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.

3.6.3.01 Guidelines to the rules for applying the Impairment Tables - purpose & design of the Tables

Summary

This topic provides guidance on Part 2 of the Social Security (Tables for the Assessment of Work-related Impairment for Disability Support Pension) Determination 2023 (the Determination), which sets out rules that are to be complied with in applying the Impairment Tables. This topic has headings emphasising significant principles and concepts contained in that part of the Determination. It also provides guidance on the concepts and practical application of the DSP eligibility criteria contained in the SSAct.

This topic does not restate the definitions contained in Part 1 of the Determination. These definitions are to be accessed directly from the Determination.

Act reference: Social Security (Tables for the Assessment of Work-related Impairment for Disability Support Pension) Determination 2023 Part 1 - Preliminary, Part 2 - Rules for applying the Impairment Tables

Purpose & design of the Impairment Tables

Unless otherwise authorised by law, the Impairment Tables are used to determine whether a person whose qualification for DSP is being considered, meets a qualifying impairment threshold stipulated in the SSAct. No other use of the Impairment Tables is currently authorised.

This determination is made by assessing the level of functional impact of a person's impairment and assigning an impairment rating corresponding to the identified level of impact.

To qualify for DSP, a person must have, among other things, a physical, intellectual or psychiatric impairment assessed as 20 points or more under the Impairment Tables. A person is considered to have a severe impairment if they have 20 points or more under a single Impairment Table.

A person must also have a CITW (1.1.C.330) - that is, they must be unable, because of the impairment, to do any work of at least 15 hours per week independently of a POS (1.1.P.440) in the next 2 years (see below for definition of a POS), or be trained or re-skilled for such work within the next 2 years. To meet the CITW requirements, a person whose impairment is not assessed as severe, must have also actively participated in a POS.

Act reference: Social Security (Tables for the Assessment of Work-related Impairment for Disability Support Pension) Determination 2023 section 7 Purpose and design of the Tables

Impairment & continuing inability to work

The determination of an impairment rating and the assessment of CITW are 2 separate assessments based on 2 different DSP qualification criteria. When assessing qualification for DSP, the requirement for a person to have a minimum qualifying impairment rating of 20 points or more and the requirement for a person to have a CITW, must both be met and are of equal importance.

Being assigned an impairment rating of 20 points or more does not mean a person qualifies for DSP, but merely indicates the impairment-related DSP qualification criterion has been satisfied.

Being assigned this rating does not mean a person will be unable to do any work of at least 15 hours per week in the next 2 years. What it does mean is a person's impairment may have a significant functional impact in many work situations. However, depending on their individual circumstances, coping mechanisms and reasonable adjustments by an employer, that person may still be able to work.

Example 1: A person is assessed as having an impairment rating of 20 points under Table 14 - Functions of the Skin, because they have severe difficulties performing tasks involving exposure to sunlight due to heightened sensitivity resulting from extensive skin grafts to their upper limbs. Also, this person is not able to wear clothing required in the workplace, such as protective gloves, because of sensitivity of their hands. While this person must avoid exposure to sunlight and cannot wear gloves or other protective equipment on their hands, they may be able to do work that does not involve such exposure or protective equipment. For instance, they may be able to perform clerical tasks and have their desk located away from windows.

Example 2: A person has sustained brain and spinal injuries in a motor vehicle accident. Their impairments are assessed at:
  • 10 points under Table 4 - Spinal Function (as they can drive a car for at least 30 minutes, but they are unable to bend forward to pick up light objects placed at knee height), and
  • 10 points under Table 7 - Brain Function (as they have moderate difficulty solving some day to day problems and may need help from another person occasionally, but less than once per day).

This person therefore meets the minimum impairment threshold of 20 points and is unable to do work that requires lifting objects and solving certain problems without assistance. However, they may be able to undertake work that does not involve lifting, but involves routine repetitive tasks, such as processing simple forms or data entry.

Summary of key medical & work capacity qualification requirements for DSP (as per SSAct section 94 (1)(a), (b), (c)(i) & (ii))

A person has a physical, intellectual or psychiatric impairment, and their impairment is rated at 20 points or more under the Impairment Tables, and they have a CITW, or they are participating in the supported wage system.

