Eligibility for Disability Support Pension (DSP) 008-03050000

Is the customer aged 16 or over?

• Yes, go to Step 2
• No, the customer is not eligible for DSP:
• If claiming online, the customer will be warned they are not eligible before starting the claim
• If running the First Contact Service Offer (FCSO) workflow, DSP would not be offered
• A customer turning 16 within 3 months may be invited to claim if a person gets Carer Payment for them. See Claiming DSP
• Procedure ends here

• Yes, go to Step 3
• No, go to Step 4

Is the customer making a new claim for DSP?

• Yes, they do not qualify for DSP. They should test their eligibility for Age Pension. See Rejecting a new claim for DSP including manifest rejections. Procedure ends here
• No, if a customer is receiving DSP when they turn Age Pension age, they may continue to receive DSP or transfer to Age Pension. To help them decide which is better, and if they can transfer back to DSP from Age Pension. Procedure ends here

Does the customer satisfy the residence requirements?

• Yes, go to Step 5
• No, they do not qualify for DSP, reject the claim. Procedure ends here

Has the customer been assessed as permanently blind?

Note: if a blind customer wishes to test their eligibility for Rent Assistance (RA), the pension income and assets tests are used to work out their rate. To be paid RA, they must have their income and assets coded on their record.

• Yes,
• If they are claiming RA, go to Step 6
• If they are not claiming RA, see Granting DSP (manifest). Procedure ends here
• No, go to Step 6

Does the customer meet the Pensions income and assets test?

• Yes. If they are:
• permanently blind, see Claiming DSP or Granting DSP (manifest)
• not permanently blind, go to Step 7
• No, DSP is not payable, reject the claim:
• If the customer is permanently blind, contact them as they may choose to not claim Rent Assistance and be granted manifest

Procedure ends here

The customer's claim may be:

• granted if they meet non-medical criteria and are manifestly medically eligible for DSP. For example, they are terminally ill, have an intellectual disability or require nursing home level care
• rejected if they do not meet non-medical criteria or are clearly manifestly ineligible for DSP. For example, the medical condition(s) is likely to persist for less than 2 years or the customer has a clear ability to sustain at least 15 hours per week work in open employment

If the customer:

• meets non-medical criteria and is manifestly medically eligible, go to Step 11
• meets non-medical criteria and is not manifestly medically eligible, go to Step 8
• does not meet non-medical criteria or is clearly manifestly ineligible, reject the claim. Procedure ends here

Unless manifestly medically eligible, a Job Capacity Assessment (JCA) is required to assess whether the customer is medically eligible for DSP.

A Disability Medical Assessment (DMA) with a Government-contracted Doctor (GCD) will also be required if the JCA recommends medical eligibility and the non-medical criteria have been met.

The customer is expected to attend these assessments. In limited cases, other options may be available such as phone or video conference.

A new JCA referral may not be required if there is a current and valid assessment of the customer's work capacity available.

To view an existing JCA:

• In Customer First, go to the referral summary workflow and select the relevant ESAt/JCA report
• In Process Direct from the More Options menu, select DSP Claim Summary and the JCA/ESAt icon

If there is no current and valid JCA, the customer must be referred for a JCA .

If applicable, a GCD will also review the customer's medical evidence and complete a DMA before the claim for DSP is finalised.

To be eligible for DSP, the JCA and DMA reports must recommend a rating of 20 points or more under the Impairment Tables, unless the customer is manifestly medically eligible.

If a customer's conditions are not considered diagnosed, reasonably treated and stabilised, a rating cannot be assigned under the Impairment Tables.

Do the customer's conditions attract a rating of 20 points or more under the Impairment Tables?

• Yes, go to Step 10
• No, they do not qualify for DSP. Assessment of Continuing Inability to Work (including active participation in a Program of Support) is not required. See Rejecting the claim. Procedure ends here

A customer's CITW is not assessed unless they meet the impairment criteria for DSP.

Customers participating in the Supported Wage System (SWS) satisfy the CITW requirement.

To be eligible for DSP, all other customers must be assessed as having a CITW.

To have a CITW, a person must be unable to work or be retrained to work for 15 hours or more per week for at least the relevant minimum wage within the next 2 years because of their impairment.

People who claim DSP from 3 September 2011 must also show they have actively participated in a Program of Support (POS). This is if they are not manifestly eligible and do not have a severe impairment.

See Assessing CITW for transitional or new customers.

Does the customer have a CITW?

• Yes, go to Step 11
• No, they do not qualify for DSP, reject the claim. Procedure ends here

Has the customer lodged a claim for DSP?

• Yes, go to Progress of claim - DSP
• No, go to Claiming DSP