The purpose of this practitioners’ guide is to explain the medical criteria a person must satisfy to qualify for Disability Support Pension (DSP).
The impairment tables
To be eligible for DSP a person must score at least 20 points under the ‘impairment tables’. There are 15 tables which detail the points that may be awarded to a person who has a disability. The tables are designed to assign ratings to determine the level of functional impact of the person’s disability.
For example table 5 relates to ‘Mental Health Function’. It provides that a person may receive points where their disability impacts on activities involving mental health function in areas such as self-care and independent living; social and recreational activities; interpersonal relationships; concentration and task completion; decision making and work training capacity.
Where there is no functional impact on these activities the person will be awarded no points.
Where there is mild functional impact in most of the above mentioned activities five points may be awarded.
Where there is moderate functional impact in most of the above mentioned activities 10 points may be awarded.
Where there is severe functional impact on these activities 20 points may be awarded.
Where there is extreme functional impact on these activities 30 points may be awarded.
The other tables operate in the same manner. Those tables deal with, for example, limb function; spinal function; brain function; functioning relating to drug and alcohol abuse; intellectual function and ear and visual function.
In assessing functional activities Centrelink will look at what the person can do or could do, not what the person chooses to do.
A person may only be awarded DSP where they have a permanent disability. A permanent disability is considered to be a condition that may last for two years or more.
Fully diagnosed, treated and stabilised
Before any points may be awarded under the impairment tables the person’s disability must be fully diagnosed, treated and stabilised. Many DSP applicants have a disability but are awarded no points as it is considered that their disability has not been fully diagnosed treated and/or stabilised.
In determining whether a condition has been fully diagnosed and treated, Centrelink has regard to:
- the evidence to support the claim that the person has a disability;
- what treatment or rehabilitation has occurred; and
- whether treatment is continuing or planned in the next two years.
In relation to whether a disability has been fully stabilised Centrelink has regard to whether the person has undertaken reasonable treatment for the condition and whether any further reasonable treatment is unlikely to result in significant functional improvement.
In applying the tables the information about the person’s condition must be provided by the health professionals specified in the relevant table as well as other medical or work information that is relevant.
For example under table 5 ‘Mental Health Function’ the diagnosis of the condition must be made by an appropriately qualified medical practitioner with evidence from a clinical psychologist, or a psychiatrist.
Program of support
Even where a person has been awarded 20 points they may still not qualify for DSP unless they have actively participated in a Program of Support (POS) or are exempt from this requirement. A person needs to be awarded 20 points under one Impairment Table to be exempt from the POS.
For a person to satisfy the POS rules they must have satisfied one of the following in the three years before they claimed DSP:
- have been in a POS for 18 months;
- have completed a POS;
- were in a POS which was terminated because the person’s medical condition alone meant that continuing would not improve the person’s capacity to find, get or stay in work; or
- were in a POS on the day they claimed the DSP and were prevented, solely because of his or her impairment, from improving his or her capacity to find, gain or remain in employment through continued participation in the POS
The program must be wholly or partly funded by the Commonwealth, unless the person commenced the program before 27 November 2014.
This Guide was prepared by Jessica Raffal at the Welfare Rights Centre NSW.