Dr Louise St Guillaume[i], The University of Notre Dame Australia
According to Services Australia, the Disability Support Pension (DSP) is an income support payment available to people with a permanent intellectual, physical or psychiatric condition who are unable to work. Nonetheless, people whose primary impairment is psychiatric experience significant systemic and structural barriers to applying for and receiving the DSP.
Research published in July 2021 by Dr Louise St Guillaume and Jasmine Robertson from The University of Notre Dame Australia in collaboration with Economic Justice Australia and the Welfare Rights Centre New South Wales, found numerous systemic and structural barriers to accessing the DSP for people with a psychiatric condition, resulting in poverty, hardship and injustice.
DSP – the structural barriers to access
Specifically, the requirement that a condition be ‘fully diagnosed’, ‘fully treated’ and ‘fully stabilised’ for the condition to be assigned an impairment rating, disadvantages people with a psychiatric condition. Additionally, the evidence required to support a DSP claim is difficult to gather for people with a psychiatric impairment because they experience barriers to obtaining it. In particular, it is challenging to ensure that the evidence that is gathered complies with the Departmental guidelines administered by Centrelink Job Capacity Assessors and delegates.
Furthermore, for those who appeal rejection of a DSP claim, it is difficult to gather evidence which complies with the Administrative Appeal Tribunal members’ interpretation of what is required under the legislation, as informed by the Department of Social Services policy guidelines and case law. This is concerning because a lack of understanding of the vagaries of evidence by applicants and their doctors can mean that people with a psychiatric impairment have to appeal a denied claim or access an alternative income support payment.
JobSeeker Payment – a viable alternative to DSP?
One of the alternative payments available is JobSeeker Payment. JobSeeker Payment is an income support payment available to people between the ages of 22 and Age Pension age who are looking for work. Statistics published by the Department of Social Services indicate that 39 per cent of people receiving JobSeeker Payment as at September 2021 had a partial capacity to work (373 358 of the 965 632 people). Partial capacity to work refers to ‘activity tested recipients who have an assessed physical, intellectual or psychiatric impairment, which would prevent them from working 30 hours per week’.
Data is not currently publicly available on what percentage of those 39 per cent of people have a primary condition that is psychiatric. However, answers to Parliamentary questions on notice, based on 2020 data, indicate that a psychiatric/psychological condition is the highest primary condition for those receiving JobSeeker Payment who have been assessed as having a partial capacity to work.
JobSeeker Payment is paid at a lower rate than the DSP, and people who receive JobSeeker Payment are ineligible for additional concessions, allowances and subsidies which are available to those on the DSP. This disadvantages people with a psychiatric impairment whose DSP claim has been denied. Additionally, people receiving JobSeeker Payment are expected to uphold ‘mutual obligations’ in order to receive their payment.
Our research shows that these mutual obligations are particularly challenging for people with a psychiatric impairment to meet and comply with. People whose primary condition is psychiatric experience difficulties negotiating job plans, attending appointments, engaging with Centrelink and their employment service provider, and applying for jobs. Data from the Welfare Rights Centre New South Wales shows that over the period 16 December 2018 to 16 December 2020, 36 per cent of their clients who were experiencing a problem with meeting mutual obligations had a mental health condition. These difficulties can result in payment suspension or cancellation. This leads to financial hardship and many people experience an exacerbation of their psychiatric condition.
While in some cases it was found that people were able to obtain a temporary medical exemption from mutual obligation requirements, people with a psychiatric impairment experienced problems negotiating and/or extending temporary medical exemptions. Additionally, requiring that someone provide evidence of ‘temporary’ incapacity can be problematic if they are also trying to access the DSP on the grounds that their psychiatric condition is permanent.
Addressing the barriers – what needs to be done?
These barriers to claiming the DSP and to meeting the mutual obligation requirements for JobSeeker Payment demonstrate how the social security system systematically and structurally disadvantages people with a psychiatric impairment. We need fundamental reform, including:
- Completion of a treating doctor report (TDR) should be reintroduced as a mandatory component of DSP claims, with the TDR a pro forma part of the claim package. Completion of the TDR as part of a DSP claim package should be billable under Medicare, with a new Medicare item number introduced for report completion.
- The Australian Medical Association (AMA) and the Fellowship of the Royal Australian College of General Practitioners (FRACGP) should be consulted about the most effective ways to communicate these guidelines.
- The ‘fully’ qualifier should be removed from references to a condition being ‘fully diagnosed’, ‘fully treated’ and ‘fully stabilised’.
- The DSP program of support requirement applying for people who do not rate at least 20 points on a single DSP Impairment Table should be abolished.
- The policy guidelines should be revised to enable grant of DSP to people with psycho-social disability who are manifestly eligible.
- Additional Commonwealth funding should be granted to enable community legal centres to provide legal advice and advocacy to DSP applicants and appellants.
- Services Australia should consult with national disability peaks to facilitate implementation of the Fifth National Mental Health and Suicide Prevention Plan.
- JobSeeker Payment recipients identified as suffering severe psychiatric impairment and mental distress should be offered support to claim DSP, with referrals to community advocates, particularly where there is a history of suspensions and non-payment penalties.
- A cost of disability allowance should be introduced for people with disability in receipt of JobSeeker Payment or other activity tested income support payments.
Access the full report, BARRIERS TO DISABILITY SUPPORT PENSION ACCESS FOR PEOPLE WITH PSYCHIATRIC IMPAIRMENTS AND THEIR EXPERIENCES ON JOBSEEKER PAYMENT, here
[i] Dr St Guillaume is Lecturer & Discipline Coordinator, Sociology – School of Arts & Sciences, The University of Notre Dame Australia