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

This matter concerned an application for a disability support pension by the Applicant, Ms. Pham, against the Secretary of the Department of Social Services. The core of the dispute revolved around whether the Applicant's medical conditions met the criteria for the pension, specifically whether her impairments attracted 20 points or more under the relevant Impairment Tables. The Administrative Appeals Tribunal was tasked with reviewing the decision to affirm the rejection of her claim.

The legal issues before the Tribunal were whether the Applicant's medical conditions, primarily myofascial pain syndrome, were fully diagnosed, fully treated, and fully stabilised during the relevant period. Crucially, the Tribunal had to determine if these conditions, along with co-morbidities such as PTSD and depressed mood, resulted in an impairment rating of 20 points or more as required by section 94(1)(b) of the Social Security Act 1991 (Cth).

The Tribunal considered the Applicant's evidence of persistent pain, its impact on her daily activities, and her desire to work. However, it was bound by the statutory requirements for eligibility. The Tribunal noted that while the Applicant presented with pain in multiple areas and it affected her functional capacity, the Respondent contended that her myofascial pain syndrome could not be considered fully diagnosed, treated, and stabilised. This contention was supported by evidence indicating the progressive spread of her pain, a lack of engagement with specialists such as rheumatologists or pain specialists since 2011, and that her psychological treatment was aimed at symptoms rather than pain management. The HPAU doctor opined that given the spread of pain, absence of laboratory screening, and lack of specialist engagement, the diagnosis of myofascial pain syndrome could not be established, and even if it were, it was not fully treated and stabilised due to the lack of multidisciplinary treatment.

Ultimately, the Tribunal found that the Applicant's impairments did not attract more than 20 points under the Impairment Tables for the purposes of section 94(1)(b) of the Act. Consequently, the decision under review was affirmed.