CITW criteria are met when:

  1. in cases where
    1. a person's impairment is NOT a severe impairment, or
    2. a person is a reviewed 2008-2011 DSP starter who has had an opportunity to participate in a POS
    3. they have actively participated in a POS and the POS was wholly or partly funded by the Commonwealth, and
  2. in all cases, the impairment is sufficient to prevent a person from doing any work independently of a POS within the next 2 years, and
  3. in all cases, either
    1. the impairment is sufficient to prevent a person from undertaking a training activity during the next 2 years, or
    2. if the impairment does not prevent a person from undertaking a training activity - such activity is unlikely to enable a person to do any work independently of a POS within the next 2 years.

Severe impairment

Severe impairment means a person has an assessed impairment of 20 points or more under the Impairment Tables, of which 20 points or more are assigned under a single Table. To have a CITW, DSP claimants with a severe impairment are not required to have actively participated in a POS but still need to meet the remaining CITW criteria listed above in dot points 2 and 3.

A person who does not have 20 points assigned under a single Table is not considered as having a severe impairment, even if their total impairment rating is 20 points or more from multiple Impairment Tables.

They are therefore required to have actively participated in a POS as part of the CITW requirements. If a person does not meet the POS criterion, they do not have a CITW and their claim must be rejected. If a person meets the POS requirement, to be considered to have a CITW, they must also meet the remaining CITW criteria in dot points 2 and 3 above.

Reviewed 2008-2011 DSP starter

A reviewed 2008-2011 DSP starter means a person who meets all the following conditions:

  • the person made a claim for DSP before 3 September 2011 and was granted the payment on or after 1 January 2008
  • on or after 1 July 2014 the person was legally notified their DSP qualifications would be reviewed
  • at the time of being so notified the person was under age 35
  • before the person was notified of the review, they had an assessed and recorded work capacity to work for at least 8 hours per week or they had no recorded work capacity at all
  • as a result of the review it is determined the person
    • does not have a severe impairment
    • has a capacity to work for at least 8 hours per week, and
  • the person does not have a dependent child under 6 years of age.

POS

Active participation in a POS is assessed under provisions of the Social Security (Active Participation for Disability Support Pension) Determination 2014.

Independently of a POS means a person:

  • is unlikely to need a POS
  • is likely to need a POS provided occasionally, or
  • is likely to need a POS that is not ongoing.

POS means a program designed to assist persons to prepare for, find or maintain work and is funded (wholly or partly) by the Commonwealth or is of a type similar to such a program.

Work means work that is for at least 15 hours per week, at or above the relevant minimum wage and exists (anywhere) in Australia, even if not within the person's locally accessible labour market, regardless of whether vacancies exist.

Act reference: Social Security (Active Participation for Disability Support Pension) Determination 2014 section 7 Requirements for active participation

Conceptual design model of the Impairment Tables

The Impairment Tables are function-based rather than condition or diagnosis-based. They assess the functional impact of conditions on activities related to work performance, and impairment ratings are assigned consistent with the identified level of impact.

The basis for understanding the concept and design of the Impairment Tables as being function-based rather than condition or diagnosis-based, lies in a distinction between the concepts of conditions and impairments. The distinction between a condition and an impairment is therefore necessary.

Note 1: Condition is defined in the instrument as a diagnosed medical condition or disorder.

Note 2: Impairment is defined in the instrument as a loss of functional capacity affecting a person's ability to work that results from the person's condition.

Understanding the difference between a condition and an impairment, and selecting an appropriate Table for assessment, is crucial to avoid double counting an impairment (assigning 2 ratings for one impairment on one or more Table/s). Assessors must identify when a single condition may result in a number of discrete functional impairments assessable under more than one Table and equally, when a number of conditions may cause a combined functional impairment, appropriately assessable under a single Table. See 3.6.3.06. Also, see section 'rating multiple conditions with common impairments & double counting' on 3.6.3.06.

Each person's level of impairment must be assessed on an individual basis to account for the varying spectrum of severity and stability that can occur with medical conditions. It must not be assumed that all individuals with the same condition or diagnosis will have the same level of impairment.

Explanation: Two individuals with the same condition, 'below knee amputation of the left leg' may not necessarily have the same impairment rating assigned under Table 3 - Lower Limb Function, even though they share the same diagnosis. This is because it is the level of functional impairment rather than their condition that is assessed under the Impairment Tables. While one person may experience mild pain and have mild difficulties completing tasks due to adapting well through the use of an assistive device, another may have severe pain following amputation and have severe difficulties tolerating any weight bearing, resulting in them needing assistance to undertake daily activities.

Consistent with the function-based approach, the Impairment Tables describe functional activities, abilities, symptoms and limitations that must be taken into consideration when assessing the level of impact of impairments.

