Assessing Continuing Inability to Work (CITW) 008-03040010

This file relates to Assessing a customer’s CITW. This is separate to the process of assessing 'where a customer’s CITW occurred’ for the purpose of residence.

Where a customer is an Australian resident, with less than 10 years qualifying residence, and no Qualifying Residence Exemption (QRE), we must assess where their CITW occurred, to determine if they meet the residence criteria for DSP.

Is an assessment of ‘where the customer’s CITW occurred’ required for residence?

• Yes, refer to Streaming a new claim for Disability Support Pension (DSP)
• No, go to Step 2

Is the customer participating in the SWS or do they meet the Disability Support Pension (DSP) manifest eligibility guidelines?

• Yes, and the customer is:
• not working for 15 hours or more per week, CITW is established, an assessment is not required. Procedure ends here
• working for 15 hours or more per week, the Assessor must consider the employment in their recommendation. See Streaming a new claim for Disability Support Pension (DSP). Procedure ends here
• No, the Medical Assessment Team (MAT) recommends the customer is referred for a Job Capacity Assessment (JCA). Note: the Health Professional Advisory Unit (HPAU) can provide and/or facilitate medical advice and opinion to the Assessor for the purpose of helping to determine a customer's medical eligibility for DSP if the Assessor requires extra support to complete their assessment

The Assessor submits the JCA report electronically. It includes an assessment of the customer's impairment rating under the Impairment Tables and CITW. It may also include an assessment of where the customer's CITW occurred for residence purposes. When the report is accepted the Assessor's recommendations about the customer's medical conditions, impairment rating and work capacities (and where relevant, participation in a Program of Support (POS)) are downloaded onto the Medical Conditions (MC) screen and Work Capacity Details (WC) screen. The report automatically uploads onto the customer's record and can be viewed via Document Tools.

See Checking and actioning a Job Capacity Assessment (JCA) report.

The Service Officer is to review the Assessor's recommendations and make sure they are consistent with other information available to Services Australia.

Has the customer been assigned a combined Impairment Rating of 20 points or more by the Assessor?

• Yes, go to Step 5
• No, the customer is not qualified for DSP. If the assessment is for a DSP new claim, it is rejected when the claim is coded. See Rejecting a new claim for Disability Support Pension (DSP) including manifest rejections. If the assessment is for a current DSP recipient, the claim is cancelled. See Cancellation of Disability Support Pension (DSP). Procedure ends here

The Assessor determines if the customer has met POS requirements.

When the JCA report is accepted, the Assessor's recommendations will default to the WC screen to indicate if the customer satisfies POS requirements or not.

Valid values for the 'Program of Support' field on the WC screen are Yes, No, and Not Required.

If the customer has not met the POS requirements, the Assessor is not able to assign Diagnosed, Reasonably Treated and Stabilised (DTS) Work Capacities and these fields will not be populated on the WC screen.

A CITW (baseline and with intervention work capacity of less than 15 hours per week) cannot be established for a DSP new claim unless the 'Program of Support' field has a value of Yes or Not Required.

If the customer is assessed as having actively participated in a Program of Support, this does not by itself mean they have a CITW. The delegate must also be satisfied the customer cannot work or be retrained for work within the next 2 years because of an impairment.

Has the Assessor determined the customer has actively participated in a POS (or is not required to satisfy these requirements)?

• Yes, go to Step 6
• No, the customer cannot satisfy the CITW criteria and is not qualified for DSP. If the assessment is for a DSP new claim it is rejected when the claim is coded. See Rejecting a new claim for Disability Support Pension (DSP) including manifest rejections. If the assessment is for a current DSP recipient, the claim is cancelled, see Cancellation of Disability Support Pension (DSP). Procedure ends here

The Assessor recommends if the customer has work capacities of less than 15 hours per week.

• Work capacity for DTS conditions, including baseline work capacity and work capacity with intervention - for people granted DSP on or after 1 July 2006. CITW is met when the customer has baseline and with intervention work capacity of less than 15 hours per week for DTS conditions only

Does the customer have a CITW (POS and work capacities)?

• Yes, confirm all qualification and payability criteria for DSP are met. Once confirmed, refer customer to a Disability Medical Assessment (DMA) to determine medical eligibility for a DSP new claim or ongoing medical eligibility if the customer is current on DSP. See Disability Medical Assessment (DMA) referrals. Procedure ends here
• No, the customer cannot satisfy the CITW criteria. If the assessment is for a DSP new claim, it is rejected when the claim is coded. See Rejecting a new claim for Disability Support Pension (DSP) including manifest rejections. If the assessment is for a current DSP recipient, the claim is cancelled. See Cancellation of Disability Support Pension (DSP). Procedure ends here

Does the customer's impairment alone prevent them from undertaking any work of 15 hours a week or more at minimum wages independently of a POS within the next 2 years?

If the customer is currently working in open employment, is the employment in jeopardy, suspended, expected to cease or significantly reduce solely due to the customer's medical conditions?

The concept of training extends to the types of work in which the customer has potential to perform. Training is defined as:

• education
• pre-vocational training
• vocational training
• vocational rehabilitation
• work-related training (including on-the-job training)

This includes:

• all mainstream training programs, for example, TAFE courses including mainstream training programs that accommodate people with disabilities
• mainstream labour market programs
• training which is designed specifically for people with physical, intellectual or psychiatric impairments (that is, where it is a prerequisite the customer has a disability for acceptance into the course)

In assessing whether the customer can be trained for work within the next 2 years, the following factors are considered:

• whether the customer has the necessary prerequisite skills
• the length of time it would usually take to complete the training
• the nature of the training being dependent on the type of work the customer is potentially capable of performing

The following is not considered:

• the customer's motivation to be trained, except where medical evidence indicates the lack of motivation is directly attributable to the impairment
• the customer's preferences regarding the type of training

Literacy, numeracy or language difficulties

• these difficulties are considered if they are directly attributable to the medical condition
• the impact of the medical condition on the customer's potential to undertake training which would help them in getting such skills is considered
• other non-medical influences, which prevent literacy, numeracy or language skills from being acquired should not be taken into account

Consider the following:

• is the study or training full-time
• will the customer be able to benefit from such study or training within 2 years

The activities required for full-time study are the same as those for open employment. If a customer is studying without any modifications because of their disability, they may not have a CITW.

If the customer is not studying full-time and there will be no benefit within 2 years, this may indicate the customer meets the CITW criteria.