The Guides to Social Policy Law is a collection of publications designed to assist decision makers administering social policy law. The information contained in this publication is intended only as a guide to relevant legislation/policy. The information is accurate as at the date listed at the bottom of the page, but may be subject to change. To discuss individual circumstances please contact Services Australia.

3.6.2.15 Specialist assessments for DSP

Summary

Job capacity assessors (assessors) can arrange a specialist assessment (1.1.S.260) to complete a JCA report or an ESAt report, where the evidence supplied to the assessor indicates the person may be eligible for DSP, and:

  • the available evidence is unclear or insufficient for the assessor to complete the report
  • the person is unable to obtain or supply additional evidence, and
  • the assessor is unable to obtain the necessary additional information or clarification from the person's treating doctor/s (1.1.T.160), THP, the Services Australia HPAU (1.1.H.60) or contributing assessors.

A specialist assessment may be conducted internally by an appropriately qualified assessor (including the assessor preparing the JCA/ESAt report), or by an appropriately qualified external medical or allied health professional.

A specialist assessment is generally scheduled after the JCA appointment, once the assessor establishes that a specialist assessment is required. In exceptional circumstances, a specialist assessment may be conducted at the time of the JCA appointment where the assessor establishes that a specialist assessment is required prior to or at the time of the assessment and the person provides informed consent. Clinical assessments which are able to be completed during the JCA and where no specialist report is produced are not considered specialist assessments.

Example:

The assessor conducts … This is …
a Beck Depression Inventory as part of the JCA to measure the severity of a person's depression, a separate report is not produced. not a specialist assessment. It is a clinical assessment which is adding value to the JCA and may help to inform a referral to a GP.
an assessment of a person's psychological well-being and functioning including mood status, substance use, clinical conditions and personality, if the assessor is a Services Australia psychologist. This is completed separately to the JCA and a separate report is produced. a specialist assessment.
a measurement of range of movement as part of the JCA if the assessor is an occupational therapist, physiotherapist or exercise physiologist and the information is captured in the assessment summary in the JCA report. not a specialist assessment it is considered to be a test which is adding value to the JCA.
a comprehensive assessment of a person's functional capacity, to provide specific information to clarify the impact of physical conditions. This is completed separately to the JCA by an assessor with appropriate qualifications and a separate report is produced. a specialist assessment.

A specialist assessment should only be arranged where:

  • comprehensive evidence has been provided to the assessor (that is, a medical report - DSP or a combination of other documentation containing equivalent information) but clarification or additional information is required and cannot be obtained by any other means, or
  • the assessor observes or suspects that a person has an intellectual disability, acquired brain injury or psychological/psychiatric disorder and there is no evidence of diagnosis or treatment as the person lacks insight into (or does not acknowledge) the condition or is otherwise incapable of independently engaging in medical services to obtain the required information, or
  • Services Australia Legal Services considers a specialist assessment is required with respect to an appeal to the AAT (or the Federal or High Court).

Explanation: Assessors should refer to the preamble of the appropriate Impairment Table in deciding whether a Specialist Assessment is required.

Type of assessment Use of specialist assessments Suitable specialist assessor
Standard ESAt Not appropriate to use. -
Medical ESAt Generally not appropriate to use. Can be used where the person has a suspected undiagnosed intellectual/learning disability, mental health condition or an acquired brain injury (ABI).

Or when it is not possible for an assessor, without specialist input to:

  • establish the likelihood a condition and resulting impairment will persist for more than 2 years
  • diagnose a medical condition that is likely to impact on a job seeker's capacity for work or eligibility for participation in employment services, or
  • gauge the likely impact of a medical condition on a person's ability to work or participate in employment services.
 Appropriately qualified medical and allied health professional. May be internal or external.
Potential DSP recipient with suspected mental health condition May be used where the person has no or little insight or capacity to engage with appropriate medical services and medical evidence is not available or is insufficient. Services Australia psychologist (3.6.2.10).
DSP new claim/medical review Generally it is the claimant's responsibility to provide medical evidence to support their claim.

However, it may be appropriate to refer vulnerable claimants to a specialist assessor where it is suspected that they have:

  • an undiagnosed intellectual/learning disability or ABI
  • an undiagnosed mental health condition and are living in a remote community with little or no access to health services, or
  • an undiagnosed mental health condition and have little or no insight into their condition or lack capacity to access or effectively engage with appropriate medical services.
 Appropriately qualified medical and allied health professional. May be internal or external.
Original decision maker reconsideration or ARO review of DSP rejection or cancellation Generally it is the claimant's responsibility to provide additional medical evidence to support their request.

It may be appropriate to refer to a specialist assessor for suspected undiagnosed conditions, such as, intellectual/learning disability, mental health conditions or ABI.

 Appropriately qualified medical and allied health professional. May be internal or external.
DSP appeals case (AAT or Federal Court) Expert medical specialist assessment may be appropriate (for example, psychiatrist, neuro-psychiatrist, occupational physician, orthopaedic surgeon). This can only be approved and arranged by staff in Services Australia Legal Services (Advocacy). Usually sourced through an external provider.

Policy reference: SS Guide 3.6.2 Assessment for DSP, 3.6.2.10 Medical & other evidence for DSP

Last reviewed: