6.2.5.03 DSP - Application of DSP Qualification Rules at Review

Overview

Since 2006, the DSP legislative qualification criteria have undergone a number of changes, mainly to the CITW (1.1.C.330) requirements and associated definitions.

The Impairment Tables (1.1.I.10) were also reviewed in 2011 and the revised (current) Impairment Tables have been in force since 1 January 2012.

This topic explains which DSP impairment and CITW qualification criteria apply at review, dependent on the DSP recipient's start date and other factors. The topic also explains which version of the Impairment Tables is to be used at review.

Act reference: SSAct pre-1 July 2006 section 94(2) A person has a continuing inability to work…

SSAct section 94(2) A person has a continuing inability to work…

Policy reference: SS Guide 3.6.1.10 Qualification for DSP - 30 Hour Rule, 3.6.1.12 Qualification for DSP - 15 Hour Rule

Assessment of impairment at review

At review ALL DSP recipients are assessed against the DSP qualification requirement of having a physical, intellectual or psychiatric impairment of at least 20 points under the Impairment Tables. However, depending on the commencement date of an individual review, either the pre 1 January 2012 or the current Impairment Tables are used at review to assess the recipient's impairment.

Which version of the Impairment Tables applies at review?

The current Impairment Tables (commenced on 1 January 2012) apply to ALL DSP medical reviews, regardless of a recipient's start date on DSP, where a notice to participate in such a review is issued on or after 1 January 2012.

Explanation 1: The current Impairment Tables came into force on 1 January 2012. The SSAct section 27(3) applies to all people in receipt of DSP on or after 1 January 2012, regardless of whether the recipient started receiving DSP before, on or after that date. Under this section, if the Secretary gives a DSP recipient a notice in relation to assessing their qualification for DSP (a review notice), the Secretary must apply the Impairment Tables in force on the day the review notice is given. Therefore, for any reviews where a notice is given on or after 1 January 2012, the applicable Impairment Tables are the current Tables.

Explanation 2: Technically, the pre-1 January 2012 Impairment Tables would apply to medical reviews that commenced before 1 January 2012 and are still undetermined and to appeals arising from such reviews which are still continuing. In practice, however, it is unlikely that decision makers would now encounter any cases of this type.

Act reference: SSAct section 27(3) If a person is receiving DSP…

SSAct pre-1 January 2012 Schedule 1B Tables for the assessment of work-related impairment for DSP

Social Security (Tables for the Assessment of Work-related Impairment for Disability Support Pension) Determination 2011

Policy reference: SS Guide 3.6.3 Guidelines to the Tables for the Assessment of Work-related Impairment for DSP

Assessment of CITW at review - DSP recipients with start date before 11/05/2005

At review, DSP recipients whose start date on DSP is before 11 May 2005 are assessed against the pre-1 July 2006 CITW criteria and definitions, including the 30 hour work capacity rule.

Act reference: SSAct pre-1 July 2006 section 94(2) A person has a continuing inability to work…, section 94(3) In deciding whether or not a person has a continuing inability to work…, section 94(4) For the purposes of subparagraph (…) if a person has turned 55…, section 94(5) In this section…

Policy reference: SS Guide 3.6.1.10 Qualification for DSP - 30 Hour Rule, 3.6.2.110 Assessment of Continuing Inability to Work - 30 Hour Rule

Assessment of CITW at review - DSP recipients with start date from 11/05/2005 to 30/06/2006

These DSP recipients originally qualified for DSP under the 30 hour work capacity rule. Recipients in this group are known as transitional recipients.

At review, these recipients are assessed against the CITW criteria and definitions in force from 1 July 2006, including the 15 hour work capacity rule. The POS requirements do not apply to these recipients.

In practice it is unlikely that decision makers would now encounter any cases in this category that have not already been reviewed.

Act reference: SSAct section 94(2)(a) and (b) A person has a continuing inability to work…, section 94(3) In deciding whether a person has a continuing inability to work…, section 94(4) A person is treated as doing work independently of a program of support…, section 94(5)-'program of support', section 94(5)-'training activity', section 94(5)-'work', section 94(3A) If a person is receiving DSP and the Secretary gives the person a notice under subsection 63(2) or (4)…

SS(Admin)Act section 63 Requirement to attend Department…

Policy reference: SS Guide 3.6.1.12 Qualification for DSP - 15 Hour Rule, 3.6.2.112 Assessment of Continuing Inability to Work - 15 Hour Rule

Assessment of CITW at review - DSP recipients with start date on or after 1/7/2006

At review, ALL DSP recipients whose start date on DSP is on or after 1 July 2006 are assessed against the CITW requirements of being unable to work for 15 hours per week in the next 2 years and being unable to be retrained for such work in the next 2 years (the 15 hour work capacity rule).

However, under the SSAct section 96(1) and (2), from 1 July 2012 DSP recipients may continue to receive DSP if they obtain paid work of at least 15 and less than 30 hours a week notwithstanding that to qualify for DSP they must be assessed as having a work capacity of less than 15 hours a week. This means that if a DSP recipient to whom the 15 hour work capacity rule applied at claim is reviewed and is found working for these hours but is also found not be a reviewed 2008-2011 DSP starter (1.1.R.285), they will be considered to have a CITW.

