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

This matter concerned an appeal by Mr Lozi against a decision to affirm the rejection of his claim for a Disability Support Pension. The central dispute revolved around whether Mr Lozi’s impairments, specifically a mental health condition and a spinal condition, resulted in a functional impairment rating of 20 points or more under the relevant Impairment Tables, as required by section 94(1)(b) of the Social Security Act 1991 (Cth). The case was heard by Dr I Alexander, Member, of the Administrative Appeals Tribunal.

The Administrative Appeals Tribunal was required to determine if Mr Lozi’s impairments met the threshold for a Disability Support Pension, specifically whether his combined functional impairment rating was 20 points or more. This involved assessing the severity of his mental health condition and considering other potential impairments, and then applying the criteria outlined in the Impairment Tables. The Tribunal also needed to consider whether any diagnosed conditions were permanent and had a severe functional impact.

The Tribunal found that while Mr Lozi did suffer from a mental health condition, described as depression, the evidence presented was insufficient to reliably assess his functional impairment under the Impairment Tables. The medical evidence was noted as incomplete, with inconsistencies in diagnoses, prescribed medication, and compliance. Reports from treating doctors were considered superficial and lacked a clear rationale or assessment of functional impact. Furthermore, reports assessing functional impairment were provided significantly after the claim period, raising concerns about their relevance. Crucially, assertions made in some reports regarding severe difficulties with self-care and travel were directly contradicted by Mr Lozi’s own evidence and other recorded evidence, leading the Tribunal to place little weight on those assessments. Consequently, the Tribunal was not satisfied that Mr Lozi’s impairment rating reached 20 points or more.

The Tribunal affirmed the decision under review, concluding that Mr Lozi did not satisfy the requirements for a Disability Support Pension because his impairment rating was not 20 points or more under the Impairment Tables.