What to do if your DSP claim is rejected

If your claim is rejected

If your DSP claim is rejected, and you don’t agree with the decision or want more information, you can ask Centrelink for an explanation.

Centrelink should provide a brief explanation in its letter rejecting your DSP claim, explaining why it was rejected.

Common reasons Centrelink provides for rejecting claims for the DSP include:

• one or more of your health problems have not been fully diagnosed, treated and stabilised
• your health problem has not been diagnosed by an appropriately qualified professional, for example, if you have a mental health condition and you did not provide a report from a psychiatrist or clinical psychologist
• your health condition is likely to improve in the next two years if you undertake further reasonable treatment
• you were not awarded a total of 20 points under the Impairment Tables
• you did not participate in a program of support for a total of 18 months in the last three years
• the evidence you provided is not relevant to your health problem at the time of your claim for the DSP or in the 13 weeks after your claim.

It is possible that your claim for the DSP was rejected for a reason not relating to your health problems. For example, your claim for the DSP may have been rejected because you did not meet the income and assets test or because Centrelink does not consider you to be a resident of Australia. 

If your claim has been rejected, you should get legal advice.

Getting other financial support

If Centrelink rejects your claim for the DSP, you will continue to receive JobSeeker Payment or you can claim for JobSeeker Payment, if you were not granted this payment at the time of your claim for the DSP.

You will also need to satisfy the activity test. This means you will need to actively look for work, attend appointments with your job service provider or disability employment provider, and participate in approved training programs. If you don’t satisfy the activity test, your payment may be suspended.

If you are too sick to satisfy the activity test, you should get a medical certificate from your doctor and give it to Centrelink or your job service provider or disability employment service provider. For more information, see Income support payments.

If your health problems get worse

If your claim for the DSP was rejected, but your health problems are getting worse, you should consider making a new claim.

In support of your new claim, you can provide new evidence about your health problem and any treatments you have received since your previous claim.

Problems with medical certificates rejected by Centrelink

If you give Centrelink or your employment service provider a medical certificate that lists the same health problems that were part of your claim for the DSP, your medical certificate may be rejected.

If your medical certificate has been rejected you should:

• satisfy the activity test, for example, attend any appointments made for you
• ask your doctor if they believe your health problem is a temporary flare up of an existing health condition and obtain a new medical certificate if this is the case
• appeal the decision to reject your medical certificate to an Authorised Review Officer.

If your new medical certificate is accepted, you do not need to satisfy the activity test. However, this means that you are not participating in a Program of Support, which may affect any future claims you make for the DSP.

Appeal to the Authorised Review Officer 

If you have contacted Centrelink and you still don’t agree with the decision to reject your claim for the DSP, you have the right to appeal to an Authorised Review Officer (ARO). 

To get full arrears to the date you claimed the DSP, you need to appeal within 13 weeks of receiving the decision to reject your claim. You don’t have to pay a fee to appeal.

The ARO will look at all the evidence you have provided in support of your claim for the DSP. They will also give you an opportunity to provide new evidence, that is relevant at the date of your claim and 13 weeks after this. They will also look at the Job Capacity Assessment and the Disability Medical Assessment.

You will receive a written decision from the ARO providing detailed reasons regarding your appeal.

If your appeal was successful and you applied within 13 weeks, you will usually receive back pay to the date of your claim the difference between the rate of the JobSeeker Payment and the rate of the DSP.

If your appeal was unsuccessful, you will receive a written decision explaining why your appeal was denied. You have a right to appeal the decision of the ARO or Subject Matter Expert to the Administrative Review Tribunal (ART).

Some common issues related to DSP claim decisions are detailed below.

Insufficient evidence in support of your claim 

If you received a written decision from the ARO it will provide the reasons why your appeal is successful or unsuccessful. If the reasons show that the evidence you provided in support of your claim was not considered, there may be a few reasons for this.

Centrelink will only look at evidence of your health problems that is relevant at the time of your application and 13 weeks after this date.

If you have provided evidence to Centrelink, that refers to your health condition as it was more than 13 weeks after your application, they will not take this evidence into account. However, this evidence may be relevant to a new claim for the DSP.

