1.1.D.180 Disability medical assessment (DSP)
As part of the DMA a GCD will review the medical evidence provided by a person in support of their DSP claim to verify whether the evidence demonstrates:
- that the medical condition/s are permanent for the purpose of DSP qualification (1.1.P.220), and
- the level of functional impairment resulting from any permanent medical conditions (1.1.I.10).
DMA is conducted by a GCD
Where possible, a DMA will be a face-to-face assessment. As part of the DMA, the GCD will have access to relevant available information about the person including all the medical evidence previously provided in support of the DSP claim.
The DMA will also review the report produced by the job capacity assessor (1.1.J.20), prior to the DSP claim being finalised. The GCD may seek clarification or further medical evidence from a person's treating medical practitioner (1.1.T.160). This may include payment of a fee to the practitioner, where applicable.
DMA by a GCD has been progressively implemented from 1 January 2015, with full implementation from 1 July 2015.
From 1 January 2015 this process was initially limited to people applying for DSP who:
- were aged 35 years or under,
- lived in a capital city, and
- submitted a claim for DSP on or after 1 January 2015.
From 1 July 2015 the DMA process applies to all new DSP claims, unless the claim is covered by the exclusions listed below.
Under DSS policy, a person may be referred for a DMA if they have:
- submitted an application for DSP,
- met the non-medical qualification criteria for DSP, including residential qualification and income and assets tests,
- submitted sufficient medical evidence (1.1.M.100), and
- attended a JCA and their JCA report indicates potential medical eligibility for DSP.
In limited circumstances DSP may be granted without the need for further assessment (126.96.36.199).
A DMA will not be required where the available medical evidence indicates a person is manifestly qualified for DSP, regardless of whether a JCA or any other assessment has been completed.
Policy reference: SS Guide 3.6.1 DSP - qualification & payability