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[2018] AATA 2112
appellant. The Tribunal affirmed the decision to cancel the Applicant's Disability Support Pension effective 5 September 2016.
The Administrative Appeals Tribunal upheld the cancellation of a man's Disability Support Pension because his medical conditions did not score enough points under the government's disability assessment tables. The Tribunal looked only at his health as it was on the date his pension was cancelled (September 2016), not at the time of the hearing. While the man had genuine problems with his shoulder and back, these only scored 15 points total—below the 20-point threshold needed to keep the pension. His other conditions couldn't be counted because they either weren't fully diagnosed, were still being treated, or he had refused recommended treatment without medical evidence showing it would be dangerous for him.
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2 cited instruments linked from this judgment.
Dr Holthouse noted that of the Applicant's conditions, lumbar back pain was causing the most impact on the Applicant's ability to function. It was noted that the impact of the Applicant's ability to function would persist for more than 24 months and that the effect of the condition was uncertain.[11] 2. Dr Holthouse listed the Applicant's second condition as "Right shoulder pain - past rotator cuff surgery (failed)".[12] It was noted that the impact on the Applicant's ability to function would persist for more than 24 months and within the next 2 years the effect of the condition on the Applicant's ability to function was expected to remain unchanged.[13] 3. On 31 August 2016, the Applicant attended a face-to-face Job Capacity Assessment (JCA).[14] The JCA reported that: * (a) The Applicant's spinal condition was fully diagnosed, fully treated and fully stabilised and recommended an Impairment Rating of 10 points under Table 4 of the Impairment Tables; * (b) The Applicant's upper limb condition was fully diagnosed, fully treated and fully stabilised and recommended an Impairment Rating of 5 points under Table 2 of the Impairment Tables; * (c) The Applicant's psoriasis condition was fully diagnosed but not fully treated and fully stabilised and as a result could not be assigned an Impairment Rating; * (d) The Applicant's osteoarthritis condition was fully diagnosed but not fully treated and fully stabilised and as a result could not be assigned an Impairment Rating; * (e) The Applicant's respiratory condition was fully diagnosed but not fully treated and fully stabilised and as a result could not be assigned an Impairment Rating; and * (f) The Applicant had a baseline work capacity of 8-14 hours per week and this could increase to 15-22 hours per week within two years with intervention.[15] 4. The Applicant's DSP was cancelled on 5 September 2016 ("date of cancellation").[16]
("the Act") and the Social Security (Administration) Act 1999 ("Administration Act"). 2. The Administration Act provides for the cancellation or suspension of a social security payment,[18] if the Secretary is satisfied that a social security payment is being paid to a person who is not qualified for the payment:[19] * (1) If the Secretary is satisfied that a social security payment is being, or has been, paid to a person: 1. who is not, or was not, qualified for the payment; or 2. to whom the payment is not, or was not, payable;
the Secretary is to determine that the payment is to be cancelled or suspended.[20]
"His Honour held the Tribunal to have been correct to limit its consideration to the circumstances existing at the time the decision to cancel was made. The Tribunal was entitled to take into account all the facts placed before it, but the issue was whether the decision it was reviewing, to cancel the pension, was the correct or preferable decision when it was made. It was not whether Mrs Freeman had an entitlement to a widow's pension at the date of the Tribunal's decision".
the Secretary, in assessing the person's qualification for that pension, must apply the instrument in force under section 26 of this Act on the day the assessment notice was given.
At the date of cancellation did the Applicant's impairments attract 20 points or more under the Impairment Tables?
2 years.[42] 5. Both Dr Dean and Dr Sutherland reported that the Applicant was not undertaking treatment for his right shoulder condition.[43] 6. On 9 May 2016, Dr Holthouse stated in the Applicant's DSP Medical Review Form that the Applicant suffered from right shoulder pain and that this condition was expected to affect his ability to function for more than 24 months.[44] Further, Dr Holthouse provided additional evidence by telephone to Centrelink that the Applicant's Upper Limb Condition was unlikely to improve with any additional treatment.[45] 7. The Respondent accepts that the weight of evidence supports a finding that the Applicant's Upper Limb Condition was fully diagnosed, fully treated and fully stabilised at the date of cancellation.[46] Having considered the material before me, I find that the Applicant's Upper Limb condition was fully diagnosed, fully treated and fully stabilised. I am therefore able to assign the conditions an Impairment Rating under Table 2 of the Impairment Determination. 8. The Respondent submitted that the Applicant's Upper Limb condition attracted an Impairment Rating of 5 points under Table 2 of the Impairment Determination.[47] 9. I will now consider the Impairment Rating that should be assigned to the Applicant's Upper Limb condition.
