Medical evidence

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

Why we need medical evidence

We need to know how your disability or medical condition affects you. This will help us work out if you can get DSP.

We need medical evidence from your treating doctors or other health professionals. In most cases, we need current evidence for each condition that affects your ability to work.

Give us all your medical evidence with your claim so we can assess it faster. It should support what you’ve put in the medical details section of your claim form.

If you don’t give us evidence, we may either:

  • reject your claim
  • stop your payment.

If you’re having problems getting evidence, call us. We can talk with you about your options.

What we need to know

Your medical evidence should tell us:

  • your diagnosed disability or medical conditions
  • past, current and planned treatment
  • how your condition impacts you day to day
  • the names and contact details of your treating doctors.

Your symptoms

This helps us know:

  • when the symptoms started
  • how often and for how long the symptoms happen
  • the impact of your conditions with treatment and use of aids, equipment or assistive technology.

Your prognosis

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

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

What types of medical evidence you need to give us

The evidence we need depends on your disability or medical condition. For some conditions or situations we need particular information.

Manifest medical rules

So we can assess if you meet the manifest medical rules, you need to give us specific medical evidence.

Your condition or situation Medical evidence we need
You are permanently blind

Either:

You require nursing home level care

Details from your treating doctor that shows your diagnosis and symptoms, including how your condition impacts you day to day.

You also need to provide details of the level of care showing both:

  • why you need this level of care
  • how long you need this care.
You have an intellectual disability with an IQ of less than 70

Either:

  • a psychologist assessment of your intellectual function and adaptive behaviour
  • a special school report with the same information.

The evidence you provide must include information supported by a psychologist about your IQ score or your ability to undergo IQ testing.

You are terminally ill with an average life expectancy of less than 2 years

Details from your treating doctor that shows your diagnosis, the stage of the condition, treatment details, and prognosis.

You have Category 4 HIV/AIDS Details from your treating doctor of your diagnosis, the stage of the condition, treatment details, and prognosis.
You get a Department of Veterans’ Affairs special rate disability pension (totally and permanently incapacitated)

Special Rate Disability Pension letter from the Department of Veterans’ Affairs.

You can give us permission to ask the Department of Veterans’ Affairs for the same information.

General medical rules

To help us assess if you meet the general medical rules, you can give us evidence such as:

  • medical history records or reports
  • specialist medical reports
  • psychologist reports, including IQ testing
  • medical imaging reports, but not films or CDs
  • physical examination reports
  • hospital or outpatient records including details of operations
  • compensation and rehabilitation reports
  • special school reports
  • other evidence such as physiotherapy or audiology reports.

For some conditions we need specialist medical evidence.

Your condition Specialist medical evidence we need Why we need this

Mental health conditions

Evidence showing if either:

  • a psychiatrist diagnosed your condition
  • a clinical psychologist supports your treating doctor’s diagnosis.

This helps us assess your condition on Table 5 of the Impairment Tables.

We can only do this where the condition is fully diagnosed, treated and stabilised.

Intellectual disability

Evidence showing an assessment of intellectual function and adaptive behaviour by a psychologist.

This helps us assess your condition on Table 9 of the Impairment Tables.

We can only do this where the condition is fully diagnosed, treated and stabilised.

Ear conditions affecting hearing or balance

Evidence showing both:

  • the diagnosis has been made by a qualified medical practitioner
  • an audiologist or an ear, nose and throat specialist supports the diagnosis.

This helps us assess your condition on Table 11 of the Impairment Tables.

We can only do this where the condition is fully diagnosed, treated and stabilised.

Eye conditions affecting vision

Evidence showing an ophthalmologist or ophthalmic surgeon supports the diagnosis.

This helps us assess your condition on Table 12 of the Impairment Tables.

We can only do this where the condition is fully diagnosed, treated and stabilised.

How to give us the correct medical evidence

Use the Claim for Disability Support Pension Medical Evidence Checklist. It will help you work out what medical evidence you need to submit with your claim.

Your treating health professional can use the Medical Evidence Checklist for treating health professionals form. This helps them to check your evidence includes the information we need about your condition.

Call us if you’re not sure what evidence we need from you.

Your consent

We may talk to your treating health professionals. They may ask us if you agree to them giving us information.

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

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

Page last updated: 28 August 2019

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