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

This matter concerned an appeal by Miss Simmonds against the Secretary of the Department of Social Services' decision to reject her claim for a disability support pension. The appeal was heard by Mark Hyman, Member, of the Administrative Appeals Tribunal.

The primary legal issue before the Tribunal was whether Miss Simmonds met the criteria for a disability support pension, specifically paragraph 94(1)(b) of the Social Security Act 1991 (Cth). This required determining if her diagnosed conditions, namely a psychiatric condition and bilateral subacromial bursitis of the shoulders, were fully diagnosed, treated, and stabilised according to the Impairment Tables, and if they resulted in a sufficient level of functional impairment.

The Tribunal found that Miss Simmonds' psychiatric condition was fully diagnosed by a psychiatrist. While her compliance with treatment was an issue, the Tribunal accepted that her non-compliance was a symptom of her psychiatric condition, and therefore, the condition could still be considered fully stabilised under the Act, particularly in light of the provisions allowing for stabilisation even without full treatment if there is a compelling reason for non-treatment, such as a lack of insight due to the condition. However, regarding her shoulder condition, the Tribunal found it was not fully treated and stabilised. Despite a referral to physiotherapy, there was no evidence it was acted upon, and the available treatment consisted of steroid injections and anti-inflammatories, with Dr Rifat noting other treatment options remained available and describing the condition as temporary with an excellent prognosis. Consequently, the Tribunal could not rate the shoulder condition under the Impairment Tables.

As Miss Simmonds did not meet the required 20 points under the Impairment Tables due to her shoulder condition not being fully treated and stabilised, she did not satisfy paragraph 94(1)(b) of the Act. Therefore, she did not qualify for the disability support pension, and the decision under review was affirmed.