3.6.5.60 Assessment of SA

Summary

Assessment of SA is based on medical evidence (1.1.M.100) from the recipient's treating doctor. This topic describes the following assessment issues for SA:

  • the need to provide medical evidence,
  • which medical certificates are acceptable, and
  • validation of medical certificates.

Recipient to provide medical evidence

A claim for SA must be supported by a certificate from a medical practitioner on the approved form, stating:

  • the practitioner's diagnosis (name or description of the condition), AND
  • the practitioner's prognosis, AND
  • that the recipient is incapacitated for work, AND
  • the period for which the recipient is incapacitated for work.

A certificate which is not on the approved form can be accepted in the circumstances described in the table below.

If… Then…
all of the necessary information is included, the certificate can be accepted.
some of the necessary information is missing, contact the doctor to obtain it.
  • some of the necessary information is missing, BUT
  • the delegate is satisfied that the recipient is incapacitated for work,
  • the delegate has the discretion to accept the certificate, BUT
  • a written determination is required.

Acceptable medical certificates

Certificates can only be accepted from a person who is registered and licensed as a medical practitioner under a state or territory law.

Examples: Certificates from the following practitioners are NOT acceptable: naturopaths, osteopaths, homeopaths, iridologists, reflexologists, chiropractors, acupuncturists, hypnotherapists, podiatrists, optometrists, and physiotherapists.

Act reference: SSAct section 669 Time limit on qualification for SA, section 94 Qualification for DSP

Policy reference: SS Guide 3.6.1 DSP - Qualification & Payability, Part 6 Reviews & Payment Recovery

Last reviewed: 12 August 2013