JCPN and Secretary, Chief Executive Centrelink (Social security second review) - [2025] ARTA 793

JCPN and Secretary, Chief Executive Centrelink (Social security second review) [2025] ARTA 793 (19 June 2025)
Applicant:JCPN
Other Parties: Secretary, Chief Executive Centrelink
Tribunal Number: 2023/6481
Tribunal:Senior Member T Hamilton-Noy (second review)
Place:Melbourne
Date:19 June 2025
Decision:The Tribunal affirms the decision under review.

……………[SGD]………..……
Senior Member T Hamilton-Noy
Catchwords
Disability support pension – rejection of claim – conditions not fully diagnosed, treated and stabilised – dysfunctional uterine bleeding – menorrhagia – recurrent urinary tract infections – pelvic floor dysfunction – depression – anxiety – lumbar spine prolapse – diabetes – irritable bowel syndrome – eczema – cervical spine spasm – asthma – gastro oesophageal reflux disease - sciatica
Legislation
Administrative Review Tribunal (Consequential and Transitional Provisions No. 1) Act 2024
Social Security Act 1991
Social Security (Administration) Act 1999
Cases
Bobera and Secretary, Department of Families, Housing, Community Services and Indigenous Affairs [2012] AATA 922
Coates and Secretary, Department of Employment and Workplace Relations [2006] AATA 938
Fanning and Secretary, Department of Social Services [2014] AATA 447
Harris v Secretary, Department of Employment and Workplace Relations [2007] FCA 404
Secondary Materials
Social Security (Tables for the Assessment of Work-related Impairment for Disability Support Pension) Determination 2011
Statement of Reasons
Background

This matter relates to the Applicant’s qualification for disability support pension.
The Applicant made a claim for disability support pension with Services Australia (Centrelink) on 10 August 2022 in respect of the medical conditions of depression, disc prolapse, recurrent urinary tract infections, dysfunctional uterine bleeding, gastro-oesophageal reflux disease and asthma. Following lodgement of the claim, a decision was made by an employee of Centrelink on 21 October 2022 that the Applicant was not qualified for the payment. An authorised review officer of Centrelink internally reviewed the decision and affirmed the decision on 22 February 2023.
On 8 March 2023, the Applicant applied to the Administrative Appeals Tribunal (the AAT) for an independent review of the Centrelink decision and on 15 August 2023 the AAT at first review affirmed the decision to reject the claim.
The Applicant sought second review of the decision at the AAT on 29 August 2023.
From 14 October 2024, the AAT became the Administrative Review Tribunal (the Tribunal). Under the transitional provisions in the Administrative Review Tribunal (Consequential and Transitional Provisions No. 1) Act 2024 (the Transitional Act), applications for review to the AAT that were not finalised before 14 October 2024 are taken to be an application for review to the Tribunal. The Transitional Act gives the Tribunal the authority to continue and finalise any aspect of the review not already completed by the AAT. This decision and statement of reasons is made by the Tribunal.
The Tribunal held a hearing in this matter on 15 May 2025, where the Applicant participated by MS Teams audio and gave evidence on affirmation. A representative of the Respondent also participated by MS Teams audio.

Documents before the Tribunal

At the hearing, the Tribunal had been provided the following documents, copies of which had also been made available to the Applicant and the Respondent:
·Main bundle of Centrelink documents (“T documents”) and supplementary bundle (ST1 to ST4);
·Medical reports and written submissions from the Applicant (18 attachments); and
·Medical reports including Centrelink-generated assessments and Statement of Facts Issues and Contentions prepared by the Respondent.

