How we assess your claim

When you claim Disability Support Pension (DSP), we assess if you meet both non-medical and medical rules.

You must continue to meet all the non-medical and medical rules. Remember to let us know if any of your circumstances change.

Steps in assessing your claim

1. We assess non-medical rules

We review the information you give us with your claim to check if you meet non-medical rules. This includes your financial situation, residency and age.

If you don’t meet all non-medical rules you can’t get DSP. You may be able to get other payments.

2. We assess manifest medical rules

We review the medical evidence you give us with your claim to check if you meet the manifest medical rules.

We may talk to your treating doctors and other health professionals about your medical evidence.

If you meet manifest medical rules, there is no further medical assessment.

If you don’t meet manifest medical rules, we’ll check if you meet general medical rules.

3. We assess general medical rules

We review the medical evidence you give us in your claim to check if you meet the general medical rules. We’ll do this if you don’t meet manifest medical rules.

We assess if your condition is fully diagnosed, treated and stabilised and unlikely to improve with further treatment.

We check if the impact of your condition:

  • will last more than 2 years
  • rates at least 20 points on the Impairment Tables
  • will stop you working at least 15 hours a week in the next 2 years, even with training.

We also check if you meet Program of Support rules, if these apply to you.

We may ask you to go to both a Job Capacity Assessment and Disability Medical Assessment. If you have any new evidence you haven’t already given us, you can bring it to these appointments.

We may talk to your treating doctors and other health professionals about your medical evidence.

If you don’t meet either the manifest or general medical rules, you’re not medically eligible. This means you can’t get DSP. You may be able to get other payments.

4. We let you know the result of your claim

We assess if you can get DSP and let you know the result of your claim. We'll send a letter to explain our decision to your preferred type of communication. This could be one of the following:

If you don’t meet all the medical and non-medical rules we’ll reject your claim. If we reject your claim, we will try to call you to explain why. We’ll also write to you. You need to keep your contact details up to date so we can contact you.

One of our Service Officers will call you to explain:

  • the reason for our decision
  • your options if you don’t agree with our decision.

We can also provide referrals to other services such as Disability Employment Services if you’re eligible.

If you are still unsure, you can contact us to ask for more information about our assessment, including:

  • a copy of your medical assessment
  • why you don’t meet DSP eligibility.

If you think we’ve made a mistake you can ask us to review our decision.

If your situation changes, and you think you may now be eligible for DSP, you can submit a new claim. Read about who can get it and what to do before claiming DSP again.

If you get DSP, you’ll need to meet your obligations to keep getting the payment. Read more about how to manage your payment.

Page last updated: 5 September 2019