One word can make all the difference: Revised Disability Support Pension Assessment Tables

Lucia MaiDisability, Social security rights review

By Linda Forbes, Economic Justice Australia

New tables for assessing eligibility for the Disability Support Pension (DSP) were released earlier this year and we were thrilled to see that the input of Economic Justice Australia and other peaks to the consultation on developing the new Tables was substantially reflected.  

One of the most fundamental changes is superficially so minor it could go unnoticed – the removal of one problematic word, ‘fully’.

The simple removal of the word ‘fully’ in the preamble to the Tables, as a qualifier to considerations of whether a person’s medical condition has been ‘diagnosed’, ‘treated’ and ‘stabilised’ has made a huge difference – a difference that will enhance access to the DSP.

Most importantly, the change in wording may mean that people who failed to qualify for the DSP under the previous Tables, may now be eligible and should reapply. In this article we explain how this can be so.

Removal of the ‘fully’ qualifier

The DSP eligibility criteria are notoriously complex but the primary requirement is that a person must generally be assessed under the DSP Impairment Tables, with scores assigned for each of their “permanent” conditions – a permanent condition being a condition likely to persist for at least the next two years.

The bugbear under the previous Tables was that a condition could only be assessed under the Tables if:

  • it had been ‘fully diagnosed’ by an appropriately qualified medical practitioner;
  • it had been ‘fully treated’; and
  • it had been ‘fully stabilised’.

As outlined in EJA’s submission to the Senate Community Affairs References Committee Inquiry into the purpose, intent and adequacy of the Disability Support Pension, the requirement under the former Impairment Tables that a condition be ‘fully diagnosed’, ‘fully treated’, and ‘fully stabilised’ to be assessed, has been central to many appeals against DSP rejections and the source of considerable confusion among claimants, treating doctors, Services Australia delegates and Administrative Appeals Tribunal (AAT) members alike. DSP claimants could provide reports from their GP and specialists definitively attesting to diagnosis of a particular condition, the treatment regime and prognosis, only to have Centrelink or the AAT effectively question their doctors’ diagnoses and assessments.

Changes particularly significant for people with psycho-social disability

As shown in the case studies included in Economic Justice Australia’s submission to the DSP Senate inquiry, the word ‘fully’ as a qualifying adjective before ‘diagnosed’, ‘treated’ and ‘stabilised’ created ambiguity and uncertainty in assessing medical evidence, for a range of reasons:

  • The concept of diagnosis is an absolute – a condition has either been diagnosed, or a diagnosis is pending, or a diagnosis accounting for a person’s symptoms has not been possible.
  • Diagnoses in the light of particular symptoms may change – e.g. bipolar disorder with psychosis, to schizophrenia with psychosis; or bipolar disorder to borderline personality disorder – but the change does not necessarily mean that the current or former diagnosis was invalid or incomplete. Diagnosis of the underlying condition causing physical impairment may also change, e.g. for people with chronic fatigue syndrome, or multiple sclerosis.
  • Treatment for a particular condition may arguably be less than ‘full’ where, for example, a person who has episodes of or ongoing severe psychosis with delusions and paranoia, or depression, cannot or will not adhere to a treatment regime; or where the person’s physical or psychiatric condition is resistant to treatment, and new treatment strategies are tried from time to time.
  • ‘Full’ stabilisation of symptoms associated with a condition may be impossible, especially where instability of symptoms, or the episodic nature of symptoms, is a feature of the condition.
  • Only the person’s treating medical professionals are in a position to make an assessment as to prognosis.

We are hopeful that the simple removal of the ‘fully’ qualifier will lead to a clearer and fairer DSP assessment process.

New EJA Factsheet now available!

To celebrate the new Impairment Tables, which came into force from 1 April 2023, EJA has produced a new DSP factsheet – for recent DSP claimants and also for people appealing rejection of a DSP claim lodged before 1 April. Our new DSP factsheet is available on the EJA website here.