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

Case

[2018] AATA 3857

12 October 2018


Godfrey and Secretary, Department of Social Services (Social services second review) [2018] AATA 3857 (12 October 2018)

Division:GENERAL DIVISION

File Number(s):      2018/1182

Re:Kasey Godfrey

APPLICANT

AndSecretary, Department of Social Services

RESPONDENT

DECISION

Tribunal:Member D K Grigg

Date:12 October 2018

Place:Brisbane

The Tribunal affirms the decision under review

..........................[sgd]......................................

Member D K Grigg

Catchwords

SOCIAL SECURITY – disability support pension – DSP – mental health condition –– whether mental health condition fully diagnosed, fully treated and fully stabilised – whether 20 points or more under the impairment tables during the relevant period – decision under review affirmed

Legislation

Social Security Act 1991 (Cth)
Social Security (Administration) Act 1999 (Cth)
Social Security (Tables for the Assessment of Work-related Impairment for Disability Support Pension) Determination 2011 (Cth)

REASONS FOR DECISION

Member D K Grigg

12 October 2018

  1. The Applicant is currently 18 years old. On 6 February 2017, at 16 years of age, the Applicant applied for the Disability Support Pension (“DSP”), describing his medical conditions as “Asperger’s syndrome” and “secondary anxiety disorder”.[1]

    [1]           Exhibit 1, T Documents, T8, page 83, The Applicant's Claim for DSP dated 30 January 2017, lodged         on 6 February 2017;  T18, page 132, Centrelink record.

  2. After a Job Capacity Assessment (“JCA”), the Department of Human Services (“Centrelink”) rejected the Applicant’s claim for DSP on the basis that his impairments did not attract an impairment rating of 20 points.[2]

    [2]           Exhibit 1, T Documents, T10, pages 97 – 98, Letter from Centrelink to The Applicant dated 31 May            2017.

  3. The Applicant sought a review of Centrelink’s decision by an Authorised Review Officer (“ARO”). The subsequent review by the ARO was unsuccessful on the grounds that the Applicant’s medical conditions were not fully diagnosed, treated and stabilised or did not attract an impairment rating of 20 points.[3]

    [3]           Exhibit 1, T Documents, T 14, pages 112 – 118, Decision of ARO and notes dated 3 October 2017.

  4. The Applicant then lodged an application for review with the Social Services and Child Support Division (“SSCSD”) of this Tribunal.[4] The SSCSD rejected The Applicant’s claim and affirmed the ARO’s decision on 8 February 2018.[5]

    [4]           Exhibit 1, T Documents, T 15, pages 119 – 120, Request for Statement dated 19 October 2017.

    [5]           Exhibit 1, T Documents, T2, pages 3- 8, SSCSD’s Decision and Reasons for Decision dated 8     February 2018.

  5. The Applicant has sought a review of the SSCSD’s decision by the General Division of the Tribunal.[6] At the hearing the Applicant was represented by his mother, Trudie Godfrey.

    [6]           Exhibit 1, T Documents, T1, pages 1-2, The Applicant's Application for Review dated 7 March 2018.

    ISSUES FOR DETERMINATION

  6. The legislation relevant to this matter is contained in the Social Security Act 1991 (Cth) (the “Act”).

  7. Section 94(1) of the Act relevantly prescribes that to qualify for DSP the following requirements must be met (“Section 94 Requirements”):-

    (a)The Applicant must have a physical, intellectual or psychiatric impairment;

    (b)The Applicant’s impairments must be of 20 points or more under the Impairment Tables contained within the Social Security (Tables for the Assessment of Work-related Impairment for Disability Support Pension) Determination 2011 (“Determination”).[7]

    (c)The Applicant must have a continuing inability to work.

    [7] A legislative instrument made under the Act: see s 26(1).

