7.2.1.30 Medical assessment for DSP
Summary
From 1 January 2015 portability for DSP recipients is limited to 4 weeks in a 12-month period (7.1.2.20). However, different rules apply to DSP recipients who are:
- considered to have a permanent and severe impairment (1.1.S.127) and no future capacity to work, or
- considered to be terminally ill (3.6.2.20) and severely disabled (1.1.S.110), or
- covered by an international social security agreement (1.1.A.120).
DSP recipients who are severely impaired & with no future work capacity
DSP recipients with a permanent and severe impairment and no future capacity to work are eligible for indefinite portability of their pension. DSP recipients applying for portability under these provisions are required to undergo a portability assessment which includes an assessment of their impairment and their future work capacity (JCA) before departure. As part of this assessment, a DSP recipient is required to provide medical information.
Generally, recipients must be in Australia in order to apply for indefinite portability under these provisions (and undergo a portability assessment). Recipients who are overseas will generally need to return to Australia to apply, unless they are unable to return to Australia because they have had a serious accident, or been hospitalised, before the end of their current portability period.
Act reference: SSAct section 94(3B) Severe impairment, section 1218AAA Unlimited portability period for DSP-severely impaired disability support pensioner
Policy reference: SS Guide 7.1.1.10 Overview of portability legislation, 7.1.2.10 General rules of portability, 7.1.2.20 Application of portability rules (portability table)
DSP recipients who are severely disabled & have a terminal illness
DSP may be payable overseas indefinitely if a recipient is assessed under the SSAct section 23(4B) as severely disabled, is terminally ill and the purpose of going overseas is to be with or near a family member or to return to their country of origin.
If a recipient may be eligible for indefinite portability under these provisions (i.e. they are terminally ill and severely disabled), this should be ascertained before they leave Australia. The recipient needs to provide relevant medical information before their departure if they are intending to travel overseas for more than 4 weeks.
If a recipient is not terminally ill at the time of leaving Australia, but becomes terminally ill during the 4 week absence, the pension may be portable indefinitely once the recipient has provided medical evidence.
Note: If a recipient has provided medical information but is not considered to be severely disabled and/or terminally ill and remains unable to return to Australia, they may be able to make use of discretionary provisions in the SSAct section 1218C to extend their portability period.
Departure before medical information available
In some cases where medical information required to determine indefinite portability is not available before departure, DSP may still be paid after departure, provided the person is eligible for general portability (1.1.P.310). DSP will stop when the 4 weeks general portability has expired, unless relevant medical information is provided. Payment may be restored with no break in entitlement provided the medical evidence is valid and the person is granted indefinite portability.
Recipient no longer medically qualifies for DSP
If a recipient applies for indefinite portability and undergoes a pre-departure medical assessment and it is determined, based on that assessment, that the recipient is no longer medically qualified for DSP, their DSP will be cancelled. They may be eligible for another payment instead.
Recipient overseas no longer qualified for indefinite portability
If a person who is overseas ceases to qualify for indefinite portability as a severely impaired DSP recipient with no future work capacity, or as a terminally ill and severely disabled recipient, but still qualifies for DSP, they will be subject to general portability starting on the day the recipient ceases to qualify for indefinite portability. If the person has not accessed general portability within a 12-month period, they can be paid DSP while overseas for up to 4 weeks.
Note: It is possible for this period to be extended in extreme or unforeseen circumstances that prevent the person from returning to Australia before the end of the 4 weeks.
DSP recipients going to an agreement country
A DSP recipient may be eligible to receive their payment for longer than 4 weeks in a 12-month period under an international social security agreement.
Only some agreements cover DSP. Agreements generally limit long term portability in an agreement country to only those who are severely disabled. The relevant agreement needs to be checked to determine whether the agreement covers DSP and whether long term portability is applicable. For more details see Part 10.