Issues and relevant law

The legislative requirements relevant to this matter are contained in the Social Security Act 1991 (the Act) and the Social Security (Administration) Act 1999 (the Administration Act). The relevant Determination in place at the time of claim, which sets out the circumstances in which points may be allocated for a condition, is the Social Security (Tables for the Assessment of Work-related Impairment for Disability Support Pension) Determination 2011 (the Determination).
Section 94 of the Act sets out the qualification requirements for the payment of disability support pension. The Tribunal must consider in this matter whether the Applicant met subsection 94(1) of the Act at the time of her claim, that is, whether:
a. The applicant has a physical, intellectual or psychiatric impairment (paragraph 94(1)(a) of the Act);
b. The Applicant’s impairment is of 20 points or more under the Impairment Tables (paragraph 94(1)(b) of the Act); and
c. The Applicant has a continuing inability to work or the Applicant is participating in the program administered by the Commonwealth known as the supported wage system (paragraph 94(1)(c) of the Act).
The Determination establishes rules for applying the Impairment Tables and contains 15 Impairment Tables under which an impairment rating may be allocated. An impairment is defined in the Determination to be a loss of functional capacity affecting a person’s ability to work which results from the person’s condition.
Section 5 of the Determination notes that the Tables are function-based rather than diagnosis-based and that they are designed to assign ratings to determine the level of functional impact and not to assess conditions. The Determination states that the impairment of a person must be assessed on the basis of what they can, or could, do and not on the basis of what they choose not to do or what others do for them (subsection 6(1) of the Determination).
An impairment rating is only able to be assigned under an Impairment Table after a person’s medical history has been considered (subsection 6(2) of the Determination) and where the condition is permanent and where it is more likely than not to persist for more than two years (subsection 6(3) of the Determination). A condition is considered permanent where it has been fully diagnosed by an appropriately qualified medical practitioner, fully treated, fully stabilised and is more likely than not to persist for more than two years (subsection 6(4) of the Determination).
In considering whether a condition is fully diagnosed and fully treated, the Tribunal must consider whether it has been diagnosed by an appropriately qualified medical practitioner, whether there is corroborating evidence of the condition, what treatment or rehabilitation has occurred in relation to the condition and whether treatment is continuing or is planned in the next two years (subsection 6(5) of the Determination).
In considering whether a condition is fully stabilised, the Tribunal must consider whether the person has undertaken reasonable treatment and whether any further reasonable treatment is unlikely to result in significant functional improvement to a level enabling the person to undertake work in the next two years. In the alternative, the Tribunal must consider whether, if the person has not undertaken reasonable treatment, significant functional improvement to a level enabling the person to undertake work in the next two years is not expected to result, even if the person undertakes reasonable treatment, or there is a medical or other compelling reason for the person not to undertake reasonable treatment (subsection 6(6) of the Determination).
The Determination notes that there is no Table relating specifically to pain. When assessing pain, subsection 6(9) of the Determination requires the Tribunal consider:
·That acute pain is a symptom which may result in short-term loss of functional capacity in more than one area of the body; and
·That chronic pain is a condition and, where it has been diagnosed, any resulting impairment should be assessed using the Table relevant to the area of function affected; and
·Whether the condition causing pain has been fully diagnosed, fully treated and fully stabilised.
The Determination further provides that symptoms reported by a person in relation to their condition can only be taken into account where there is corroborating evidence (section 8 of the Determination). Single conditions causing multiple impairments are to be assessed under each relevant Impairment Table; multiple conditions causing a single impairment are to be assigned a single rating in relation to the common or combined impairment (section 10 of the Determination).
The Respondent has noted the following relevant case law in respect of considerations under the Determination.
While the Applicant’s qualification for disability support pension must be assessed at the date of claim, Clause 4 of Schedule 2 to the Administration Act provides that where a person makes a claim and is not qualified on the day of claim but becomes qualified within 13 weeks of the claim, the claim is taken to have been made on the first day on which the person is qualified for the payment. In Bobera and Secretary, Department of Families, Housing, Community Services and Indigenous Affairs [2012] AATA 922, the AAT stated (at [34]) that
In the Tribunal’s consideration as to whether a condition has been stabilised and is likely to persist for the foreseeable future, the Tribunal must look at the situation as it was, and the evidence that was available, at the time of the application for DSP (and the subsequent 13 weeks). Any subsequent evolution of a particular condition might be relevant to any weight the Tribunal places on competing prognostications or on an assessment of the quality of the medical reports provided (most notably where evidence indicates that the creator of a medical report may not have had access to all relevant information or may not have turned his or her mind to all the relevant issues). This point is important as it is quite frequently the case that appeals on DSP decisions arrive at this Tribunal twelve or more months after the initial DSP application was refused. In many instances, the natural course of illnesses or injuries has then become more obvious, thereby confounding the professional opinions honestly proffered by thorough and conscientious treating doctors. If a medical condition has progressed since the time of the original DSP application, then it is up to the Applicant to make a new DSP application. It is not open in law for this Tribunal to use any evidence of such progression to directly award a DSP because of those changed circumstances.
In Harris v Secretary, Department of Employment and Workplace Relations [2007] FCA 404, Gyles J (at [1]) noted that:
[t]he Applicant’s entitlement to a pension must be considered as at the date of her claim, namely, 3 May 2004 and a period of 13 weeks thereafter. Any subsequent change in her health is irrelevant to the questions which arise in this proceeding except insofar as it may cast light on the position at the relevant time.
In Coates and Secretary, Department of Employment and Workplace Relations [2006] AATA 938 (at [21]–[22]), the AAT stated that:
It is, I think, important to realize that ‘temporary’ is used by Centrelink in this context in a special sense. It is a shorthand way of describing a condition which is not, at that time, capable of being regarded as being permanent. That judgment is to be made on the basis of the material capable of throwing light on the issue of whether the conditions were, at the relevant time, fully documented and diagnosed conditions which had been investigated, treated and stabilised.
It is not to the point that they may have answered that description at a later time. Nor is it to the point, for present purposes, that the point at which the conditions could have been investigated, treated and stabilised at an earlier time had Centrelink acted in a different manner. The Parliament has determined that disability support pensions are to be paid when certain qualifying criteria are satisfied. The evident legislative intent is that disability support pensions be paid only when the disabling condition has reached the stage where it can be regarded as being permanent and having a permanent impact upon normal function as it relates to work performance.
In Fanning and Secretary, Department of Social Services [2014] AATA 447, the AAT noted that:
The language in clauses 6(5) and 6(6) of the 2011 Determination is forward-looking. With respect to whether a condition was fully stabilised, for example, the question for the Tribunal is whether “any further reasonable treatment is unlikely to result in significant functional improvement to a level enabling the person to undertake work in the next two years”. While hindsight may suggest that treatment did not result in improvement within two years that is not the question for the Tribunal to determine. The legislation requires the Tribunal to consider the treatment that has taken place, and was intended to take place, and the likely effect of that treatment, at the time of the claim and in the 13 weeks thereafter.
For that reason, evidence of treatment, and the efficacy of that treatment, after the relevant period is not directly relevant to the Tribunal’s decision.

The Applicant’s reasons for seeking a review

The Applicant gave evidence at the hearing that she believes she met the qualification requirements for disability support pension as of August 2022, as she had “already had the 20 points” and had been participating in work and meeting her jobseeker requirements prior to the claim being lodged. The Applicant noted in her evidence that she had not been given a program of support to participate in, which was a “gap”, due to her meeting her jobseeker requirements through the work she had been undertaking. She noted she hadn’t worked since 10 August 2022 and believes she has been qualified since that date. She noted that she had subsequently been granted disability support pension, in June 2024.
The Applicant provided written submissions to the Tribunal about her reasons for disagreeing with the decision to reject her claim, which included the following in relevant part:
I ceased working on 1/8/2022 and since that day I have to [sic] returned to work.
The reason I ceased is that I have been unable to sustain work activities or other tasks for more than 3 hours a day, due to my medical conditions.
My medical conditions affect my quality of life. Such as;
·difficulty getting out of bed due to depression and pain.
·Needing help with showering as I tend to faint in shower due to loss of blood and abdominal pain.
·Need help with getting dressed as my hands are burning with pain due to eczema
·Reminders to take my medication.
·Unable to drive long hours as the pain gets to me and I would need to stop on side of road.
·I would go the wrong direction to work end up late and let my team down.
My lower abdominal pain is effecting [sic] my work in many ways;
·I would need to frequently visit the bathroom at work.
·Due to the excruciating pain in my lower stomach and bladder I was unable to concentrate at work.
·Needed then to go home due to the pain and also the need to shower due to bladder accidents.
·Going frequently to bathroom exacerbates my eczema in my hands due to the fact that I need to wash my hands at all times.
·My concentration was effecting [sic] me and my colleagues at work.
·I was not attending work on a daily basis and that was effecting [sic] the quality of work and letting my team down. This triggered my depression.
·I would try to take breaks in between to see if I get better but that would not work.
·I was affecting the comfort and attention of my coworkers by no being there for them. I was frequently absent from work.
·Unable to carry or lift any items due to the pain in my lower abdomen.
·Unable to stand up and prepare and serve food without the help of my colleagues as I would be in pain.