  8. The date for determining whether The Applicant meets the Section 94 Requirements is the date of the claim (in this instance as at 6 February 2017), unless the Applicant became qualified within 13 weeks of lodging the claim, in which case is start day is the day he becomes qualified.[8] Therefore, in order to qualify for DSP, the Applicant must have met the Section 94 Requirements between 6 February 2017 and 8 May 2017 (“Qualification Period”).

    [8]           See ss 41 and 42 and clauses 3 and 4(1), Schedule 2, Part 2 of the Social Security (Administration)         Act 1999 (Cth).

  9. It is important to keep in mind that medical evidence concerning the functional impact of the Applicant’s impairments after the Qualification Period can only be considered if it “casts light on” the functional impact of the impairments as at the Qualification Period.[9]

    DID THE APPLICANT HAVE A PHYSICAL, INTELLECTUAL OR PSYCHIATRIC IMPAIRMENT/S DURING THE QUALIFICATION DATE: SECTION 94(1)(A)?

    [9]           See Harris v Secretary, Department of Employment and Workplace Relations [2007] FCA 404 at [1]; and on appeal Secretary, Department of Employment and Workplace Relations v Harris [2007] FCAFC 130; (2007) 97 ALD 534; and Gallacher v Secretary, Department of Social Services [2015] FCA 1123 at [25]-[29].

    What is an Impairment

  10. The Determination defines “Impairment” to mean “a loss of functional capacity affecting a person’s ability to work that results from the person’s “condition” and “condition” as “a medical condition”.[10]

    [10] Determination, s 3.

    The Applicant’s Medical Conditions

  11. In 2009, Dr Louise Ford, Clinical Psychologist, reported that the Applicant, then only eight years of age, met the diagnostic criteria for Asperger’s syndrome. Dr Ford recommended, amongst other things, that the Applicant complete a course of cognitive behavioural therapy with a psychologist.[11]

    [11]          Exhibit 1, T Documents, T6, pages 48 – 56, Report of Dr Ford dated 1 July 2009.

  12. Dr Ford noted that the Applicant’s condition was not conducive to his attending mainstream schooling as he would be too disruptive and as a result he has been home-schooled by Mr Godfrey.

  13. In 2012, the Applicant’s prescribed treatment was reported as consisting of diet modification.[12]

    [12]          Exhibit 1, T documents, T4, pages 44 – 45, AIC medical statement by Dr Lewis Lassig dated 15   February 2012.

  14. In January 2017, Mark Shoring, practice principal and owner of Master Healthcare, an Acupuncture and Chinese Medicine Clinic, reported that he had been seeing the Applicant since May 2015 and had been aiding “him with his growth and development generally while also aiding where possible with anxiety, concentration and focus and behavioural impulses”.[13] Mr Shoring provided no details regarding the nature of the treatment he provided.

    [13]          Exhibit 1, T documents, T7, page 57, report of Mr Shoring dated 30 January 2017.

  15. On 28 September 2017 Dr Robert Wishart, Developmental and Behavioural Paediatrician, reported that:[14]

    [14]          Exhibit 1, T documents, T 13, pages 107 – 111, report of Dr Wishart dated 28 September 2017.

    (a)      he assessed the Applicant over two visits in May and June 2015;

    (b)the Applicant had previously seen Anna Clarkson, Clinical Psychologist, for two years;

    (c)a diagnosis of Asperger’s disorder was suggested following an assessment in 2009;

    (d)the Applicant had not seen a psychologist since 2011;

    (e)in 2015 he felt there was insufficient information to confirm a DSM-V diagnosis of a high functioning autism spectrum disorder (“ASD”) but that his history was highly suggestive of probable autism spectrum disorder;

    (f)he requested the Applicant’s mother provide copies of the psychologist’s diagnostic assessment report and other relevant material but he has no record of the requested material ever being provided;

    (g)it was his impression that the Applicant “probably has a high functioning autism spectrum disorder, has generalised anxiety disorder [“GAD”], and attention deficit hyperactivity disorder [“ADHD”] - predominantly combined presentation, significant problems with fine motor impairment impacting written expression and a possible specific learning disorder of mathematics”;

