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

This matter concerned an application for a second-tier review by the Administrative Appeals Tribunal (AAT) of a decision to refuse a Disability Support Pension (DSP). The applicant, born in 1958, had migrated to Australia in 1988 and previously received a DSP in 1993 following a motor vehicle accident in 1993 that caused significant injuries. After returning to Australia in 2000, the applicant reapplied for the DSP on 24 October 2018, which was subsequently refused. The applicant’s claim for the DSP was based on several conditions: a mental health condition, a left leg condition, chronic back pain, hearing loss, and diabetes.

The primary legal issues before the Tribunal were whether the applicant's claimed impairments attracted a rating of 20 points or more under the relevant Impairment Tables, and whether these conditions were fully diagnosed, treated, and stabilised within the qualification period. The qualification period for the DSP claim was from 24 October 2018 to 23 January 2019. For an impairment rating to be assigned, the Tribunal was required to be satisfied that the condition causing the impairment was permanent, meaning it was fully diagnosed, fully treated, and fully stabilised, and likely to persist for more than two years.

The Tribunal considered medical reports and oral evidence from the applicant. It applied the criteria for a condition being fully treated and stabilised, which requires either that reasonable treatment has been undertaken and further treatment is unlikely to result in significant functional improvement enabling work in the next two years, or that no reasonable treatment has been undertaken and significant functional improvement is not expected even with treatment, or there is a compelling reason not to undertake treatment. The Tribunal's assessment focused on the applicant's conditions during the qualification period, with evidence post-qualification being relevant only to the weight given to prognostications made during that period. The Tribunal affirmed the decision to refuse the DSP.