The Respondent’s position

The Respondent accepts that the Applicant had physical, intellectual or psychiatric impairments at the time of claim. However, the Respondent submits that the Applicant’s conditions of dysfunctional uterine bleeding, menorrhagia, recurrent urinary tract infection, pelvic floor dysfunction, eczema and asthma were fully diagnosed for the purposes of the disability support pension claim but were not fully treated and stabilised. The Respondent submits that the conditions of depression, anxiety, lumbar disc prolapse, diabetes, irritable bowel syndrome, cervical spine spasm, gastro oesophageal reflux disease and sciatica were not fully diagnosed, treated or stabilised for the purposes of the claim.
The Respondent further submits that the Applicant did not have a continuing inability to work at the time of the claim and was not participating in the supported wage system program. The Respondent noted that the period for the Applicant to have participated in a program of support was from 10 August 2019 to 9 August 2022 and that the Applicant had undertaken no days in a program of support in that period.

The Applicant’s physical, intellectual or psychiatric impairments

The Applicant submits, and the Respondent has accepted, that at the time of claim the Applicant had the conditions of dysfunctional uterine bleeding, menorrhagia, recurrent urinary tract infection, pelvic floor dysfunction, depression, anxiety, lumbar spine prolapse, diabetes, irritable bowel syndrome, eczema, cervical spine spasm, asthma, gastro-oesophageal reflux disease and sciatica. The Tribunal accepted that at the time the claim was lodged in August 2022, the Applicant had physical, intellectual or psychiatric impairments and met paragraph 94(1)(a) of the Act.

Impairment ratings in respect of the Applicant’s conditions

The Tribunal accepted that the relevant period, in considering each of the Applicant’s medical conditions in respect of the August 2022 claim, was the period from 10 August 2022 to 9 November 2022.
The Tribunal considered the following evidence, and made the following findings, about each of the Applicant’s medical conditions.

Dysfunctional uterine bleeding, menorrhagia

In the written disability support pension application, the Applicant claimed that the condition of dysfunctional uterine bleeding had date of onset on 25 October 2019.
The Applicant underwent a series of pelvic ultrasounds during 2019. The results of a pelvic ultrasound performed in April 2019 identified five small intramural fibroids measuring up to 13mm in diameter and noted that the endometrium outlines normally. Results of a pelvic ultrasound performed in July 2019 indicated the uterus was bulky, there was a “fibroid uterus”, endometrium was thickened and there was a complex right ovarian cyst. Results of a pelvic ultrasound performed in August 2019 reported that the uterus is bulky, there are small fibroids, there was no IUCD although it had been detected in a previous scan, and there was no ovarian cyst. A further pelvic ultrasound was performed in February 2020 at which time multiple small fibroids in the uterus were identified and it was reported that both ovaries appear normal.
The Applicant’s GP, by medical certificate dated 10 August 2022, noted that she had had a hysteroscopy and dilatation and curette on 8 January 2021. The Applicant attended obstetrician and gynaecologist Dr HN in or around January 2021, at which time she advised she was seeking another hysteroscopy. She was placed on the specialist’s list at a private hospital. She was admitted to hospital in February 2021 for symptoms of menorrhagia and was discharged from hospital with medication.
Commensurate with the time of claim, the Applicant attended a job capacity assessment and the assessor noted that the Applicant had reported the following in respect of the conditions:
Onset: The client reported 6-7 years ago.
Symptoms: The client reported fainting episodes, with last episode falling in the bathroom a few months ago. The client reported she has effects from medication such as dizziness. The client reported ongoing lower back pain, difficulty walking due to pain. The client reported daily accidents and requiring to use continence aids. The client reported her anxiety and pain affects her ability to change the continence aids and she requires the assistance of her children to do this at times. Dr indicates bladder and bowel control issues with difficulties and episodes once per week...
Treatment: The client reported she had many surgical interventions with the last surgical intervention 2 years ago, the client reported she has iron infusions every 2 months, the client reported specialist reviews every few months, the client takes medication (Promil). The client reported she completed exercises, pelvic floor physiotherapy etc. Dr [HN], Obstetrician and Gynaecologist, 02/01/21 indicates 'medical treatment has been reasonably effective (Implanon).