    (h)results of multidisciplinary assessments including opinions from other qualified specialists are crucial to provide an accurate diagnosis;

    (i)the Applicant has very significant behavioural difficulties related to frustration associated with his learning and writing difficulties, his ADHD symptoms of inattention, distractibility and impulsivity and emotional reactivity and dysregulation driven by anxiety;

    (j)the Applicant requires a high degree of daily parental support for both teaching and behavioural management;

    (k)he was not familiar with herbal therapy as being an evidence based intervention for anxiety;

    (l)the Applicant’s anxiety would be best managed by a compatible child psychologist;

    (m)the Applicant’s symptoms are highly suggestive of a comorbid ADHD and are impairing his learning and contributing to emotional dysregulation;

    (n)evidence-based management of ADHD alone or comorbid with ASD includes the use of stimulant medication;

    (o)he recommended that the Applicant’s mother consider trialling a one-month stimulant medication trial;

    (p)he recommended a hearing evaluation be conducted by an audiologist;

    (q)he strongly advised against further behavioural optometry therapy due to low grade evidence of its efficacy;

    (r)the Applicant will benefit from a psychoeducational assessment including a cognitive assessment to exclude a specific learning disorder of numeracy;

    (s)the Applicant would benefit from adjusted expectations for written output and emphasis on keyboarding and training in the use of speech detection recognition software; and

    (t)the decision to avoid immunisations places the Applicant at risk for serious infectious diseases and immunisation is strongly recommended.

  16. In September 2017, Centrelink referred the Applicant for review by the Health Professional Advisory Unit (“HPAU”) of the Department of Human Services. The doctor from the HPAU that reviewed the Applicant’s file was a general practitioner. The HPAU doctor reported that in their opinion:[15]

    (a)Dr Ford’s 2009 report was “not very explicit on explaining her reasoning” for the diagnosis; and

    (b)as a result of Dr Wishart’s report, the Applicant’s Asperger’s disorder was not fully diagnosed, treated and stabilised and that further assessments were required.

    [15]          Exhibit 1, T documents, T12, pages 104 – 106, HPAU report dated 29 September 2017.

  17. On 28 October 2017, the Applicant was assessed by Dr Brian Ross, Consultant Specialist Psychiatrist. Dr Ross reported that:[16]

    [16]          Exhibit 3, report of Dr Ross dated 28 October 2017.

    (a)the Applicant had ASD level I (Asperger’s syndrome);

    (b)the Applicant had mild developmental inattention which did not fulfil the diagnostic criteria of ADHD or ADD;

    (c)current management of the Applicant’s conditions included naturopathic and supplementary medicines (RejuvaCalm and Neuro C);

    (d)the Applicant’s ASD is a “lifelong developmental disability” affecting his socialisation, communication and adaption;

    (e)the Applicant has undertaken extensive assessments and therapies to rehabilitate his impairments including seeing Anna Clarkson, the clinical psychologist, for three years and attending drama classes to improve social and emotional communication and expression;

    (f)the Applicant’s conditions are permanent, stable and have undergone all reasonable evidence-based approaches to manage and rehabilitate his impairments;

    (g)in 2015, at the time of the Applicant’s assessment by Dr Wishart, the family was experiencing significant anxiety-provoking family stresses which lead to the Applicant displaying anxiety-based aggression towards his younger sibling. At that time the Applicant’s mother pursued Dr Wishart to develop further strategies to help manage his anxiety with Dr Wishart’s practice claiming to do mindfulness meditation with his patients. In Dr Ross’ opinion the Applicant would have displayed anxiety at the time of his assessments with Dr Wishart and this may have been misinterpreted as part of an ADHD; and

    (h)the use of psychostimulants are not only not indicated for the management of the Applicant’s inattention but are contraindicated with his secondary anxiety that arises in the context of the Applicant’s ASD. The use of psychostimulants could potentially exacerbate the Applicant’s anxiety and precipitate aggressive externalising behavioural issues.