"Table 2 is to be used where the person has a permanent condition resulting in functional impairment when performing activities requiring the use of hands or arms".[48]
(1) The person can manage most daily activities requiring the use of the hands and arms, but has some difficulty with most of the following:
(a) picking up heavier objects (e.g. a 2 litre carton of liquid or carrying a full shopping bag);
(b) handling very small objects (e.g. coins);
(c) doing up buttons;
(d) reaching up or out to pick up objects.[58]
2 of the Impairment Determination, the Applicant's medical evidence would need to support a finding that the Applicant satisfied at least 4 of the 6 descriptors for a 10 point rating.[59] Table 2 of the Impairment Determination provides the following descriptors for
(1) The person has difficulty with most of the following:
(b) picking up a light but bulky object requiring the use of 2 hands together (e.g. cardboard box);
(f) unscrewing a lid on a soft-drink bottle.[60]
10 points under Table 4 of the Impairment Tables.[63] 2. The Tribunal has had regard to the material before it and the evidence provided from the Applicant himself at the hearing regarding his Spinal condition. At the hearing, the Applicant reported that he has suffered from chronic back pain since the age of 19, as he reports fracturing his spine when he was 19 years old. 3. On 7 March 2002, Dr Sutherland noted in a medical report that the Applicant's spinal condition was stable and likely to persist for more than 2 years.[64] 4. On 9 May 2016, Dr Holthouse reported that the Applicant's spinal condition was expected to affect his ability to function for more than 24 months.[65] Dr Holthouse also reported that the Applicant's spinal condition required further investigation and treatment, and noted that the diagnosis was presumptive and that the Applicant required a CT of his lumbar spine.[66] 5. When Dr Holthouse provided additional evidence in a telephone conversation on
29 August 2016, he confirmed that the Applicant had a CT of his lumbar spine on
29 August 2016 and that it indicated degenerative changes to the Applicant's lumbar spine. Further, Dr Holthouse reported that the Applicant's spinal condition was unlikely to improve with additional treatment and that no specialist assessment was required.[67] 6. The Respondent accepts that the weight of evidence supports a finding that the Applicant's Spinal Condition was fully diagnosed, fully treated and fully stabilised at the date of cancellation.[68] Based on the material before me, I find that the Applicant's Spinal condition was fully diagnosed, fully treated and fully stabilised. I am therefore able to assign the condition an Impairment Rating under Table 4 of the Impairment Determination. 7. The Respondent submitted that the Applicant's Spinal condition attracted an Impairment Rating of 10 points under Table 4 of the Impairment Determination.[69] 8. I will now consider the Impairment Rating that should be assigned to the Applicant's Spinal condition.
"Table 4 is to be used where the person has a permanent condition resulting in functional impairment when performing activities involving spinal function, that is, bending or turning the back, trunk or neck."[70]
29 August 2016, Dr Holthouse provided additional evidence by telephone, and is reported as confirming that the Applicant was unable to bend forward to pick up a light object at knee height.[73] 4. On 31 August 2016, the Applicant attended a face-to-face JCA and reported to the JCA that the impact of his Spinal condition was as follows:[74] * constant dull back pain which was aggravated by physical activity; * able to stand for 10-15 minutes; * able to walk for 450 meters; * able to sit in a car for 30 minutes; * able to twist his head to the side; * had difficulty bending forward and a reduced range of motion with twisting; and * able to perform activities of daily living including self-care, cooking, light cleaning, washing and washing up. 5. The Applicant reported at the Tribunal hearing that he is able to walk to the RSL Club, which he estimated was a walk of 450 yards, but after 40 yards he is in pain. He further stated that his back has always been bad, in particular it aches when he goes to bed and it hurts when he sits for too long; he cannot stay in one spot but he needs to move around. 6. The Respondent submitted that the Applicant's Spinal condition attracted an Impairment Rating of 10 points under Table 4 of the Impairment Determination.[75] Table 4 of the Impairment Determination provides the following descriptors for 10 points to be considered appropriate:
(1) The person is able to sit in or drive a car for at least 30 minutes, and at least one of the following applies:
(a) the person is unable to sustain overhead activities (e.g. accessing items over head height); or
(b) the person has difficulty moving their head to look in all directions (e.g. turning their head to look over their shoulder); or
(c) the person is unable to bend forward to pick up a light object placed at knee height; or
(d) the person needs assistance to get up out of a chair (if not independently mobile in a wheelchair).
4 of the Impairment Determination, the Applicant's medical evidence would need to support a finding that the functional impact of the Applicant's spinal condition was severe. Table 4 of the Impairment Determination provides the following descriptors for 20 points to be considered appropriate:
(b) turn their head, or bend their neck, without moving their trunk; or
(c) bend forward to pick up a light object from a desk or table; or
"...test results within normal ranges for arthritic changes, awaiting tests for blood work regarding psoriasis. For condition of psoriasis Dr Holthouse confirmed no recent specialist referral within 2 years, and future treatment is awaiting results of blood tests." [82]
29 August 2016, Dr Holthouse is reported as confirming that recent radiological test results were within normal ranges for arthritic changes.[90] 3. The Applicant has not provided any medical information in relation to treatment or the impact of this condition at the date of cancellation. As such, I cannot be satisfied that this condition is fully treated or fully stabilised. Consequently, I am unable to assign an Impairment Rating to this condition.