The Tribunal noted that the assessor considered that the condition was permanent, given the nature of the condition, its longevity of onset and because it was likely to persist for 24 months or more. The assessor considered the condition to be fully diagnosed, treated and stabilised on the basis that the Applicant had had “optimum treatment for this medical condition and no further reasonable treatment is likely to result in significant functional improvement”.
The Applicant’s GP prepared a letter on 21 November 2023 about her medical conditions. The GP described the onset of the condition of dysfunctional uterine bleeding (and urinary incontinence secondary to pelvic floor dysfunction) as having occurred six years earlier. The GP described the condition as permanent, stable, not improving and as fully diagnosed and treated. The GP noted: “No room for surgical or physical therapy currently on treatment with Vesicare and ring”. The GP referred to a 20 point impairment rating, referring to relevant factors (as outlined in the relevant Impairment Table in the Determination) of: “severe difficulty travelling to or participating in community or social environments due to symptoms or management of the gastrointestinal or reproductive system functions, causing frequent disruption to daily activities due to avoidance of activities”. The GP described that two specialists had been involved in respect of the condition and stated that the Applicant “remains symptomatic, requiring transfusion and iron supplementation”.
Obstetrician and gynaecologist Dr HN wrote to the Applicant’s GP on 11 April 2024, describing that the condition of menorrhagia had been persistent, that the Applicant had had a hysteroscopy, D&C twice, insertion of a Mirena IUCD and was, at the time of the letter, taking Primolut. Dr HN had suggested a hysterectomy but the Applicant was described as reluctant to consider the option and needing more time to consider this.
The Applicant’s GP prepared a further letter about her conditions dated 30 April 2024. At the time the letter was prepared, the GP noted that the Applicant continued to be treated for dysfunctional uterine bleeding with Primolut N, 10mg twice daily, that she was regularly having to wear and change pads on a daily basis, needed the toilet frequently and was attending Dr HN for specialist care. The GP then stated that:
The condition has been in place for in excess of five [y]ears and its extent is fully diagnosed treated and stabilised with quite a quantum of negative impact on her life. The continuous bleed makes her go to [t]he toilet frequently with frequent hand washing that further exacerbates her eczema and has negative psychosocial impact on her self image and worthiness. She has fainted intermittently during period where her iron dropped and became anaemic. She has required iron infusion repeatedly over the years.
The Applicant attended a second obstetrician and gynaecologist, Dr SA, who wrote to the GP on 5 August 2024 stating that the Applicant had trialled a Mirena but it had not worked, that she did not want a hysterectomy, that her dose of medication had been increased and that she was given Betmiga 50mg daily.
A further letter prepared by the GP on 1 September 2024 noted the following in respect of the conditions:
She also continues to suffer from recurrant [sic] heavy bleeding to the extent that it caused her iron deficiency and anemia and this is difficult to address and she has been seen by multiple gynecologists [sic] and none of which have had the courage to advice [sic] operative intervention to remove the uterus however various medical treatments are in place with little success at controlling the bleeding she has had to have multiple iron transfusions in order to maintain and treat the iron deficiency that has been caused by this. It is undoubtedly this iron deficiency contributes to the ongoing tiredness and fatigue and difficulty in being able to concentrate and probably also contributes to the headaches that she frequently comes with this also is one factor in making her unable to cope with many of her demands and responsibilities.
The Applicant gave evidence at the hearing that she believes these conditions are fully diagnosed, treated and stabilised on the basis that she had many surgeries years ago and ongoing treatment is impacted by her low blood pressure and low iron. She told the Tribunal that these conditions are impacting her the most. As of 2022, she was managing the conditions by medication and by resting and was prescribed treatment and medication by her GP.
The Applicant told the Tribunal that she is worried about having any further surgery for the condition of uterine bleeding because she has been “under the knife” many times. She has low iron for which she has had numerous blood infusions. She has attended gynaecologist Dr HN who advised her against having a hysterectomy but said to take medication; she was unsure whether written confirmation of this advice had been provided to her. The Applicant told the Tribunal that she had trialled a Marena which had not helped. She continued taking medication and she has had “D&Cs” done previously; the reason she has not been able to have a hysterectomy is because of her low iron and many blood infusions.
When asked about any functional impact caused by the conditions, the Applicant stated that due to the conditions and her pain levels, she is unable to get up in the mornings. She has difficulty showering because she becomes dizzy. She requires help from her children to get dressed and there have been days she would faint and her children would phone for an ambulance. She has had blood infusions and iron infusions and the condition has affected her memory. Her family feels as though she is not the person she was before and she has needed support on a daily basis, including help going for a walk.
The Applicant gave evidence that, in the time leading up to the disability support pension claim, she was only working a maximum of two to three days per week. She was missing work due to bleeding and was needing to use the toilet urgently and was using nappies. She described having been uncomfortable, irritated, crying and depressed. She stopped working because she had been required to lie down while working and had been unable to continue with her work.
The Tribunal found from the medical evidence before it that the Applicant’s conditions of dysfunctional uterine bleeding and menorrhagia likely had onset between 2017 and 2019. The Applicant underwent a series of ultrasounds during 2019 and attended an obstetrician and gynaecologist in 2021, Dr HN, but appears to have been managed by her GP at the time of the disability support pension claim. Consistent with the time of claim, the Applicant was prescribed medication, had had a hysteroscopy and dilatation and curette, and had been treated for associated symptoms relating to low iron, including through at least one hospital admission. The Applicant had had a Mirena inserted but had not persisted with this and had been recommended for a hysterectomy but was reluctant to have this done. There was little written evidence about these aspects of her treatment and no clear medical evidence about the recommendation for the hysterectomy and the Applicant’s reasons for not following this recommendation. Nor was it clear to the Tribunal, from the medical evidence provided, the reasons for the removal of a Mirena shortly after it was inserted. Given there were reasonable treatments available to the Applicant at the time of claim that had not been pursued by the Applicant, the Tribunal considered that these conditions were not fully diagnosed, treated and stabilised within the relevant period, for the purposes of the disability support pension claim. The Tribunal concluded that it is unable to consider the allocation of points under the relevant Impairment Tables for these conditions.

