1.1.D.140 Diagnosed, reasonably treated & stabilised (DSP)

Definition

For the purposes of DSP, the Impairment Tables (1.1.I.10) can only be applied when a person has a condition which is diagnosed, reasonably treated and stabilised; resulting in an impact on the person's ability to function (including zero impact) which is expected to persist for more than 2 years.

The diagnosis of the condition causing the impairment must be made by an appropriately qualified medical practitioner. This includes a GP or other non-GP specialist such as a cardiology, respiratory, rheumatology or other specialist physician.

In determining whether a condition has been diagnosed by an appropriately qualified medical practitioner it must be considered whether there is corroborating evidence of the condition, as set out in the requirements of each Table.

It must also be determined whether a condition has been reasonably treated, and the following is to be considered:

• what treatment or rehabilitation has occurred in relation to the condition, and
• whether treatment is continuing or is planned in the next 2 years and is likely to result in significant functional improvement.

A condition is stabilised if:

• either the person has undertaken reasonable treatment for the condition and any further reasonable treatment is unlikely to result in significant functional improvement, or
• the person has not undertaken reasonable treatment for the condition and
  • significant functional improvement is not expected to result, even if the person undertakes reasonable treatment, or
  • there is a medical or other compelling reason for the person not to undertake reasonable treatment.

The term ‘significant functional improvement’ is defined in the instrument as improvement that is likely to enable the person to undertake work in the next 2 years.

There may be medical and or other compelling and acceptable reasons for not proceeding with reasonable treatment, such as a person’s religious or recognised cultural beliefs prohibiting treatment, or where the person lacks insight or the ability to make appropriate judgements due to their condition. See 3.6.3.02 ‘Reasonable treatment & compelling reasons for not undertaking reasonable treatment’.

The criteria for treatment is interrelated to the criteria for stability, required of conditions for the Impairment Tables to apply.

Note: For more information on the requirements regarding diagnosis, treatment and stabilisation in applying the Impairment Tables, refer to 3.6.3.02 Guidelines to the rules for applying the Impairment Tables - applying the Tables.

Note: A condition may last for more than 2 years, but the impairment resulting from that condition may be assessed as likely to improve or cease within 2 years. If this is the case, an impairment rating cannot be assigned to the impairment.

Rules pre 1 April 2023

Prior to 1 April 2023, for the Impairment Tables to be applied, a person’s medical condition was required to be fully diagnosed, fully treated and fully stabilised. The condition and resulting impairment also had to be likely to persist for more than 2 years. This criteria was defined as ‘permanent’.

From 1 April 2023 the term permanent is no longer used to describe a medical condition.

Permanent, for the purposes of DSP, did not use the plain English meaning. That is, a permanent medical condition did not necessarily mean a condition is lifelong or incurable. The condition could only be considered permanent, the Impairment Tables applied and an impairment rating allocated, if, in light of the available corroborating evidence, it was determined that:

• a person's medical condition was fully diagnosed by an appropriately qualified medical practitioner, fully treated and fully stabilised, and the impact of the impairment was expected to persist for more than 2 years, and
• this condition resulted in an impact on a person's ability to function (impairment).