To get Disability Support Pension we need to assess how your condition affects you.
You need to provide medical evidence from your treating health professionals. We need this to understand how your disability or condition currently affects you and to correctly assess your claim.
When you give us your medical evidence with your claim we’ll initially check if you’re manifestly medically eligible. We check if you:
- are permanently blind
- have a terminal illness with a life expectancy of less than 2 years
- have an intellectual disability with an IQ of less than 70, or
- need nursing home level care
Use the Claim for DSP Medical Evidence Checklist to help you determine the medical evidence you need to submit with your claim.
Fully diagnosed, treated and stabilised
If you’re not manifestly medically eligible, we need to assess if your disability or condition is fully diagnosed, treated and stabilised. We’ll do this by reviewing your medical evidence and usually by talking with you or your treating health professionals.
To decide if your disability or condition is fully diagnosed we assess if:
- a qualified medical professional examined you
- you have medical evidence about your disability or condition
To decide if your disability or condition is fully treated we assess if:
- you’ve received treatment or rehabilitation for the disability or condition
- treatment will continue or you have a plan for the next 2 years
To decide if your disability or condition is fully stabilised we assess if:
- treatment will help you work 15 hours or more a week in the next 2 years, or
- there are medical or other reasons why you can’t receive treatment
If we assess your disability or condition as fully diagnosed, treated and stabilised, we’ll also assess how it affects your ability to function each day. You may need to attend a Job Capacity Assessment to help us assess this using Impairment Tables.
There are 15 Impairment Tables and they’re used to give an impairment rating that helps us assess if you’re eligible for DSP.
You can read more about Impairment Tables on the Department of Social Services website.
In the Job Capacity Assessment we’ll also assess how your disability or condition affects your ability to work.
You may be medically eligible
You may be medically eligible for DSP if your disability or condition stops you from working 15 hours a week or more in the next 2 years and we give an impairment rating of:
- 20 points or more on a single Table, or
- 20 points or more combined across more than 1 Table - if this is your rating, you also need to have completed a Program of Support
After you attend the Job Capacity Assessment, you may also need to attend a Disability Medical Assessment.
You’re not medically eligible
You’re not medically eligible if we assess that your disability or condition:
- isn’t fully diagnosed, treated or stabilised, or
- has an impairment rating of less than 20 points, or
- doesn’t stop you from working 15 hours a week or more a week in the next 2 years
Example 1 – not fully treated
Brian reduced his hours of work due to a bad hip and has claimed DSP. Brian’s medical evidence shows he’s waiting to have his hip replaced. The operation is in 3 months and his doctor says Brian will need another 3 months to recover. His doctor also recently diagnosed Brian with depression. The clinical psychologist who is now treating Brian confirmed the diagnosis and that his condition isn’t stabilised.
We review Brian’s medical evidence and find his hip condition is not fully treated because treatment is ongoing and his operation is likely to improve his condition. As Brian’s conditions are expected to improve within the next 2 years they’re not considered fully treated and stabilised.
Brian isn’t eligible for DSP.
Example 2 – impairment rating of less than 20 points
Natalie is physically fit but has reduced her hours of work due to a mental health condition. She’s received treatment for her condition for many years from her GP and from a clinical psychologist. They both report Natalie’s condition is stable. Natalie’s condition affects her day to day activities. She finds most activities difficult such as relationships, concentration, completing tasks, planning, decision making and full time work.
Natalie attends a Job Capacity Assessment where the assessor gives her a 10 point impairment rating under Impairment Table 5. Natalie’s impairment rating is less than the 20 points needed to be medically eligible.
Natalie isn’t eligible for DSP.