  18. On 19 March 2018, Dr Ross reported that in his clinical assessment, the Applicant “meets the DSM V diagnostic criteria for Generalised Anxiety Disorder (GAD) in the context of ASD” which “arises from his developmental impairments in his socialisation, communication and adaption”.[17]

    [17]          Exhibit 6, Report of Dr Ross dated 19 March 2018.

  19. On 19 June 2018 Dr Ross reported that based on his initial assessment of the Applicant in October 2017 and the Applicant’s mother’s report, it was his professional opinion that the Applicant fulfilled the requirements for ASD level one for the period 6 February 2017 and 8 May 2017.[18] Dr Ross also completed a questionnaire prepared for the purposes of the hearing which indicated that the Applicant’s condition was having a severe impact on his ability to function.[19]

    [18]          Exhibit 4, Report of Dr Ross dated 19 June 2018.

    [19]          Exhibit 5, Questionnaire completed by Dr Ross dated 13 June 2018.

    Conclusion on Impairment

  20. The Respondent accepts that the Applicant suffered from impairments for the purposes of section 94(1)(a) of the Act during the Qualification Period.[20]

    [20]          See Exhibit 2, Respondent’s Statement of Facts and Contentions dated 26 July 2018, para 4.24.

  21. In light of the above medical evidence the Tribunal finds that during the Qualification Period the Applicant suffered Psychiatric Impairments for the purposes of the Act and that the requirement in section 94(1)(a) of the Act has been met.

    DO THE APPLICANT’S IMPAIRMENTS ATTRACT AN IMPAIRMENT RATING OF 20 OR MORE POINTS: SECTION 94(1)(B)?

    How are Impairment Ratings Assessed?

  22. The Impairment Tables are used to assess whether a person satisfies the qualification requirement in paragraph 94(1)(b) of the Act.[21] They are function based[22] and designed to assign ratings to determine the level of functional impact of impairment (“Impairment Rating”) and not to assess conditions.[23]

    [21] Determination, s 4(2) and 5(2)(a).

    [22] Determination, s 5(2)(b) and (c).

    [23] Determination, s 5(2)(d).

  23. An Impairment Rating can only be assigned to an impairment if:[24]

    (a)the Applicant’s condition causing that impairment is “permanent”; and

    (b)the impairment that results from that condition is more likely than not, in light of available evidence, to persist for more than 2 years.

    [24] Determination, see s 6(3).

  24. The Applicant’s condition/s can only be “permanent” for the purposes of the Determination if the following conditions are satisfied:[25]

    (a)the condition has been fully diagnosed by an appropriately qualified medical practitioner;

    (b)the condition has been fully treated;

    (c)the condition has been fully stabilised; and

    (d)the condition is more likely than not, in light of available evidence, to persist for more than 2 years.

    [25] Determination, see s 6(4).

  25. In determining whether a condition has been fully diagnosed by an appropriately qualified medical practitioner and whether it has been fully treated[26] the following must be considered:[27]

    (a)whether there is corroborating evidence of the condition; and

    (b)what treatment or rehabilitation has occurred in relation to the condition; and

    (c)whether treatment is continuing or is planned in the next 2 years.

    [26] For the purposes of ss 6(4)(a) and (b) of the Determination.

    [27] Determination, see s 6(5).

  26. A condition is fully stabilised[28] if:[29]

    (a)either the person has undertaken reasonable treatment for the condition and any further reasonable treatment is unlikely to result in significant functional improvement to a level enabling the person to undertake work in the next 2 years; or

    (b)the person has not undertaken reasonable treatment for the condition and:

    (i)significant functional improvement to a level enabling the person to undertake work in the next 2 years is not expected to result, even if the person undertakes reasonable treatment[30]; or

    (ii)there is a medical or other compelling reason for the person not to undertake reasonable treatment.