Recurrent urinary tract infections

There is limited information before the Tribunal about this condition. A Medical Certificate prepared by the Applicant’s GP, dated 27 April 2022, noted that the Applicant had been under the care of the GP for the condition since 19 October 2019. A letter prepared by the GP dated 23 July 2023 states that the condition was diagnosed four years earlier and was “permanent”. The GP noted that the condition had been diagnosed by two doctors and was deteriorating with time, the Applicant was on treatment with Vesicare and ring device, that urine urgency and incontinence were the main factors obstructing work capacity and that the GP considered the condition “fully treated with stable symptomatic and dysfunctional end stage at maximum therapy” and considered that it attracted an impairment rating of 15 points. A subsequent letter prepared by the GP dated 10 August 2023 provided the same information again.
The Tribunal had regard to comments prepared in a Health Professional Advisory Unit report, prepared by a Medical Advisor and dated 28 February 2024, about this condition. From this report, the Tribunal had particular regard to the following observations of the Medical Advisor:
·   Recurrent UTIs are defined as greater than two episodes within six months or greater than three episodes within 12 months. However, the Applicant is documented as having pyelonephritis; if left untreated, the condition can cause kidney damage and can result in septicaemia or infection in the blood stream which is considered life threatening.
·   It is likely that the Applicant’s bladder prolapse has contributed to the recurrent urinary tract infections, but could not be considered the only reason. After an episode of pyelonephritis, it would be usual to have an ultrasound of the kidneys and of the ureters and bladder. It would also be usual to refer a patient to a urologist, for performance of a cystoscopy or possible urodynamic studies.
·   The cause of the recurrent urinary tract infections remained unclear during the qualification period.
The Applicant gave evidence that when she has an infection, she uses the bathroom all of the time. She previously had difficulty concentrating at work when she had an infection and she had difficulty being around workmates because she was in and out of the bathroom. The infections made her feel dizzy. When giving evidence about this condition, the Applicant spoke of having had two surgeries and having had an injection in her leg to stop the bleeding. The Tribunal was of the view that this evidence related to conditions other than the recurrent urinary tract infection condition.
The Tribunal is prepared to accept the Applicant’s evidence that she suffers recurring urinary tract infections and is prepared to accept the evidence she gave at hearing about the impact of the condition. There is, however, insufficient medical evidence for the Tribunal to be satisfied that the condition was fully diagnosed, treated and stabilised in the relevant period, noting in particular the absence of investigation for the underlying cause and the lack of evidence about attendance at specialists or treatment undertaken. The Tribunal has concluded that it is unable to consider the allocation of points for this condition in the absence of it having been fully diagnosed, treated and stabilised in the relevant period.

Pelvic floor dysfunction

The Tribunal noted that the condition was not one of the conditions recognised in the disability support pension claim and was not a condition considered by the AAT at first review (although had been considered by the authorised review officer in conjunction with the condition of dysfunctional uterine bleeding). The condition first appeared in medical documentation in a “Carer Payment and/or Carer Allowance Medical Report” prepared by the Applicant’s GP dated 1 November 2021, with stated date of onset in November 2020. No information is provided (or sought) in the medical report about treatment, prognosis or functional impact of the condition.
The Applicant’s GP prepared a medical certificate dated 27 April 2022, in support of an application for public housing and listing a number of conditions that the Applicant had been under his care for; this condition was not listed. A medical certificate in the same terms, and for the same purpose, was prepared by the GP on 10 August 2022 and again did not mention this condition.
Further documentation prepared by the GP dated 23 July 2023 did mention the condition and stated the condition had onset six years earlier and described the condition as permanent, stable, fully diagnosed and treated. The Applicant’s GP noted that no further changes were likely over time and that two specialists had been involved, and that the Applicant remained symptomatic and required transfusion and iron supplementation. The GP further noted an impairment rating of “15 points” for the condition. The same information was repeated in another medical report dated 10 August 2023.
The Applicant’s GP, by letter dated 30 April 2024, described the condition of pelvic floor dysfunction as a separate condition yet closely related to the uterine bleeding condition. The Applicant’s GP stated that she had attended specialist Dr KM and that she remained symptomatic with no long-term improvement despite “all therapies”. The GP stated that: “It is clear from passage of time and the trial of many therapies that the condition is fully diagnosed, treated and stabilised. She is on treatment with vaginal ring pessary and Vesicare and pelvic floor exercises”.
In a subsequent document prepared by the GP, the Applicant’s GP provided the following comments about the condition:
[s]he also has a separate problem to do with pelvic floor dysfunction which is causing her Incontinence of significant nature this restricts her ability to go anywhere an maintain herself she has been treated by Dr [KM] who’s a specialist in this field and is currently on treatment with vesicare and is using a vaginal ring to lift the bladder and maintain the pelvic floor in a taught [sic] position this has not completely relieved her symptoms in her symptoms and she remains somewhat distorted because of her constant fear of being embarrassed in public … There is another dimension to the urinary difficulty control is that she has incomplete bladder emptying and that causes her to have residual urinary contents in the bladder causing her to get recurrent urinary tract infections as well.
When asked at hearing about the medical reports prepared by her GP in 2022, which had not mentioned the condition of pelvic floor dysfunction, the Applicant stated that the medication given to her for the condition had been given by another doctor. The Applicant, in her evidence at the hearing, agreed that she had not seen Dr KM for this condition, but stated she had seen another specialist for the condition.
The Tribunal accepted that the condition of pelvic floor dysfunction had onset in or around late 2020 and that the Applicant had attended her GP for the condition and had attended a specialist for the condition at an unspecified time. The difficulty for the Tribunal is that the medical evidence does not establish comprehensive assessment and treatment of the condition at the time of the disability support pension claim or within the relevant period after the claim. Given this, the Tribunal concluded that the condition was not fully diagnosed, treated and stabilised for the purposes of the disability support pension claim. In consequence, the Tribunal is unable to consider the allocation of points for this condition.