Explanation: Protection of SSAct section 96(2) does not apply to a DSP recipient from the date the recipient becomes a reviewed starter at (first) review until the person's DSP qualification is next reviewed.

The POS requirements (1.1.P.440) generally do not apply at review unless a DSP recipient is a reviewed 2008-2011 DSP starter. A recipient can only become a reviewed starter if the recipient is under age 35 at review, their start date is between 1 January 2008 and 2 September 2011 and they meet all the other conditions for reviewed starters. The rules applying at review to DSP recipients under age 35 whose start date on DSP is between 1 January 2008 and 2 September 2011 are provided below.

Act reference: SSAct section 96 Continuation of DSP

Policy reference: SS Guide 3.6.1.100 Continuation, variation or termination of DSP

DSP recipients under age 35 years with start date between 01/01/2008 & 31/12/2011

The following rules apply to reviewing DSP recipients who are under age 35 when they are given a review notice (initial review) and whose start date on DSP is between 1 January 2008 and 2 September 2011.

The DSP recipients in this category who are found on review to have a total impairment rating of less than 20 points and/or are found NOT TO meet the CITW criteria of being unable to work for at least 15 hours per week in the next 2 years and being unable to be retrained for work in the next 2 years, do not qualify for DSP and their payment is to be cancelled.

The DSP recipients in this category who are found at review to have a severe impairment (i.e. they are assessed as having an impairment rating of at least 20 points under a single Impairment Table) and meet the CITW criteria of being unable to work for at least 15 hours per week in the next 2 years and being unable to be retrained for such work in the next 2 years, continue to qualify for DSP. The POS requirements do not apply to these recipients.

The DSP recipients in this category who are found at review NOT TO have a severe impairment (i.e. they are assessed as having at least 20 points under the Impairment Tables with no rating of at least 20 points under a single table) and meet ALL OTHER conditions for reviewed 2008-2011 DSP starters in the SSAct section 94(5), will become reviewed 2008-2011 DSP starters for DSP qualification purposes.

Explanation: A DSP recipient under age 35 at the commencement of a review whose DSP start date is between 1 January 2008 and 2 September 2011 (inclusive), who is found at review not to have a severe impairment, can become a reviewed 2008-2011 DSP starter ONLY IF ALL the conditions for reviewed 2008-2011 DSP starters in the SSAct section 94(5) are met. If even one condition is not met, the recipient cannot become a reviewed starter.

The DSP recipients who become reviewed 2008-2011 DSP starters continue to qualify for DSP at least until such time when their DSP qualification is reviewed again (subsequent review) but are required to meet the additional CITW requirement in the SSAct section 94(2)(aa) of undertaking and actively participating in a POS for and within a certain period of time (1.1.A.30).

Explanation 1: If a DSP recipient does not become a reviewed 2008-2011 DSP starter at review (because they do not meet any one of the requirements for reviewed DSP starters in SSAct section 94(5)), the POS requirements in SSAct section 94(2)(aa) do not apply to the recipient.

Explanation 2: Protection of SSAct section 96(2) discussed above under 'Assessment of CITW at review - DSP recipients with start date on or after 1 July 2006' does not apply to DSP recipients from the date the recipient becomes a reviewed starter at review until the subsequent review of their DSP qualification is conducted.

If a DSP recipient under age 35 and start date between 1 January 2008 and 2 September 2011 has their DSP cancelled as a result of the initial DSP qualification review (cancellation decision) and the cancellation decision is subsequently overturned on internal review or on appeal (review decision), and the review decision determines that the person has no severe impairment, the person CAN become a reviewed 2008-2011 DSP starter (upon further assessment by DHS of the person's circumstances) if they meet ALL the other conditions for reviewed 2008-2011 DSP starters in the SSAct section 94(5).

Reviewed 2008-2011 DSP starters will generally have their subsequent review after 36 months of becoming a reviewed 2008-2011 DSP starter. At this review, the reviewed 2008-2011 DSP starters who have had an opportunity to participate will have their CITW reassessed against ALL the CITW criteria in the SSAct section 94(2)(aa), (a) and (b) , including whether:

  • they have actively participated in a POS, and
  • whether they meet the other CITW requirements of being unable to work for at least 15 hours per week in the next 2 years and being unable to be retrained for such work in the next 2 years.

The result of the subsequent review will determine whether these recipients remain qualified for DSP or not. If they are found NOT TO meet the required CITW criteria because they have not actively participated in a POS and/or they do not meet one or more of the CITW criteria in the SSAct section 94(2)(a) and (b), they will not be eligible for DSP.

Act reference: SSAct section 94(2) A person has a continuing inability to work, section 94(3) In deciding whether or not a person has a continuing inability to work…, section 94(4) A person is treated as doing work independently of a program of support…, section 94(5)-'program of support', section 94(5)-'training activity', section 94(5)-'work', section 94(3A) If a person is receiving DSP and the Secretary gives the person a notice under section 63(2) or (4)

SS(Admin)Act section 63 Requirement to attend Department etc

Policy reference: SS Guide 3.6.1.12 Qualification for DSP - 15 Hour Rule, 3.6.2.112 DSP Assessment of Continuing Inability to Work - 15 Hour Rule

Last reviewed: 15 August 2016