    [28] For the purposes of ss 6(4)(c) and 11(4) of the Determination.

    [29] Determination, see s 6(6).

    [30]          For reasonable treatment see s 6(7) of the Determination.

  27. Once it has been established that the Applicant has a permanent impairment, it can then be determined whether the permanent impairments are likely to persist for at least 2 years. If the answer to that question is yes, an Impairment Rating using the Impairment Tables can be assigned.

    ARE THE APPLICANT’S MENTAL HEALTH CONDITIONS PERMANENT AND LIKELY TO PERSIST FOR AT LEAST 2 YEARS?

  28. Table 5 of the Determination, which relates to mental health function, specifically provides that, in order to assign an Impairment Rating, the diagnosis of the condition must be made by an appropriately qualified medical practitioner (this includes a psychiatrist) with evidence from a clinical psychologist (if the diagnosis has not been made by a psychiatrist).

  29. Table 7 of the Determination, which relates to brain function, specifically provides that, in order to assign an Impairment Rating, the diagnosis of the condition must be made by an appropriately qualified medical practitioner.

  30. Without the appropriate medical evidence, no Impairment Rating can be assigned.[31]

    [31]          The Determination, Introduction to Table 5.

    Autism Spectrum Disorder (“ASD”)

    Diagnosis

  31. Dr Ford diagnosed the Applicant with ASD in 2009.[32]

    [32]          Exhibit 1, T Documents, T6, pages 48 – 56, Report of Dr Ford dated 1 July 2009.

  32. The Secretary submits that the ASD Impairment was not fully diagnosed because, although a diagnosis had been made in 2009 by a clinical psychologist, there was no reasoning provided in the report. It is not clear to the Tribunal why Centrelink needs to understand the reasons for the diagnosis. Dr Ford has diagnosed that condition and there is no evidence that she did so negligently. The Secretary contended that because Dr Wishart had not confirmed the diagnosis, the condition could not be considered to be fully diagnosed. There is nothing in the legislation that requires a diagnosis be made by more than one person. There is also no suggestion that Dr Ford was not sufficiently qualified to make the diagnosis that she had. In addition, although Dr Wishart did not feel that he was able to confirm definitively the diagnosis, what he did state was that the history of the Applicant’s condition “was highly suggestive of a probable ASD” and that it was his “impression that this student probably has a high functioning autism spectrum disorder”. Dr Wishart’s evidence is hardly contradictory to the conclusion reached by Dr Ford. In these circumstances, the Tribunal accepts that the Applicant had been fully diagnosed with ASD prior to the Qualification Period. Dr Ross, who saw the Applicant five months after the Qualification Period, has also confirmed the diagnosis of ASD and made the point that it is a lifelong condition and therefore would have been present throughout his whole childhood, including the Qualification Period.

    Treatment

  33. For the following reasons, however, the Tribunal finds that the ASD Impairment was not fully treated.

  34. There is evidence that the Applicant had received some psychological counselling treatment prior to 2011, when he was 9 to 11 years of age. There is no evidence of any recent treatment nor the results of the earlier treatment available. The Applicant is now 18 years of age. Dr Wishart is of the view that psychological treatment would be of use. Dr Ross has also recommended this treatment to the Applicant.

  1. There has not been a recent review by a clinical psychologist.

  2. There has also been no pharmacological treatment for the ASD. The Tribunal notes that Dr Wishart is of a differing view to Dr Ross as to whether or not such treatment is advisable. Dr Wishart recommended trialling medication but Dr Ross is against it. In the circumstances the Tribunal finds that a conclusion can be reached that pharmacological treatment may not constitute reasonable treatment for the Applicant’s ASD Impairment.  There is nothing in the material which suggests that treating the ASD Impairment with medicine will improve the ASD.

