An OT functional assessment may contribute to a Disability Support Pension claim by explaining difficulties with activities and the assistance a person needs. It is supporting evidence, not a DSP approval or a substitute for every medical requirement.
Tell Seeds that DSP is the intended purpose before booking. An NDIS report is not automatically suitable because the two systems ask different questions.
What Services Australia considers
DSP has both medical and non-medical requirements. Non-medical rules include matters such as age, residence, income and assets.
For claims assessed under the general medical rules, Services Australia looks at the diagnosis, treatment and stability of the condition, its effect on capacity to work and the level of impairment, among other requirements. Some claims are assessed under separate rules. This is an overview; the current Services Australia guidance and the person's circumstances determine the requirements.
What an OT report can add
The report may describe practical activities such as personal care, managing a routine, communicating, travelling or completing tasks. It can explain the assistance used, how functioning varies and what the assessor directly observed or learned from other sources.
Where work-related activities are relevant, the report should describe the evidence rather than assume that a diagnosis or difficulty in one task establishes the overall DSP work-capacity requirement.
Appropriate medical and treating reports may already include functional information. An FCA is most useful when it addresses an identified gap, not when it repeats material already available.
What it cannot replace
Services Australia may require particular evidence for a condition, including evidence from specified treating professionals. A general OT FCA does not automatically establish diagnosis, treatment history, stability or every medical requirement.
Services Australia applies the DSP rules and may arrange its own assessments. A privately commissioned FCA is not the same as a Job Capacity Assessment or Disability Medical Assessment.
Scores from tools such as WHODAS are not DSP points. They should not be converted into an impairment rating or treated as a prediction of the decision.
Using evidence prepared for another purpose
An existing NDIS report may contain useful information, but check whether it addresses the questions relevant to DSP. Additional treating evidence or a differently scoped assessment may be needed.
Seeds writes a DSP report for the DSP and an NDIS report for the NDIS, because the two schemes ask different things. A DSP report lines the functional evidence up against the areas Services Australia looks at. It gives no ratings or points: the rating and the decision are Services Australia's.
Before commissioning an assessment
Review the current Services Australia evidence requirements and the documents already held. Explain any specific request for information, deadline and other professional involvement.
The assessment should have a defined contribution to the claim. No assessor can guarantee the DSP outcome, and a report should not be purchased on the understanding that it will produce a particular point score.
Further information
- Services Australia: General medical rules for DSP
- Services Australia: DSP eligibility rules for health professionals
- Services Australia: DSP medical evidence rules for health professionals