Depression and anxiety

The Tribunal was provided a Centrelink medical certificate dated 24 December 2017, which described the Applicant as having anxiety disorder with depression, with onset on 25 November 2017. The Tribunal accepted that the Applicant had subsequently attended psychologist FS in April 2020 for an initial session and that the psychologist had written to the Applicant’s GP seeking that a mental health care plan be prepared. The Tribunal accepted from the information provided by Centrelink that FS is registered as a general psychologist.
The Applicant then attended psychologist Dr JS during 2021. On 2 November 2021, Dr JS prepared a letter stating that the Applicant had been attending him under a mental health care plan for symptoms of depression and anxiety and was prescribed Valdoxan and Efexor 150mg. The Tribunal accepted that Dr JS is a clinical mental health social worker and registered psychologist.
Commensurate with the disability support pension claim, the Applicant attended a job capacity assessment on 24 August 2022, at which time the following was noted in respect of the mental health condition:
[C]lient reported difficulty managing stress, poor sleep, reduced concentration, difficulty socialising, thinking, negative thought patterns, phobia, anxiety regarding tunnels, looking around due to paranoia. The client reported stress also exacerbates her skin condition, and results in skin irritation when stressed. The client takes Zyrtec and it assists her with 'calming down'.
Treatment: The client reported she has taken anti-depressants and due to being allergic, the client has stopped taking medication due to the effects and allergic reactions. The client reported this was prescribed by her GP.
The client reported she still sees Mr [Dr JS], Psychologist every few months for treatment or as needed.
The Applicant’s GP provided written information about the mental health condition, by letter dated 21 November 2023, indicating that the condition had been diagnosed four years earlier. The GP described the condition as fully diagnosed and permanent and stated that it had been diagnosed by Dr JS and was not improving despite therapy, cognitive behavioural therapy and medication and further noted that: “No room for surgical or physical therapy currently on treatment with antidepressant and CBT”. The GP referred to a 20-point impairment rating under Table 5 of the Impairment Tables but did not describe any specific functional limitations in relation to the condition.
The Tribunal accepted that the Applicant attended registered psychologist LT in 2024. A letter prepared by LT to the Applicant’s GP dated 17 January 2024 stated LT had seen the Applicant “at last year (2018)” and was seeking a further referral for 2024 as the Applicant was wanting to continue with her counselling sessions. The letter prepared by LT noted that some of the Applicant’s symptoms had improved and that the Applicant would like to continue with counselling in 2024.
In a letter prepared by the Applicant’s GP, dated 1 September 2024, the GP noted that one of the Applicant’s major problems is ongoing persistent depression that she had had for eight years, that many treatments had been trialled without improvement, that the Applicant had had cognitive behavioural therapy and medication and attendance at psychiatrists without any benefit and that she remained withdrawn.
At the Tribunal hearing, the Applicant gave evidence that she had not been aware there was a difference in psychologists and noted that she was seeing LT. She stated that the condition had mainly been managed by her attending her doctor. When asked about the reference in the job capacity assessment to her having ceased taking medication, the Applicant stated that it had made her drowsy and she couldn’t wake up. She stated it had been her first trial of medication and she can’t remember how long she took it for but thinks it was for two to three weeks.
The Tribunal accepted that the Applicant has experienced mental health symptoms since 2017, that she attended a psychologist on one occasion in 2020 and that she commenced more regular attendance at another psychologist during 2021. As of 2022, when the disability support pension claim was lodged, the Applicant had been prescribed medication but had ceased taking this after only two to three weeks. The Tribunal accepted the Applicant’s evidence, given at hearing, that the brief medication trial had been the Applicant’s first trial of medication. The Applicant’s GP’s assertion that she had attended “psychiatrists”, in the letter prepared on 1 September 2024, is not borne out by the other medical evidence before the Tribunal. The Tribunal does not accept the Applicant has attended a psychiatrist on any occasion, for either assessment or ongoing treatment, or that she has attended multiple psychiatrists as her GP claims. The Tribunal accepted the Centrelink submissions that the psychologists attended by the Applicant are registered psychologists but not clinical psychologists.

The introductory comments to Table 5 of the Impairment Tables, which relates to mental health function, requires that diagnosis of the condition must be made by an appropriately qualified medical practitioner, including a psychiatrist, with evidence from a clinical psychologist if the diagnosis has not been made by a psychiatrist. At the time of claim, and within 13 weeks of claim, the Applicant had not been diagnosed by a psychiatrist or clinical psychologist. Given this, the condition was not fully diagnosed for the purposes of the disability support pension claim.
Further, at the time of claim, the Applicant had had one brief trial of medication, which she had ceased after only two to three weeks due to negative side effects. She was seeing her counsellor only once every few months and had not otherwise engaged in regular treatment for the mental health condition. The condition is unable to be considered fully treated and stabilised for the purposes of the disability support pension claim. The Tribunal is, accordingly, unable to consider the allocation of points for the condition.

Lumbar spine prolapse

The Tribunal accepted the Applicant attended her doctor in October 2021 for spinal pain, at which time she reported being unable to rotate in bed due to tightness in her lower back. There is no information before the Tribunal as to investigation or management of the condition following this reporting in 2021.
In April 2022, the Applicant’s GP prepared a medical certificate stating that she had been under his care for disc prolapse since 6 March 2018. In November 2022, in a Patient Health Summary prepared by the GP, the Applicant’s GP stated that “current therapy” included physiotherapy and an exercise program for lumbar spine pain. The Applicant’s GP also prepared a range of medical reports, dated 23 July 2023, 10 August 2023 and 21 November 2023. The reports stated, in respect of the condition of lumbar spine prolapse, that the initial diagnosis of the condition had been in April 2022 and described the condition as permanent, stable and fully diagnosed. The GP stated that the Applicant “is on maximal intervention but remain [sic] having complications, with disability and chronic pain”. The GP noted there was no expectation for improvement given time and that current medications were analgesics, muscle relaxants and NSAids. The Applicant was described as able to work less than 15 hours over the next five years. In the report dated 21 November 2023, the GP asserted that the condition attracts an impairment rating of 10 points.
The Applicant gave evidence that she had not attended a spine specialist, but had been attending physiotherapy and taking medication. She stated that scans had been done in 2021 and again more recently and noted that whatever her doctor had recommended, she had done.
The Tribunal notes the differing indications in the medical documentation about the timing of onset of the condition, but accepts that the Applicant’s GP was managing the condition as of 2022. The Tribunal accepts that the Applicant has taken medication for the condition and has attended physiotherapy but is mindful that there is no direct evidence before the Tribunal as to the timing or details of those treatments. The Applicant acknowledged in her evidence at the hearing that she has not attended a spine specialist. The Tribunal considered there was insufficient evidence before it to conclude that the Applicant had trialled medication for the lumbar spine condition and attended a range of physical therapies at the time of claim, or within 13 weeks of claim. Accordingly, the Tribunal considered the condition was unable to be considered as fully diagnosed, treated and stabilised for the purposes of the disability support pension claim or that points could be considered for the condition.

