Disability Support Pension (DSP) severely disabled assessments for International Agreements 008-03120010

Information on locating referrals for severely disabled assessments is available through the CIS homepage. See the Resources page for a link.

Staff in the relevant CIS teams will:

• pick up referrals to CIS for severely disabled assessments
• determine if the customer is severely disabled from existing information held on the customer's record
• check current medical information in customer's electronic MIFE
• request and follow up the return of any necessary forms
• make sure all necessary medical information is scanned to the customer's electronic MIFE
• arrange Job Capacity Assessments (JCA) or other medical examinations as required
• where their JCA recommends medical eligibility for DSP, make sure a Disability Medical Assessment (DMA) has been made
• act in a liaison role with the customer, refer cases to CIS specialists for severely disabled determination

DSP portability cases are first assessed under the 'no work capacity' provisions. See Assessment for DSP customers going overseas under the no future work capacity provisions.

Customers require a severely disabled assessment if they:

• lose entitlement after leaving their country of location and are going to an agreement country that covers DSP, or
• are claiming DSP under an international agreement, or
• are claiming an invalidity pension from the Netherlands or New Zealand

An Australian resident in Australia does not need to be severely disabled for claims under the Agreements with Austria, Germany and Norway.

Is a severely disabled assessment required?

• Yes, go to Step 2
• No, procedure ends here

A new assessment is not required where the customer is:

• assessed by CIS as severely disabled within the last 2 years, and
• there have been no changes since this assessment, (such as commencing work)

Check for previous severely disabled assessment

• Go to the Pension Disability Information (PDI) screen
• Check if Severely Disabled Code: field is already coded as Yes with an Event Date: field code within 2 years of the departure date
• Check the Document List (DL) screen for a severely disabled DOC by CIS
• If necessary, check the Employment Income Summary (EANS) and Foreign Income Details (FID) screens to see if the customer has worked since the decision was made

Has the customer already been assessed by CIS as severely disabled within the past 2 years and has had no changes in circumstances since?

• Yes, go to Step 5
• No, go to Step 3

Medical information is scanned to the customer record. In general, severely disabled assessments may be made on the basis of any current and valid assessment of the customer's work capacity.

Staff in the relevant International Services team are responsible for ensuring sufficient medical information is available before referring for severely disabled assessment.

For portability cases, normally the customer is considered under the 'no work capacity' (NWC) provisions first so sufficient medical information must already be available. If not, international forms for gathering medical information are available through the residence and International program homepage. See Resources for a link.

For Australian DSP claims from outside Australia, the agreed forms for each agreement are detailed in the country file under International Social Security Agreements.

For both portability and DSP claims outside Australia, a medical examination by the pension authorities in the agreement country can be requested. See Agreement liaisons, NZ CICs and exchange of information.

For foreign pension invalidity claims and requested medical reviews from the Netherlands or New Zealand, in most cases the customer has just been granted an Australian DSP so sufficient information is normally available. If further information is required, see Foreign pension medical assessments

Check the customer record. See Access to scanned medical information for Assessment Services.

Is sufficient medical information available?

• Yes, go to Step 5
• No, go to Step 4

Request the medical information.

Put the claim on hold based on the expected response times for the country. See Agreement Liaison Details (ALD).

Has the information been provided?

• Yes, go to Step 5
• No, take the appropriate action for the case:
• For portability cases, send the letter to the customer confirming the portability decision and record all details in a DOC. Approved letter text is available through the Residence and International program homepage. See Resources for a link
• For DSP claims from outside Australia, finalise the claim. See Claims for Australian payments under International Agreements
• For foreign invalidity pension claims and medical reviews, send the claim and/or liaison to the pension authorities in the agreement country advising of the failed attempt to obtain medical information. See Processing a foreign pension claim or Agreement liaisons, NZ CICs and exchange of information.
• Procedure ends here

Customers who are permanently blind or meet the manifest criteria are considered to be severely disabled.

