05 Mar 2009: Problems in assessing claims for disability support pension from people with acute or terminal illness

The Commonwealth Ombudsman, Prof. John McMillan, today released a report highlighting problems in the assessment of claims for disability support pension (DSP) from people with acute or terminal illness.

The Ombudsman’s office received complaints about the assessment of DSP claims from people with acute or terminal illness such as advanced or aggressive cancers. In many cases, the claimants were undergoing intensive treatment or recovering from the long term side effect of a previous treatment. They were unable to work as a result but were also unable to satisfy Centrelink that their condition was permanent for the purposes of qualifying for DSP.

‘People can face onerous activity and/or reporting requirements for newstart, youth or sickness allowances, during a time that is already difficult for them and their families’, Prof. McMillan said.

‘This report highlights the difficulties that can occur by a strict application of social security law and policy. For example, in one case Centrelink refused an application for DSP from a person undergoing aggressive chemotherapy and radiation therapy because they did not consider her condition permanent. She was granted newstart allowance with an exemption from activity testing, but was still required to lodge a request for payment form to Centrelink every ten weeks, and a new medical certificate each quarter.’

‘The main problems identified in the report are the lack of guidance for doctors in answering questions about a patient’s long term prognosis, the unavailability of DSP for people experiencing an acute illness of uncertain duration, and inadequate assessment in some instances by Job Capacity Assessment assessors of the impact of an acute illness suffered by a patient.’

The Ombudsman recommended a number of administrative measures to ensure more appropriate outcomes for social security applicants with acute or terminal illnesses.

These recommendations have been accepted by the relevant agencies—Centrelink; the Department of Education, Employment and Workplace Relations; the Department of Human Services, and the Department of Families, Housing, Community Services and Indigenous Affairs (FaHCSIA). They indicated their commitment to ensuring that policy and program settings and service delivery make appropriate allowance for people who are acutely or terminally ill, and that they have appropriate income support.

The Ombudsman also recommended that consideration be given to the development of a new category of payment for people who require a lengthy period of treatment or recovery, or further investigation to identify a more conclusive prognosis. The agencies did not support this recommendation, but FaHCSIA advised that a number of government reviews are underway considering DSP eligibility, assessment and payment rates.

Download the report: Assessment of claims for disability support pension from people with acute or terminal illness.

Date of release: 5 March 2009