1.1.M.100 Medical evidence (DSP, JSP & partial capacity to work)

Definition: DSP, JSP & partial capacity to work

For the purposes of DSP, JSP and determining partial capacity to work (1.1.P.65), medical evidence means corroborating evidence that provides information about a person's medical condition/s (1.1.M.90) and resulting functional impact. This documentation may include, but is not limited to:

• reports, medical records or certificates from medical practitioners including specialists
• reports from health professionals including appropriately qualified health and allied health professionals
• medical history reports
• specialist medical reports
• diagnostic tests, medical imaging reports (such as X-Rays or other imagery)
• results of investigations (such as liver function tests)
• compensation reports
• physical examination reports
• hospital/outpatient records
• operative reports
• rehabilitation reports
• details of any current or planned treatment from a treating doctor or specialist
• results of exercise, cardiac stress, treadmill testing or actimetry linked blood pressure and heart rate monitoring
• results of vision assessments (such as assessments done by an optometrist)
• a report from an allied health practitioner (such as physiotherapist, occupational therapist or exercise physiologist) confirming the functional impairment.

Medical evidence requirements may vary depending on the purpose for which the evidence is collected and used.

For DSP, medical evidence requirements may vary depending on a person's circumstances (3.6.2.10). Generally, medical evidence for DSP must contain sufficient information to determine whether a person's condition is diagnosed, reasonably treated and stabilised (1.1.D.140) and more likely than not, in light of available medical evidence, to persist for more than 2 years. As such, the required primary medical evidence for DSP must contain information about diagnosis, treatment (past, current and future) and prognosis for the condition. For DSP, the Impairment Tables (1.1.I.10) also set out when corroborating medical evidence of a diagnosis is required. In addition, the evidence must also contain sufficient information on the condition's impact on the person's ability to function.

Note: For further information on medical and other evidence for DSP, refer to 3.6.2.10.

For JSP, the primary source of medical evidence is a certificate from a medical practitioner containing information about diagnosis, prognosis and whether the person is incapacitated for their usual work or study, and if so for how long.

For the purpose of determining whether a person has a partial capacity to work because of an impairment, medical evidence is required to contain diagnosis by a medical practitioner of a condition that gives rise to the impairment as well as information about the functional impact of the impairment.