Diabetes

In a letter prepared on 1 September 2024, the Applicant’s GP described that the Applicant had “recently” been diagnosed with diabetes mellitus, probably due to weight gain and ongoing inflammation. The GP stated that the Applicant “has been commissioned on treatment for these and the iron is to control her sugar levels and bring her to better glycaemic control and reduce her retractors she is on current maximum therapy for this”. The GP stated that the condition is undoubtedly one of the factors causing the Applicant to feel tired all the time. At the Tribunal hearing, the Applicant stated that the condition is hereditary and she has had it for a some time. She stated that the diagnosis had been described as recent because of blood results.
Based on the evidence before it, the Tribunal found that the condition of diabetes was not fully diagnosed, treated and stabilised at the time of claim, on the basis that there was no medical evidence before the Tribunal that, in the period 10 August 2022 to 9 November 2022, the Applicant had received a diagnosis of the condition or that she had undertaken any treatment for the condition. Given this finding, the Tribunal is unable to allocate points for this condition.

Irritable bowel syndrome

The Applicant attended a job capacity assessment in March 2024, at which time she reported to the assessor that the condition was managed with diet. She reported to the assessor that she had food intolerances.
At the Tribunal hearing, the Applicant gave evidence that the condition of irritable bowel syndrome was probably first diagnosed in around 2021 and had been diagnosed by her GP. In response to a question as to whether a colonoscopy had been performed, she stated that her doctor had ordered a urine test and blood test and she has them regularly, but cannot remember when. She confirmed in her evidence that she has not had a colonoscopy.
In considering whether a condition has been fully diagnosed and fully treated, the Determination requires that the Tribunal consider whether there is corroborating evidence of the condition, what treatment has occurred in relation to the condition and whether treatment is continuing or is planned in the next two years. The Determination further requires that symptoms reported by a person in relation to their condition can only be taken into account where there is corroborating evidence.
Diagnosis, treatment and symptoms of the condition of irritable bowel syndrome, by way of detailed medical evidence by an appropriately qualified medical practitioner, have not been provided by the Applicant. In these circumstances, the Tribunal is unable to be satisfied that the condition was fully diagnosed, treated and stabilised in the relevant period and is unable to allocate points for this condition under the relevant Impairment Table.

Eczema

In a letter prepared by the Applicant’s GP dated 21 November 2023, the GP described that the condition had been diagnosed three years earlier and described the condition as “fully diagnosed” and as “permanent”. The GP stated that the condition had been diagnosed by a dermatologist and “is not improving despite therapy”. The GP asserted that the condition attracts 10 points under Table 10 of the Impairment Tables and referred to the factors outlined in the relevant Impairment Table relating to moderate difficulties performing activities involving use of the hands; and the requirement to wear protective gloves for most tasks, avoid contact with all detergents and soaps, or avoid repetitive tasks involving use of the hands. The GP described the condition as: “Fully treated with stable symptomatic and dysfunctional end stage at maximum therapy”.
A medical certificate prepared by the Applicant’s GP, dated 5 February 2024, states that the condition of eczema is “generalised and severe” and had onset on 5 January 2022. Past, current and planned treatment were stated to be medications. The Tribunal accepted that the Applicant also attended a consultant dermatologist on an unspecified date and was diagnosed with a prominent nickel allergy and was referred back to her GP with a script for Diprosone cream. A Heath Summary Sheet printed on 4 August 2022 listed Diprosone with a most recent script dated 28 December 2020. A copy of a subsequent script provided by the Applicant indicates that she was further prescribed Diprosone in April 2024.
When asked at the hearing about the condition not having been listed in the disability support pension claim form, the Applicant stated in response that she had spoken to her doctor about that and he had missed it. The Applicant stated that she had been suffering from eczema all of her life and all she has been taking is cortisone cream, which she uses on her hands and over her body. She had not been recommended to see a dermatologist or skin specialist and her doctor told her this was the only treatment for her and to continue with cortisone.
The Tribunal accepted from the medical evidence before it that, at some stage prior to 21 November 2023, the Applicant had attended a dermatologist and had been diagnosed with eczema. She had been prescribed Diprosone at least as early as December 2020 and the Tribunal is prepared to accept that, at the time she gave evidence to the Tribunal at the hearing, she was using cortisone cream.
While the Tribunal accepts the Applicant attended a dermatologist for diagnosis of the condition, there is no medical evidence about management of the condition by a specialist or of long-term use of Diprosone, cortisone or other treatment. Given the lack of comprehensive medical evidence before the Tribunal about this condition, and given the requirement in the Determination that symptoms of a condition can only be taken into account where there is corroborating medical evidence, the Tribunal concluded that the condition was not fully diagnosed, treated and stabilised for the purposes of the disability support pension claim. The Tribunal is unable to consider the allocation of points for this condition.

Cervical spine spasm

By medical reports dated 23 July 2023, 10 August 2023 and 21 November 2023, the Applicant’s GP stated that the condition had been diagnosed six years earlier and described the condition as fully diagnosed, permanent and deteriorating with time. The GP referred to the condition as having been diagnosed by Dr JS (the Applicant’s treating psychologist) and to be deteriorating with time. The GP commented, in respect of the condition: “no room for surgical or physical therapy, currently on treatment with antidepressant for fibromyalgia being in causation” and that the condition is “fully treated with stable symptomatic and dysfunctional end stage at maximum therapy”. The noted an impairment rating of 10 points.
The Applicant underwent a CT scan of the cervical spine on 22 April 2024, where the following findings were made: the cranio-vertebral junction was normal; skill base appeared normal; atlanto-occipital and atlanto-axial joints appeared normal; loss of cervical lordosis was noted; fusion of C6 and C7 vertebral bodies and fusion of bilateral C6 and C7 facet joints was noted; and no disc bulge, herniation, spinal canal or neural foraminal stenosis was found in C2-C3, C3-C4 or C4-C5.
The Applicant gave evidence that she had had a bone scan conducted for the condition in August 2024 and the findings were in keeping with a degenerative disc disease. She was diagnosed after the testing on 15 August 2024.
The written information prepared by the Applicant’s GP on three separate dates described diagnosis of the condition in or around 2017. There was no independent evidence of such a diagnosis. The GP also referred to the condition as having been diagnosed by Dr JS and to the Applicant being on antidepressant medication for the condition; the Tribunal did not accept that the comments of the GP in the three separate reports related to the condition of cervical spine spasm or that the Applicant has been treated for the condition with antidepressant medication. The GP’s reports refer to an underlying condition of fibromyalgia. This does not appear elsewhere in the medical documentation and no diagnosis of this condition is before the Tribunal. The comments of the GP do not clarify who diagnosed the condition or provide any understandable commentary about the treatment and functional impact of the condition. A CT scan of the cervical spine does not appear to have been undertaken until some 18 months after the relevant period. Based on the medical information before it, the Tribunal finds that the condition of cervical spine spasm was not fully diagnosed, treated and stabilised at the time of claim or within the relevant period.