I certify that the preceding 102 (one hundred and two) paragraphs are a true copy of the reasons for the decision herein of Senior Member P Clauson
............................[SGD]............................................
[1] Exhibit 1, T Documents, T27, pages 155-156, Cancellation of DSP, dated 5 September 2016.
[2] Exhibit 1, T Documents, T30, pages 159-165, ARO Decision, dated 3 November 2016.
[3] Exhibit 1, T Documents, T2, pages 2-10, Decision of the Social Services & Child Support Division,
[4] Exhibit 1, T Documents, T1, page 1, Applicant for review, dated 21 April 2017.
[5] Exhibit 1, T Documents, T36, page 192, Centrelink File Note, dated 9 February 2015.
[6] Exhibit 1, T Documents, T36, pages 193-195, Centrelink File Note, dated 4 April 2016.
[7] Exhibit 1, T Documents, T36, pages 193-195, Centrelink File Note, dated 4 April 2016.
[8] Exhibit 1, T Documents, T36, page 193, Centrelink File Note, dated 15 April 2016.
[9] Exhibit 1, T Documents, T22, pages 128-131, DSP Medical Review Form, issue date 15 April 2016.
[10] Exhibit 1, T Documents, T22, page 129, DSP Medical Review Form, issue date 15 April 2016.
[11] Exhibit 1, T Documents, T23, page 136, DSP Medical Review Form, issue date 15 April 2016.
[12] Exhibit 1, T Documents, T23, page 137, DSP Medical Review Form, issue date 15 April 2016.
[13] Exhibit 1, T Documents, T23, page 139, DSP Medical Review Form, issue date 15 April 2016.
[14] Exhibit 1, T Documents, T26, pages 145-154, Job Capacity Assessment Report, dated 31 August
[15] Exhibit 1, T Documents, T26, pages 145-154, Job Capacity Assessment Report, dated 31 August
[16] Exhibit 1, T Documents, T27, pages 155-156, Cancellation of DSP, dated 5 September 2016.
[18] See section 23 of the Act, DSP is included as part of the definition for "social security benefit".
[20] Section 80(1), Administration Act.
[21] Exhibit 2, Secretary's Statement of Issues, Facts and Contentions, dated 20 December 2017,
[22] Freeman v Secretary, Department of Social Security [1988] FCA 294; (1988) 15 ALD 671 at 673-674
[23] Exhibit 1, T Documents, T22, pages 128-131, DSP Medical Review Form, issue date 15 April 2016.
[24] Impairment Determination, s 5(1) - (2).
[31] Impairment Determination, s 11(1)(a) and (c).
[33] Exhibit 2, Secretary's Statement of Issues, Facts and Contentions, dated 20 December 2017,
[35] Exhibit 2, Secretary's Statement of Issues, Facts and Contentions, dated 20 December 2017,
[36] Exhibit 1, T Documents, T14, page 88, Medical Report from Dr Trifiletti, dated 27 January 1995.
[37] Exhibit 1, T Documents, T14, page 88, Medical Report from Dr Trifiletti, dated 27 January 1995.
[38] Exhibit 1, T Documents, T14, page 88, Medical Report from Dr Trifiletti, dated 27 January 1995.
[39] Exhibit 1, T Documents, T14, page 88, Medical Report from Dr Trifiletti, dated 27 January 1995.
[40] Exhibit 1, T Documents, T16, pages 91-95, Medical Report from Dr Dean, dated 7 January 2002.
[41] Exhibit 1, T Documents, T16, page 94, Medical Report from Dr Dean, dated 7 January 2002.
[42] Exhibit 1, T Documents, T19, pages 120-124, Medical Report from Dr Sutherland, dated 7 March
[43] Exhibit 1, T Documents, T16, page 92, Medical Report from Dr Dean, dated 7 January 2002; T19,
page 121, Medical Report from Dr Sutherland, dated 7 March 2002.
[44] Exhibit 1, T Documents, T23, page 139, DSP Medical Review Form, issue date 15 April 2016.
[45] Exhibit 1, T Documents, T25, pages 143-144, Additional Evidence for DSP Record: Dr Holthouse,
[46] Exhibit 2, Secretary's Statement of Issues, Facts and Contentions, dated 20 December 2017,
[47] Exhibit 2, Secretary's Statement of Issues, Facts and Contentions, dated 20 December 2017,
[48] Impairment Determination, Introduction to Table 2.