Check for permanent blindness or manifest assessment

Check the Medical Conditions Details (MC) screen for either:

• 'BLI' - permanently blind
• 'INT' (intellectual/learning), or
• 'NHM' (nursing home level care),
• 'TPI' (Disability Compensation Payment at Special Rate (Totally and Permanently Incapacitated (TPI)), or
• 'TRM' - terminal illness

Note: the Category 4 HIV (HV4) code does not automatically update the PDI screen and needs to be referred to the specialist in CIS without the need for further information.

Is the customer permanently blind or manifestly eligible for DSP?

• Yes, go to Step 6
• No, go to Step 7

As the customer is considered severely disabled, no further assessment is required.

Continue with the process as required incorporating the decision and make sure the acceptance of the previous decision is noted in a DOC.

See:

• Transfers to international social security agreements
• Claims for Australian payments under International Agreements
• Foreign pension medical assessments

Procedure ends here.

The CIS specialist will make the severely disabled decision, record the details in a DOC and refer the case back to the relevant CIS team to finalise the required process.

Once the DOC with the severely disabled decision is received, continue with the process as required incorporating the decision.

See processing files for referring to CIS specialist for severely disabled assessment:

• Transfers to international social security agreements
• Claims for Australian payments under International Agreements
• Foreign pension medical assessments

Procedure ends here.

For help making a severely disabled decision, see Assessing Continuing Inability to Work (CITW).

If required, specialist disability officers can refer cases to the Health Professionals Advisory Unit (HPAU) for support in making severely disabled determinations. Information on referring cases to HPAU is available through the Residence and International program homepage, see Resources for a link.

The specialist officers in CIS will:

• make a determination of:
• whether the customer is severely disabled
• where the customer was resident when they first met the continuing inability to work criteria (if appropriate)
• where the customer was resident when they first met the criteria for severe disablement (NZ only)
• record all details of the decision in a DOC
• for DSP claims only, code the Manual Job Capacity Assessment (MANJCA) screen, see below
• code the following fields on the Pension Disability Information (PDI) screen:
• CITW/Blind Residence:
• Severely Disabled Code:
• NZ Severe Dis Date: (NZ only)
• complete an International Medical Decision proforma (for Australian claims under agreements outside Australia or Netherlands invalidity claims only). The proforma is available through the Residence and International program homepage. See Resources for a link
• if the customer is no longer qualified for DSP as a result of the assessment, implement the decision and contact the customer
• refer all other cases back to CIS to finalise the process incorporating the severely disabled decision using Fast Note - select Auto Text, use Centrelink International Services > Portability > DSP SD Portability Approved Referral

For claims for DSP under agreements made outside Australia, the medical details must be coded manually on the customer record via the Record Manual JCA (MANJCA) screen. Access is restricted to specialist disability officers in International Services (CIS).

The information coded on the MANJCA screen will update the Medical Conditions (MC) and Work Capacity (WC) screens and allow the claim to be finalised.

Once the medical decision has been made and documented, go to the MANJCA screen in the customer's record and code:

• Update: field as 'Y'
• Impairment Tbl Version: field as '01 APR 2023'

Press [Enter]. Fields to be automatically updated on the MC and WC screens will appear.

Note: for a full list of valid codes, put '?' in the relevant field and press [Enter].

Code:

• Referral Reason: field as 'DSPNC'
• The specialist disability officer details in the following fields:
• Assessor's Name:
• Phone Area Code:
• Phone Number:
• Manifest code: field (if applicable)
• The customer's medical condition(s) details (up to 10) in the following fields:
• Condition will persist for more than 2 years:
• DTS Indicator:
• Source:
• Impairment Table:
• Impairment Rating:
• The following fields as appropriate:
• Meet POS Requirements:
• Baseline wrk cap 0/8/15/23/30:
• With Intervention:
• Mainstream only:
• DTS baseline Cap 0/8/15/23/30:
• DTS with Intervnton:
• DTS - Manstrm only:

Press [Enter]

A PEN/JCA activity will be created with the MC and WC screens coded with the information from the MANJCA screen. The activity can be finalised or cancelled as required.

Once the activity has been finalised, refer the case back to the relevant team in International Services.