Each individual Table contains a set of rules that must be followed when applying that specific Table. Typically, these rules are set out in the introduction to each Impairment Table and:

  • specify the area of function to which that Impairment Table should be applied
  • specify which appropriately qualified medical practitioner/s can diagnose conditions causing functional impairment to be assessed under that Impairment Table
  • instruct that self-report of symptoms (by a person who is being assessed) must be supported by corroborating medical evidence of their impairment in order to assign an impairment rating
  • provide examples of corroborating evidence that can be taken into account when applying that Impairment Table, and examples of who can provide it, and
  • where appropriate, an indication of conditions commonly associated with an impairment assessable under that Table.

Policy reference: SS Guide 3.6.3.06 Guidelines to the rules for applying the Impairment Tables - selecting the applicable Table & assessing impairments

Scaling system & descriptors

The Impairment Tables have been designed to be consistent where possible with the World Health Organization International Classification of Functioning, Disability and Health (WHO ICF), 2001.

Each Table contains descriptors which describe the level of functional impact of the impairment assessable under that Table. The first line of each descriptor (formatted in italics) describes the level of impact of the impairment.

In all Tables, each level of functional impact has a corresponding rating expressed in points in accordance with a consistent, generic scale that has been adapted from the WHO ICF.

The rating system is standardised across the Tables as follows:

  • no or minimal functional impact equals an impairment rating of 0 points
  • mild functional impact equals an impairment rating of 5 points
  • moderate functional impact equals an impairment rating of 10 points
  • severe functional impact equals an impairment rating of 20 points, and
  • extreme functional impact equals an impairment rating 30 points.

After the introduction each Table is divided into two columns. The first column sets out impairment ratings under the heading 'Points'. The second column sets out the level of impact of the impairment to be identified by the level of functional activity, abilities, symptoms and limitations contained in the criteria of the descriptors.

The Tables also contain examples of the application of the descriptors. These examples are illustrative only, and are not binding or exhaustive. It is the criteria of the descriptors themselves that must be considered.

While the Impairment Tables are designed to assess the level of a person's impairment in relation to their capacity to perform work-related tasks and activities, the Impairment Tables acknowledge some people being assessed for DSP purposes may have no work history and experience. This is addressed by including references to general activities of daily living in the descriptors.

Each impairment rating level specifies how it is to be met. For example, a rating may specify at least 1, 2, 3 or 4 of the descriptors must be met.

Note: The 2011 Tables used the term 'most' to describe how many descriptors must be met at each impairment rating level. Under the 2023 Tables, most has been replaced with a numeric value to clarify the number of descriptors required.

Example: Under Table 2 – Upper Limb Function, for the 5-point rating to be assigned to a person, the person must meet at least 3 of the criteria in paragraphs (1)(a), (b), (c) or (d). The requirement to meet most has been replaced with the numeric value of 'at least 3'.

Additionally, individual activities, abilities, symptoms and limitations specified in the descriptors may contain terms indicating increasing levels of difficulty in performing certain activities or frequency of symptoms experienced, such as ‘occasionally’, ‘frequently’, ‘often’, ‘sometimes’, and ‘regularly’.

Example: Table 15 - Functions of Consciousness:

  • under 5 points, infrequent episodes of involuntary loss of consciousness or episodes of altered state of consciousness are defined as occurring no more than twice per year, and
  • under 30 points, frequent episodes of involuntary loss of consciousness are defined as occurring at least once each week and frequent episodes of altered state of consciousness are defined as occurring most days.

Note: Unless specifically defined in individual Impairment Tables (for example, Table 15 - Functions of Consciousness), terms such as occasionally, frequently, often, sometimes, and regularly etc., have their ordinary meaning. Please refer to 3.6.3.08 for more explanation on the significance of these terms in the context of the hierarchy of descriptors.

Act reference: Social Security (Tables for the Assessment of Work-related Impairment for Disability Support Pension) Determination 2023 section 7 Purpose and design of the Tables, Table 3 - Lower Limb Function, Table 4 - Spinal Function, Table 7 - Brain Function, Table 14 - Functions of the Skin, Table 15 - Functions of Consciousness

Policy reference: SS Guide 3.6.3.20 Guidelines to Table 2 - Upper Limb Function, 3.6.3.150 Guidelines to Table 15 - Functions of Consciousness, 3.6.3.08 Guidelines to the rules for applying the Impairment Tables - assigning an impairment rating

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