  3. At the hearing, the Applicant’s mother:

    (a)told the Tribunal that in 2013 the Applicant was engaged in the Triple P Secret Agent Society Program which is a program designed to assist children with autism;

    (b)acknowledged that the Applicant had had no formal psychological behaviour therapy since 2011;

    (c)acknowledged that she was aware that the Applicant needed up to date behavioural strategies as he is now an adult. She said this was why she first went to Dr Wishart, however Dr Wishart told her he would not help her unless she agreed to put the Applicant on Ritalin;

    (d)a psychologist friend has provided some strategies for her to implement;

    (e)she takes her son to Mark Shoring who advises on diet, herbal supplements and vitamins; and

    (f)she cannot afford to take her son to see a psychologist.

  4. Psychological treatment is accepted and recommended by the specialists as reasonable treatment for the Applicant to undertake. Reasonable treatment is defined in the Determination (section 6(7)) as treatment that:

    (a)is available at a location reasonably accessible to the person; and

    (b)is at a reasonable cost; and

    (c)can reliably be expected to result in a substantial improvement in functional capacity; and

    (d)is regularly undertaken or performed; and

    (e)has a high success rate; and

    (f)carries a low risk to the person.

  5. At the hearing Ms Godfrey told the Tribunal that psychological therapy had been recommended by Dr Ross and that her son had done well when he was engaged in therapy previously. She says she cannot afford it, but the Tribunal notes that she is able to pay for her son to see Mark Shoring (although she says he charges her at a reduced rate) and to buy herbs and vitamins. Further, psychological treatment is available in the public system through a general practitioner mental health plan. Ms Godfrey said she was aware of this but with long lists and the uncertainty of which psychologist she could see, she has not proceeded with this avenue of potential assistance.

  6. Ms Godfrey also acknowledged that her son had learned some useful techniques at PPP (Positive Parenting Program) when he was 13 years of age.

  7. Dr Wishart also recommended that the Applicant be assessed for a numeracy disorder, but this has not been assessed. Ms Godfrey says the cost of this assessment was prohibitive and there was no Medicare funding for it.

  8. The Tribunal makes assessments based on the evidence available, that relates to the Applicant’s condition during the Qualification Period.

  9. The legislation requires that conditions can only be considered permanent for the purpose of the Act if they have been fully diagnosed and reasonable treatment has been undertaken.

  10. The Applicant’s ASD has been diagnosed but insufficient evidence-based assessment and treatment has been undertaken since the Applicant was a young child.

  11. The Tribunal finds that the Applicant’s ASD Impairment was not fully treated as defined in section 6(5) of the Determination because he has had no psychological treatment as recommended since 2011.

    Generalised Anxiety Disorder (“GAD”)

  12. Subsequent to the Qualification Period, in March 2018, Dr Ross reported that the Applicant had GAD. Dr Ross did not see the Applicant until 5 months after the Qualification Period, and therefore he is not in a position to know whether the Applicant had GAD during the Qualification Period. In his report of June 2018, Dr Ross states that the Applicant would have fulfilled the requirements for ASD level during the Qualification Period but he makes no mention of whether he would have had GAD at that time.[33]

    [33]          Exhibit 4, Report of Dr Ross dated 19 June 2018.

  13. While there is reference to the Applicant suffering from anxiety in some of the medical reports prior to the Qualification Period, this is not the same as having been diagnosed with GAD. Dr Wishart made a diagnosis of GAD based on his assessment of the Applicant in 2015, however Table 5 of the Determination which relates to mental health function requires that a diagnosis be made by either a clinical psychologist or psychiatrist. Dr Wishart is a paediatrician. Dr Ross reported in March 2018 that the Applicant met the DSM-V diagnostic criteria for GAD in the context of ASD however there is no reference made to this condition in his report of October 2017.[34] Ms Godfrey explained to the Tribunal that this is because she had come to Dr Ross in relation to her son’s ASD diagnosis. The difficulty for the Tribunal is that there is no diagnosis by a clinical psychologist or psychiatrist of the Applicant having had GAD during the Qualification Period. Whilst Dr Wishart reports that the Applicant had GAD in 2015, this was two years prior to the Qualification Period and there is no evidence relating to the condition between 2015 and the Qualification Period in 2017. Ms Godfrey acknowledged at the hearing that the GAD Impairment was a secondary condition to the ASD and that there was no medical report confirming a diagnosis of GAD during the Qualification Period. Ms Godfrey told the Tribunal that she had seen another clinical psychologist that had diagnosed the Applicant with GAD but that that psychologist no longer practices and she had been unable to obtain any report or corroborating evidence of diagnosis..

