed, bank statements will usually be considered relevant. workplace agreement, signed employment contract or letter of appointment bank statements for the 13 weeks prior to the initial appointment of the insolvency practitioner (or if employment ended before the appointment of an insolvency practitioner, bank statements for the 13 weeks prior to the end of employment) bank statements for the 30 days immediately after employment ended letter offering new employment (if applicable) payslips letter of termination timesheets payment summaries separation certificate evidence of weekly or annual wage; and evidence of salary sacrifice arrangements. How long will the internal review process take? The department aims to process applications for internal review under section 38 as quickly as possible. Assessments are generally undertaken in the order in which they are received. The time taken to assess a review may depend on its complexity and whether the department needs to request additional information from a person, the insolvency practitioner or other third parties. If the investigation of an application for internal review is likely to be delayed, the department will advise a person of this. On completion of the review, the department will notify a person in writing of the decision. The decision may affirm, vary or set aside the decision being reviewed and substitute it with a new decision. The decision letter will set out the terms of and reasons for the decision and will note any rights of further external review. Independent review by the Administrative Appeals Tribunal Where a person disagrees with the the department’s decision under section 38 internal review, they may apply to the Administrative Appeals Tribunal (AAT) for an external review of that decision. The department must have completed the section 38 review of a FEG claim decision before an application for external review can be made to the AAT. What decisions are reviewable by the AAT? Section 40 sets out which decisions under FEG are reviewable by the AAT. Subject to certain limitations, the AAT may review decisions about eligibility for FEG assistance or the amount of FEG assistance a person is eligible for. The AAT may not review a decision to reduce the amount of assistance paid under FEG due to debts owed to the former employer. Further information Further information about reviews under the FEG Act is available as follows: see the fact sheet Reviewing a FEG decision – available at www.employment.gov.au/FEG contact the insolvency practitioner managing your former employer’s business affairs telephone the FEG Hotline on 1300 135 040 visit the website at www.employment.gov.au/FEG send an email to FEG@employment.gov.au. March 2014 Important Notes to an applicant for internal review of a FEG decision under section 38! 1. The information you provide in this form must be correct to the best of your knowledge. Giving false or misleading information has serious consequences. 2. It is in your interest to include copies of all documents that may help us to assess your review when you lodge your review application. A review decision may be made on your FEG claim based on the information you have provided. 3. Please do not include copies of documents that you have already supplied to the department. 4. Please keep a copy of this form and any copies of any supporting documents for your own records as we are unable to return them to you. HOW TO FILL OUT YOUR INTERNAL REVIEW APPLICATION FORM 1. Complete this form in English. 2. If you speak a language other than English, call the Translating and Interpreting Service (TIS) on 13 14 50. 3. Read questions carefully and follow the instructions beside each question. 4. We encourage you to submit your application ONLINE. This will enable us to begin processing your application in the shortest time possible. Please go to www.employment.gov.au/FEG: (a) navigate to the ‘Application for section 38 Review Form’ (b) enter your answers by typing them into the relevant fields of the form (c) note that at any time you can save this application to your computer by clicking the ‘Save’ button (d) submit the completed application form by clicking ‘Submit’. If any fields are not completed accurately, an error message will be displayed at the end of the form. You must correct each error before you can submit your application online. (e) note that you will be advised of the successful submission of your application for section 38 review. 5. If you are using a PRINTED copy of this application form please use blue or black pen only, print clearly and use only one form per person. 6. Try to fill out all sections of the application form, answering all questions and ticking the relevant boxes. Fields marked with this symbol * are mandatory and must be completed, unless you see an instruction to go to another question. Leaving a question blank may delay the processing of your review. 7. For assistance in completing the form, call the FEG Hotline on 1300 135 040. 8. Once you have completed your application, it can be lodged with the department by sending it to: FEG Internal Reviews Employee Entitlement Branch Department of Employment GPO Box 9880 CANBERRA ACT 2601 Alternatively, you can fax your form to us on (02) 6276 8717 or email it to us at FEGreviews@employment.gov.au. 9. The department will notify you in writing when your application for internal review has been received and after a review decision is made. 10. If you would like to check the status of your internal review, call the FEG Hotline on 1300 135 040. March 2014 Fair Entitlements Guarantee Application for Internal Review of a FEG decision under Section 38 Please answer all questions and tick the relevant boxes. Fields marked with this symbol * are mandatory and must be completed, unless you see an instruction to go to another question. Leaving a question blank may delay the processing of your application for an internal review. PART A – REVIEW DETAILS FEG CLAIM REFERENCE NUMBER Question A1: FEG Claim Reference Number Instruction for question A1: Your FEG Claim Reference Number is provided on the first page of the FEG decision letter. DATE OF FEG DECISION * Question A2: What was the date of the decision you wish to have reviewed? D D / M M / Y Y Y Y Instruction for question A2: The date of the decision is provided on the FEG decision letter. * Question A3: What is your former employer’s legal name? Instruction for question A3: The legal name, for example, ‘XYZ Pty Ltd’. PERSONAL DETAILS * Question A4: Title Instructions for question A4: Please tick a box to indicate your title Mr Mrs Ms Miss Dr * Question A5: Your name * First name Middle name * Family name YOUR CONTACT DETAILS * Question A6: Instructions for question A6: Provide a way for us to contact you during working hours. Daytime contact number (include area code) Alternative contact number (include area code) Email March 2014 * Question A7: What is your date of