Centrelink may also have ignored the evidence you provided in support of your claim for the DSP because your health problem had not been diagnosed by an appropriately qualified professional, for example, if you have a mental health condition and you did not provide a report from a psychiatrist or clinical psychologist.

Evidence not related to your health problem as of the date of your claim

To be eligible for the DSP, the evidence you provide to Centrelink to support your claim must relate to your health problem at the time of your claim and 13 weeks beyond that. This is called the relevant period.

The evidence you provide needs to refer to your health problem at the date you claimed for the DSP. It is possible that a report prepared some years before your claim for the DSP is still relevant to your health problem at the time you made your claim. However, it is best to get a recent report about your health problems.

Centrelink say you need a specialist report but you can’t obtain it because it’s too expensive

If you don’t have enough money to pay a specialist for the report, you can explain to the specialist that you need the report as evidence for your claim for the Disability Support Pension and that you can't afford to pay the full fee. You can ask to have the fee waived or for a reduction. The specialist may or may not agree to your request. You can also ask your GP to refer you to another specialist who may waive or reduce their fee for the report.

Health problems not 'diagnosed, reasonably treated and stabilised'

To be eligible for the DSP, your health condition must be diagnosed, reasonably treated and stabilised.

Diagnosed

For your health problem to be diagnosed, an appropriately qualified doctor needs to provide an explanation of your health problem. Your own explanation for your health problem is not a diagnosis. For the purpose of claiming the DSP, some health problems require a specialist to confirm the diagnosis. 

For mental health conditions a diagnosis can be made by a general practitioner or psychiatrist (with evidence from a registered psychologist if the diagnosis has not been made by a psychiatrist). 

Treated

For your health condition to be treated, you must have received reasonable treatment or rehabilitation for your health problem. A treatment includes medical treatment or rehabilitation to help your physical or mental function.

Stabilised

For your health problem to be stabilised, you need to provide evidence that you have undertaken reasonable treatment or that further reasonable treatment is unlikely to help your physical or mental function within the next two years.

The rules around what constitutes ‘stabilised’ have changed. A condition can be regarded as treated and/or stabilised if treatment is unlikely to result in significant functional improvement, whether or not the person has actually undertaken that treatment. 

Appeals to the Administrative Review Tribunal

The Administrative Review Tribunal (ART) can review Centrelink decisions. There are two levels of review by the ART.

First review

If your appeal to the Authorised Review Officer (ARO) was unsuccessful, you have a right to appeal the decision to the ART. This is called a first review.

There is no fee to apply to the ART.

To be eligible for full payment of arrears from the date of your claim for the Disability Support Pension, you need to appeal within 13 weeks of receiving the ARO's decision.

For more information, see Centrelink payments on the Administrative Review Tribunal website. 

Before you appeal to the ART, you should get legal advice.

Second review

If your first review by the ART is unsuccessful, you have a right to apply for a  second review in the Guidance and Appeals Panel of the Administrative Review Tribunal.

You have 28 days from the date of the first review decision to appeal. There is no fee to apply for a second review.

Before applying for a second review, you should get legal advice. If you can't get an appointment for legal advice before the 28 days has passed, you should still lodge the appeal in time. Your appeal can be withdrawn if you decide not to proceed with it.

If more than 28 days have passed since the ART made its first review decision, you may still be able to apply for a second review. You will need to make an application for an extension of time. You need to explain in your application why you were not able to appeal within the time limit.

For more information, see Guidance and Appeals Panel on the Administrative Review Tribunal website.

Before you make an application for a second review, you should get legal advice.

Appealing to the Federal Court of Australia

If you’re unhappy with the second review decision of the Guidance and Appeals Panel of the Administrative Review Tribunal (ART) you may be able appeal the decision to the Federal Court of Australia. You have 28 days to appeal the decision.

You have to pay a fee to appeal to the Federal Court of Australia.

For more information, see Court Fees Payable on the Federal Court of Australia website.

In some circumstances, you can apply for an exemption from paying the fee.

For more information, see Exemption From Paying Court Fees on the Federal Court of Australia website.

Before you appeal to the Federal Court of Australia, you should get legal advice.