Medical evidence for DSP

You need to submit medical evidence if you claim Disability Support Pension (DSP), or have a medical review.

Why we need medical evidence

To help us work out if you can get DSP, we need to know how your condition affects you.

To do this, we need medical evidence from your treating health professionals about your conditions. In most cases, we need evidence for each condition that affects your ability to work.

If you don’t give us medical evidence when we ask you to, we may reject your DSP claim or stop your DSP payment.

If you’re having problems with medical evidence, contact us. We can look at your situation and discuss your options.

Types of medical evidence

You can give us medical evidence such as:

  • medical history records or reports
  • specialist medical reports
  • psychologist reports, including IQ testing
  • special school reports
  • other reports such as physiotherapy or audiology reports
  • medical imaging reports
  • physical examination reports
  • compensation and rehabilitation reports
  • hospital or outpatient records including details of operations

Most conditions need evidence from a health professional, such as your usual treating doctor.

Conditions that may need specialist evidence

Mental health conditions

We need evidence that a psychiatrist or clinical psychologist supports the diagnosis.

Intellectual disability

We need an assessment of intellectual function and adaptive behavior supported by a psychologist. This should include information about your IQ score, or ability to undergo testing. A report from your special school may have this information.

Ear conditions affecting hearing or balance

We need evidence that an audiologist or an ear, nose and throat specialist supports the diagnosis.

Eye conditions affecting vision

We need evidence that an ophthalmologist or ophthalmic surgeon supports the diagnosis.

What we need to know

If you’re claiming DSP, your medical evidence should support what you’ve put in the medical details section of your claim.

The evidence we need to assess your claim or medical review depends on your condition and how it affects you.

In all cases, your medical evidence should:

  • show your diagnosed conditions
  • include the name and contact details of your doctors and specialists
  • be current, usually less than 2 years old

In most cases, we need to confirm all of the information below.

Diagnosis

We need to confirm:

  • the diagnosis of your condition
  • the date of your diagnosis
  • the name and contact details of the doctor or specialist that diagnosed your condition

If you get DSP and we’ve asked you to give us current evidence for a medical review, you may not need to get new evidence confirming diagnosis if you’ve given this to us before.

Contact us to check if you’re not sure.

Treatment

We need to confirm:

  • details of any past, current or planned treatments including if you’re on a waiting list
  • if you need special care, including nursing home level or palliative care

Symptoms

We need to confirm:

  • when the symptoms started (date of onset) – including:
    • the severity, frequency and duration of the symptoms
    • if the symptoms will persist despite treatment and use of aids, equipment or assistive technology

Prognosis

We need to confirm how long your medical condition will last and if it will:

  • improve, stay the same, or get worse
  • affect how long you’ll live

In some cases, we may not need all of this information. Here are some examples:

If you are unable to work because you this information will help us assess your eligibility
have an intellectual disability
  • Psychologist report which shows your IQ and adaptive behavior, or
  • Special school report with the same information
are profoundly disabled and need nursing home level care Evidence from your treating doctor with details of diagnosis, symptoms and what care you need
are terminally ill Evidence from your treating doctor with details of diagnosis, stage of treatment and prognosis

Contact us if you’re not sure what evidence you need to give us.

Your consent

We may need to talk to your treating health professional about your medical evidence. They may ask us to confirm that we have your consent so they can talk to us.

You can do this on the Consent to disclose medical information form. We will show this to your treating health professional if they ask us.

You can also withdraw your consent at any time by contacting us.

Page last updated: 6 June 2017

This information was printed Friday 23 June 2017 from humanservices.gov.au/customer/enablers/medical-evidence-and-assessment It may not include all of the relevant information on this topic. Please consider any relevant site notices at humanservices.gov.au/siteinformation when using this material.