birth? D D / M M / Y Y Y Y REASONS FOR INTERNAL REVIEW APPLICATION * Question A8: What parts of the decision do you want reviewed? (Please indicate whether you disagree with all components of the decision, or only part of the decision. For example, if you were paid several categories of employee entitlement but only disagree with our assessment of one category of entitlement, please state clearly exactly which part of the decision you disagree with). March 2014 * Question A9: Why do you believe the decision is incorrect? (Please set out in detail all of the reasons why you disagree with the decision. If you need additional space you may include an attachment.) March 2014 PART B – AGENT DETAILS B1: Complete this section if you wish to authorise someone to speak with us about your application for internal review on your behalf. For example, your husband, wife, partner, brother, sister or child – as long as they are over the age of 18. If you wish to authorise an agent, please ensure that all parts of the agent authorisation are completed. Question B1: Do you want someone else to speak with the department on your behalf? Yes No If Yes, complete the details below and advice will be sent to your agent confirming that they will receive correspondence in relation to your application for internal review If No, go to Part C – Privacy Statement and Declaration Question B1.1: Agent’s title Mr Mrs Ms Miss Dr Question B1.2: Agent’s first name Agent’s family name Question B1.3: Relationship to agent (i.e. husband, wife, brother, sister, friend) Question B1.4: Agent’s postal address Number and street or Post Office Box number Suburb/city State or territory Postcode Country Question B1.5: Agent’s contact details Agent’s phone number (include area code) Agent’s email address March 2014 PART C – PRIVACY STATEMENT AND DECLARATION please read carefully before submitting PRIVACY NOTICE The Department of Employment is authorised under the Fair Entitlements Guarantee Act 2012 to collect personal information for the purposes of administering FEG. The department manages information given by you in this review application form in accordance with the Privacy Act 1988. It collects this information, and other information in relation to your internal review to facilitate the effective operation of the FEG, and for the purposes of determining what employee entitlements you may be owed by your former employer. The department also uses the information for statistical research, monitoring and evaluation that may be carried out by it or by external commercial researchers. The department usually discloses some or all of the information which relates to your internal review for purposes outlined above to the insolvency practitioner who is administering your former employer’s affairs; to an independent FEG contractor appointed by the department to verify entitlements; to a third party distributor engaged to distribute FEG funds; to Centrelink for the calculation of entitlements; to the Australian Taxation Office, the Australian Securities and Investments Commission and the Insolvency and Trustee Service of Australia to facilitate the recovery of FEG advances and to support compliance activities; to the Fair Work Ombudsman for investigations under the Fair Work Act 2009; to the Administrative Appeals Tribunal in the event that a decision is subject to an appeal, and to the Commonwealth Ombudsman where a complaint is made in relation to a FEG claim. For further information about the Department of Employment’s privacy policy including access, correction and complaint procedures, please go to employment.gov.au/privacy or request a full copy of the policy by emailing privacy@employment.gov.au. DECLARATION 1. The information provided in this review application form is true and correct to the best of my knowledge. 2. I confirm that I have provided the information contained in this application form either personally or through the assistance of the agent listed in Part B. 3. I authorise my employer (or the insolvency practitioner on behalf of my employer) to disclose to the department for the purpose of reviewing my claim for FEG assistance, information in relation to my employee entitlements. I understand that the department may use this information when determining the action to be taken on this application or for statistical research, monitoring and evaluation. 4. I authorise the department or its agents to exercise, on my behalf, any statutory rights I have to require the employer (or insolvency practitioner) to provide me with access to, or copies of, my employment records, where those records are required to determine the action to be taken on this application. 5. I authorise the Department of Immigration and Border Protection (DIBP) to disclose to the department information in relation to any Australian Visas I hold or have held, including the disclosure of information about my visa status available through the DIBP Visa Entitlement Verification Online system. I understand that the department may use this information when determining the action to be taken on this application. March 2014 6. I authorise the Fair Work Commission, the Fair Work Ombudsman and Fair Work Inspectors to disclose to the department for the purpose of determining the action to be taken on this application, information in relation to any Workplace Agreement and/or employment agreement to which I am, or have been, a party. I understand that the department may use this information when determining the action to be taken on this application. 7. I authorise the Fair Work Ombudsman to disclose to the department for the purpose of determining the action to be taken on this application, information in relation to me that it has collected as a result of any investigation by the Fair Work Ombudsman. I understand that the department may use this information when determining the action to be taken on this application. 8. I accept that I am not entitled to receive or retain any money paid as a result of any error on my behalf; on the part of an insolvency practitioner acting for my insolvent employer; on the part of a third party engaged to distribute FEG funds; on the part of a third party accountant who has been engaged to verify information; or on the part of a person administering FEG for the Commonwealth. I further accept that any sums paid under FEG in the above circumstances will constitute a debt owed by me and will be immediately repayable in full. Interest may be payable on this amount. 9. I confirm that any copies I have provided are true copies of the original documents. 10. I acknowledge that the giving of false or misleading information has serious consequences. YOU MUST SIGN AND DATE YOUR APPLICATION FORM * Print your full name * Your signature * Date D D / M M / Y Y Y Y Please remember to attach copies of any documents which you believe support your application. Send copies only as originals cannot be returned. March 2014