To get Disability Support Pension you need to provide current medical evidence.
We need this to understand how your disability or medical condition affects you, and to assess your claim.
Use the Claim for Disability Support Pension Medical Evidence Checklist to help you work out the medical evidence you need to submit with your claim.
We may assess you as meeting manifest eligibility rules if you are any of the following:
- 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
- have category 4 HIV/AIDS
- need nursing home level care.
If you don’t meet any of those criteria, your disability or medical condition needs to be fully diagnosed, treated and stabilised.
We’ll review your medical evidence to assess this.
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 medical condition.
To decide if your disability or condition is fully treated we assess if:
- you’ve had a medical professional treat you for the disability or medical 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 at least 15 hours a week in the next 2 years, or
- there are medical or other reasons why you can’t get treatment.
First, a medical professional needs to fully diagnose, treat and stabilise your disability or medical condition. We then 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.
We use 15 Impairment Tables to give an impairment rating. This helps us assess if you’re eligible for Disability Support Pension. 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 medical condition affects your ability to work.
You may be medically eligible for Disability Support Pension if:
- your disability or medical condition stops you from working at least 15 hours a week in the next 2 years, and
- we give you an impairment rating of 20 points or more on a single Impairment Table, or
- 20 points or more combined across more than 1 Impairment Table.
You may need to complete a Program of Support if you rate 20 points across more than 1 table.
After you attend the Job Capacity Assessment, you may also need to attend a Disability Medical Assessment.
You’re not medically eligible if we assess that your disability or medical condition:
- needs further diagnosis, treatment or stabilisation, or
- rates less than 20 points when we measure your impairment level, or
- doesn’t stop you from working at least 15 hours a week in the next 2 years.
Example 1 – not fully treated
Due to a bad hip, Brian reduced his work hours and has put in a claim for Disability Support Pension. He’s waiting to have his hip replaced and has medical evidence to show this. The operation’s in 3 months and his doctor says he’ll need another 3 months to recover. His doctor also diagnosed Brian with depression. The clinical psychologist treating Brian confirmed the diagnosis.
We review Brian’s medical evidence and find his conditions aren’t fully treated or stabilised because his treatment is ongoing. The assessor expects Brian will improve within the next 2 years.
Brian can’t get Disability Support Pension.
Example 2 – impairment rating of less than 20 points
Due to a mental health condition, Natalie reduced her work hours. She’s been getting treatment from her doctor and clinical psychologist for many years. They both report Natalie’s condition is stable but she finds most activities difficult such as:
- completing tasks
- decision making, and
- full time work.
Natalie goes to a Job Capacity Assessment where the assessor uses an Impairment Table to give her a 10-point rating. Natalie’s rating is less than the 20 points needed.
Natalie can’t get Disability Support Pension.