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We know that navigating the DSP system can be tricky and confusing. In this post, we focus on some of the ‘medical rules’ that apply to the DSP. There has been a recent change to these rules that occurred in April 2023. To help you understand this change and how it applies to the way a medical condition is assessed, we’ve broken it down for you below.
One of the eligibility criteria for DSP, looks at how medical conditions are assessed and ‘medical rules’, of which there are two classes – ‘Manifest medical rules’ and ‘general medical rules’. In order to be eligible for the DSP, one of these two rules MUST be satisfied.
Manifest Medical rules
Some conditions, such as permanent blindness or having a terminal illness with a life expectancy of less than two years are classified under the ‘manifest medical rules’. These are a list of specific conditions which mean that a person may be eligible for the DSP based on their presenting medical evidence, without the need to undergo any further assessment of their conditions by Services Australia.
A full list of these conditions can be found here: https://www.servicesaustralia.gov.au/manifest-medical-rules-for-disability-support-pension?context=22276
General Medical rules
If the condition is NOT one considered under the ‘manifest medical rules’, then the ‘general medical rules’ will apply.
Under these rules, there are a number of different assessment criteria that need to be met, one of which, requires that a medical condition is given a specific ‘impairment rating’ (a number of points usually between 0 and 30). The higher the number, the greater the severity and functional impact.
The way a condition is given an ‘impairment rating’, is by being assessed against the ‘Impairment Tables’. These tables work by giving specific examples of how a condition might impact someone’s life and functioning in order to determine its severity. The tables are broken down into different areas such as lower limb function’ and ‘mental health function’.
However, before a condition can even be given an ‘impairment rating’ under these tables, it has to meet certain criteria which we talk more about in the next section.
Changes to the Impairment Tables
Prior to April 2023, in order for a medical condition to even be given an ‘impairment rating’ under the tables, it would need to be a condition that was ‘fully’ treated, diagnosed and stabilised.
This could at times be a complex criteria to satisfy, if, for example, a person had a number of different treatment options available, but they had only tried some of them, or if a condition fluctuated and was worse on somedays than others meaning that it was not considered ‘fully stablised’. This would mean that for some people, they would not be able to get an impairment rating at all, as their condition would not even reach the point of being able to be assessed under the ‘Impairment Tables’.
Recently, there has been a change. The new change removes the word ‘fully’, making the criteria clearer in that now a condition only needs to be ‘treated, diagnosed and stablised’ in order to be given a required Impairment rating.
With these changes, it is hoped that the DSP will become more accessible to those who need it most and that the application process will be clearer.
Remember, Centrelink issues ARE legal issues. If you or someone you know have any questions about this change or about the DSP in general, please contact us for an appointment.
Further information on all of the eligibility criteria for the DSP can be found on the Economic Justice Australia fact sheet by clicking on ‘Disability Support Pension’ here: https://www.ejaustralia.org.au/self-help/
‘DSP Help’ is great tool to help summarise DSP eligibility and your options as well as having a chat bot function that can give you a DSP ‘personalised medical evidence kit’ that sums up the medical evidence you need to support your application. It can be located here: https://dsphelp.org.au/