    [34]          Exhibit 6 and Exhibit 3.

  14. The Tribunal also notes that even if it was accepted with high probability that the Applicant had GAD during the Qualification Period there is no evidence of the treatment, if any, that was being obtained for that condition.

  15. In the circumstances the Tribunal finds that the GAD condition was not fully diagnosed and fully treated during the Qualification Period and therefore no Impairment Rating can be assigned.

  16. The Applicant’s mother acknowledged at the hearing that the GAD had not been fully diagnosed during the Qualification Period. The Applicant’s mother also stated that it was the ASD condition that was the basis for the DSP application and it was the ASD condition that had been the focus of the medical reports she had obtained on her son’s behalf.

  17. In the event that the Applicant’s anxiety condition has now been fully treated and stabilised, it is open to the Applicant to lodge a new DSP application.

    ADHD

  18. Dr Wishart reported that in 2015 the Applicant’s symptoms were “highly suggestive of a comorbid Attention Deficit Hyperactivity Disorder”. This is not a confirmed diagnosis and is presumptive.

  19. Dr Ross determined in 2017 that the Applicant did not fulfil the diagnostic criteria of ADHD or ADD.

  20. In these circumstances the Tribunal finds that the ADHD condition was not fully diagnosed during the Qualification Period and therefore cannot be considered permanent for the purposes of the Act.

  21. At the hearing, Ms Godfrey confirmed that she did not agree with Dr Wishart’s presumptive diagnosis and that the Applicant did not list this condition in his DSP claim form.

  22. The parties agree that as a result, this condition does not need to be considered any further.

    Conclusion on Mental Health Impairments

  23. As the Applicant’s Mental Health Impairments were not permanent for the purpose of the Act, no Impairment Rating can be assigned.

  24. If these conditions have now been fully diagnosed and are fully treated, as required by the Act, a new DSP claim could be made.

    WERE THE APPLICANT’S IMPAIRMENTS OF 20 POINTS OR MORE UNDER THE IMPAIRMENT TABLES: S 94(1)(B)?

  25. To qualify for DSP, a minimum of 20 points is required pursuant to section 94(1)(b) of the Act. The Applicant does not qualify for DSP because his conditions were not permanent during the Qualification Period and no Impairment Rating can be assigned.

    DID THE APPLICANT HAVE A CONTINUING INABILITY TO WORK: S 94(1)(c)(i)?

  26. As the Applicant does not satisfy the criteria in section 94(1)(b) it is not necessary to consider whether the Applicant had a “continuing inability to work” (as defined in s 94(2) of the Act) for the purposes of section 94(1)(c) of the Act at that time.

    DECISION

  27. The Applicant did not qualify for DSP during the Qualification Period. The decision under review is affirmed.

I certify that the preceding 61 (sixty-one) paragraphs are a true copy of the reasons for the decision herein of Member D K Grigg

..............................[sgd]..................................

Associate

Dated: 12 October 2018

Date of hearing: 5 October 2018
Advocate for the Applicant: Trudie Godfrey (Applicant’s Mother)
Advocate for the Respondent: Mr Jake Kyranis, Lawyer
Solicitors for the Respondent: Sparke Helmore Lawyers

Areas of Law

  • Administrative Law

  • Statutory Interpretation

Legal Concepts

  • Appeal

  • Judicial Review

  • Procedural Fairness

  • Statutory Construction