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Why we need medical evidence
We need to know how your disability or medical condition affects you. This will help us work out if you can get DSP.
We need medical evidence from your treating doctors or other health professionals. In most cases, we need current evidence for each condition that affects your ability to work.
Give us all your medical evidence with your claim so we can assess it faster. It should support what you’ve put in the medical details section of your claim form.
If you don’t give us evidence, we may either:
- reject your claim
- stop your payment.
If you’re having problems getting evidence, call us. We can talk with you about your options.
What we need to know
Your medical evidence should tell us any of the following:
- your diagnosed disability or medical conditions
- past, current and planned treatment
- how your condition impacts you day to day
- the names and contact details of your treating doctors.
Your symptoms
This helps us know any of the following:
- when the symptoms started
- how often and for how long the symptoms happen
- the impact of your conditions with treatment and use of aids, equipment or assistive technology.
Your prognosis
We need to know how long your condition will last and if it:
- will improve, stay the same, or get worse
- may affect how long you’ll live.
What types of medical evidence you need to give us
The evidence we need depends on your disability or medical condition. For some conditions or situations we need particular information.
Manifest medical rules
So we can assess if you meet the manifest medical rules, you need to give us specific medical evidence.
| Your condition or situation | Medical evidence we need |
|---|---|
| You are permanently blind | You’ll need to either:
|
| You require nursing home level care | Details from your treating doctor that shows your diagnosis and symptoms, including how your condition impacts you day to day. You also need to provide details of the level of care showing both:
|
| You have an intellectual disability with an IQ of less than 70 | You’ll need to provide details of either:
The evidence you provide must include information supported by a psychologist about your IQ score or your ability to undergo IQ testing. |
| You are terminally ill with an average life expectancy of less than 2 years | Details from your treating doctor that show your diagnosis, the stage of the condition, treatment details, and prognosis. Your health professional may need to complete the Verification of Terminal Illness form. |
| You have Category 4 HIV/AIDS | Details from your treating doctor of your diagnosis, the stage of the condition, treatment details, and prognosis. |
| You get a Department of Veterans’ Affairs Disability Compensation Payment at the Special Rate (totally and permanently incapacitated) paid under the Veterans’ Entitlement Act 1986 (VEA). | Disability Compensation Payment at the Special Rate (totally and permanently incapacitated) paid under the VEA, letter from the Department of Veterans’ Affairs. You can give us permission to ask the Department of Veterans’ Affairs for the same information. |
General medical rules
To help us assess if you meet the general medical rules, you can give us evidence such as any of the following evidence:
- medical history records or reports
- specialist medical reports
- psychologist reports, including IQ testing
- medical imaging reports, but not films or CDs
- physical examination reports
- hospital or outpatient records including details of operations
- compensation and rehabilitation reports
- special school reports
- other evidence such as physiotherapy or audiology reports.
For some conditions we need specialist medical evidence.
The Department of Social Services (DSS) website has the detailed impairment tables we use to assess your eligibility for DSP under the general medical rules.
| Your condition | Specialist medical evidence we need | Why we need this |
|---|---|---|
| Mental health conditions | Evidence showing either:
| This helps us assess your condition on Table 5 of the Impairment Tables on the DSS website. We can only do this where the condition is diagnosed, reasonably treated and stabilised. If your DSP claim start date or medical review was before 1 April 2023 you need to provide either:
|
| Intellectual disability | Evidence showing an assessment of intellectual function and adaptive behaviour by a psychologist. | This helps us assess your condition on Table 9 of the Impairment Tables on the DSS website. We can only do this where the condition is diagnosed, reasonably treated and stabilised. |
| Ear conditions affecting hearing or balance | Evidence showing both:
| This helps us assess your impairment on the Impairment Tables on the DSS website. We can only do this where the condition is diagnosed, reasonably treated and stabilised. |
| Eye conditions affecting vision | Evidence showing an ophthalmologist or ophthalmic surgeon supports the diagnosis. | This helps us assess your condition on Table 12 of the Impairment Tables on the DSS website. We can only do this where the condition is diagnosed, reasonably treated and stabilised. |
How to give us the correct medical evidence
Use the Disability Support Pension Medical Evidence Checklist. It will help you work out what medical evidence you need to submit with your claim.
Your treating health professional can use the Medical Evidence Checklist for treating health professionals form. This helps them to check your evidence includes the information we need about your condition.
If you need more information on the process, read how to claim.
Call us if you’re not sure what evidence we need from you.
Your consent
We may talk to your treating health professionals. They may ask us if you agree to them giving us information.
You can do this on the Consent to disclose medical information form. We’ll show this to your treating health professional if they ask us.
You can also calling us to withdraw your consent at any time.
Contact numbers available on this page.
Disability, sickness and carers line
Use this line if you need help with your Disability Support Pension, Special Disability Trusts, Mobility Allowance, Carer Payment or Carer Allowance.
There are other ways you may want to contact us.