Cox and Secretary, Department of Social Services (Social services second review)

The Administrative Appeals Tribunal (AAT) considered the case of Ms Cox and the Secretary, Department of Social Services, concerning Ms Cox's claim for a Disability Support Pension (DSP). The dispute centred on whether Ms Cox qualified for the DSP based on her multiple medical conditions, including fibromyalgia, sleep apnoea, a heart condition, epilepsy, and an upper limb condition. The primary issue was whether these conditions were fully diagnosed, treated, and stabilised to meet the DSP eligibility criteria.

The Tribunal was required to determine if Ms Cox's medical conditions met the threshold for a DSP qualification within the relevant period, which was the date of her claim on 6 December 2017, or within the subsequent 13 weeks. This involved assessing whether her impairments, when considered collectively, resulted in a total impairment rating of 20 points or more under the Impairment Tables, as stipulated by the Social Security Act 1999.

The Tribunal applied the principles outlined in the Social Security (Administration) Act 1999 regarding the "start day" for a social security payment. This provision dictates that if a person is not qualified on the day of their claim but will become qualified within 13 weeks, the claim is taken to have been made on the first day of qualification. Crucially, the Tribunal emphasised that eligibility must be assessed based on the conditions and available evidence at the time of the claim and the subsequent 13-week period. Any progression of a medical condition after this period, while potentially relevant to the weight given to evidence, cannot be used to directly award a DSP based on those changed circumstances; a new claim would be necessary.

Ultimately, the Tribunal found that Ms Cox did not achieve the required total impairment rating of 20 points. Consequently, it was not necessary to consider whether she had a continuing inability to work. The Tribunal affirmed the decision under review, meaning Ms Cox's claim for the DSP was not successful.