Asthma

A Medical Certificate prepared by the Applicant’s GP, dated 27 April 2022, states that the Applicant had been under her GP’s care for the condition of asthma from 4 April 2022. A Patient Health Summary prepared by the GP on 30 November 2022 provided the same details. Neither document provided any details about the source of the diagnosis or any treatment for the condition, although the Patient Health Summary notes the Applicant has been prescribed Ventolin.
In a job capacity assessment conducted on 28 September 2022, the assessor noted that the condition had been diagnosed by the Applicant’s GP by letter dated 10 August 2022. The Applicant reported to the assessor that she has a reaction in dusty environments, that she is allergic to dust, pollen and humidity and that a lack of sleep aggravates the condition. The Applicant reported using a puffer daily and that, when her sinuses are bad, her asthma is triggered. The assessor noted that the Applicant had not had specialist intervention or reviews to determine treatment needs.
The Applicant told the Tribunal at the hearing that the condition is triggered by dust. The Applicant stated that she uses a puffer and sometimes an inhaler; Ventolin helps her and sometimes she uses a nebuliser. When it was observed at hearing that the condition was not mentioned in medical reports prepared in 2023, the Applicant stated in response that she had grown up with asthma.
The Tribunal accepted from medical information prepared by the Applicant’s GP that the condition of asthma has been managed by her GP since April 2022 and that her GP has prescribed Ventolin for the condition. There is no medical information about specialist attendance for the condition or about any functional impact caused by the condition. The Tribunal concluded, on the information before it, that the condition was not fully diagnosed, treated and stabilised in the relevant period and that the Tribunal is unable to consider the allocation of points for the condition.

Gastro-oesophageal reflux disease

The Tribunal noted that the Applicant claimed, in the disability support pension claim form, that onset of this condition had been on 11 November 2021. A brief report prepared by the Applicant’s GP dated 4 February 2021 indicated that the Applicant had been prescribed Somac and that the date of the last script had been issued on 25 March 2020.
There is little other medical evidence before the Tribunal about the condition. In a medical certificate prepared by the Applicant’s GP on 27 April 2022, the GP states that he has managed the condition since 11 November 2021 and this information is repeated as “active past history” in a Patient Health Summary prepared on 30 November 2022.
The Applicant gave evidence at the hearing that she takes Nexium and Somac for the condition and that Nexium helps the condition. Given the lack of detailed medical evidence before the Tribunal about the source of diagnosis of the condition, any specialists consulted, treatment for the condition and functional impact caused by the condition, the Tribunal concluded that the condition was not fully diagnosed, treated and stabilised in the relevant period and the Tribunal is therefore unable to consider the allocation of points for the condition.

Sciatica

The Tribunal noted that the condition is not listed in the conditions claimed at the time the disability support pension claim was lodged. The Applicant’s GP prepared a letter dated 1 September 2024, stating in the letter that the information being prepared was to report on illnesses the Applicant had suffered since August 2022. In respect of the condition of sciatica, the GP provided the following comments:
She continued to suffer from sciatica that occurs the recurrently affecting her lower back and causing radiation of pain to the left leg and often makes unable to mobile effectively and address many of her home calls as well as being able to be involved in work and this has led to her becoming unemployed until a degree difficult to employ investigation of this had been in the past and it’s due to a disc compression of the outgoing fibers which is not available to surgical intervention this has also been complicated with the development of chronic pain and other depressive manifestations that occurred following the ongoing marital discomfort.
The extent of permit from this is the it is difficult for her to stand for periods greater than 10 to 15 minutes because of the severity of the pain and anyways you can manage is to sit down and this further makes it impossible for her to squat kneel or handle heavy objects significantly
She has had multiple treatments including muscle trees and remains unable to function despite all these.
At the Tribunal hearing, the Applicant stated that her doctor had explained to her that she needed to just take painkillers and undertake physiotherapy for the condition. In response to a question as to whether her doctor had mentioned any other treatment available, the Applicant stated in response that she had had no further referral anywhere. When asked whether she had been referred to a surgeon or specialist, the Applicant stated that after reviewing the results of the diagnosis, her doctor said that all she needs to do is physiotherapy, to continue her medication and to exercise, including walking.
The Tribunal has not been provided any documentation confirming that the condition had been diagnosed at the time of claim or within the relevant period, or of any specialist consultation, or the “multiple treatments” referred to by the Applicant’s GP, or detailed information about functional impact caused by the condition commensurate with the disability support pension claim. On the evidence before it, the Tribunal was not satisfied that the condition was fully diagnosed, treated and stabilised within 13 weeks of claim and concluded that it is unable to consider the allocation of points for this condition.

Conclusion about medical conditions

For the reasons set out above, the Tribunal has not found that any of the Applicant’s medical conditions was fully diagnosed, treated and stabilised and able to be allocated impairment points for the purposes of the disability support pension claim made on 10 August 2022. As the Applicant does not have an impairment rating of 20 points under the Impairment Tables, she does not meet the requirement in paragraph 94(1)(b) of the Act. The decision to reject the claim for disability support pension is therefore legally correct and the decision is affirmed.

Date of hearing: 15 May 2025

Solicitors for the Applicant: Self-represented

Solicitors for the Respondent: Ms N Chandra

Date of hearing:	15 May 2025
Solicitors for the Applicant:	Self-represented
Solicitors for the Respondent:	Ms N Chandra