[49] Impairment Determination, s 10(5).
[51] Exhibit 1, T Documents, T23, page 139, DSP Medical Review Form, issue date 15 April 2016.
[52] Exhibit 1, T Documents, T23, page 139, DSP Medical Review Form, issue date 15 April 2016.
[53] Exhibit 1, T Documents, T25, pages 143-144, Additional Evidence for DSP Record: Dr Holthouse,
[54] Exhibit 1, T Documents, T25, pages 143-144, Additional Evidence for DSP Record: Dr Holthouse,
[55] Exhibit 1, T Documents, T26, pages 145-154, Job Capacity Assessment Report, dated 31 August
[56] Exhibit 1, T Documents, T2, pages 2-10, Decision of the Social Services & Child Support Division,
[57] Exhibit 2, Secretary's Statement of Issues, Facts and Contentions, dated 20 December 2017,
[58] Impairment Determination, Table 2.
[59] Impairment Determination, Table 2.
[60] Impairment Determination, Table 2.
[61] Exhibit 1, T Documents, T26, pages 145-154, Job Capacity Assessment Report, dated 31 August
2016; T2, pages 2-10, Decision of the Social Services & Child Support Division, dated 26 March 2017; T25, pages 143-144, Additional Evidence for DSP Record: Dr Holthouse, dated 29 August 2016.
[62] Exhibit 2, Secretary's Statement of Issues, Facts and Contentions, dated 20 December 2017,
[63] Exhibit 2, Secretary's Statement of Issues, Facts and Contentions, dated 20 December 2017,
[64] Exhibit 1, T Documents, T19, pages 120-125, Medical Report of Dr Sutherland, dated 7 March 2002.
[65] Exhibit 1, T Documents, T23, pages 134-136, DSP Medical Review Form, issue date 15 April 2016.
[66] Exhibit 1, T Documents, T23, page 134, DSP Medical Review Form, issue date 15 April 2016.
[67] Exhibit 1, T Documents, T25, pages 143-144, Additional Evidence for DSP Record: Dr Holthouse,
[68] Exhibit 2, Secretary's Statement of Issues, Facts and Contentions, dated 20 December 2017,
[69] Exhibit 2, Secretary's Statement of Issues, Facts and Contentions, dated 20 December 2017,
[70] Impairment Determination, Introduction to Table 4.
[72] Exhibit 1, T Documents, T23, page 136, DSP Medical Review Form, issue date 15 April 2016.
[73] Exhibit 1, T Documents, T25, pages 143-144, Additional Evidence for DSP Record: Dr Holthouse,
[74] Exhibit 1, T Documents, T26, pages 145-154, Job Capacity Assessment Report, dated 31 August
[75] Exhibit 2, Secretary's Statement of Issues, Facts and Contentions, dated 20 December 2017,
[76] Exhibit 1, T Documents,T25, pages 143-144, Additional Evidence for DSP Record: Dr Holthouse,
dated 29 August 2016; T26, pages 145-154, Job Capacity Assessment Report, dated 31 August 2016.
[77] Exhibit 2, Secretary's Statement of Issues, Facts and Contentions, dated 20 December 2017,
[78] Exhibit 2, Secretary's Statement of Issues, Facts and Contentions, dated 20 December 2017,
[79] Impairment Determination, s 10(5).
[80] Exhibit 1, T Documents, T17, pages 96-111, Medical Assessment Report completed by Dr Heugh,
[81] Exhibit 1, T Documents, T23, page 140, DSP Medical Review Form, issue date 15 April 2016.
[82] Exhibit 1, T Documents, T25, pages 143-144, Additional Evidence for DSP Record: Dr Holthouse,
[83] Exhibit 2, Secretary's Statement of Issues, Facts and Contentions, dated 20 December 2017,
Annexure A: Referral letter from Dr Dickenson to Dr Bambery, dated 28 July 2017.
[84] Exhibit 2, Secretary's Statement of Issues, Facts and Contentions, dated 20 December 2017,
Annexure A: Referral letter from Dr Dickenson to Dr Bambery, dated 28 July 2017.
[85] Exhibit 2, Secretary's Statement of Issues, Facts and Contentions, dated 20 December 2017,
Annexure A: Referral letter from Dr Dickenson to Dr Bambery, dated 28 July 2017.
Exhibit 2, Secretary&#[8]s Statement of Issues, Facts and Contentions, dated 20 December 2017, para 48.
[86] Exhibit 2, Secretary's Statement of Issues, Facts and Contentions, dated 20 December 2017, para
[87] Exhibit 2, Secretary's Statement of Issues, Facts and Contentions, dated 20 December 2017, para
[88] Exhibit 1, T Documents, T23, page 140, DSP Medical Review Form, issue date 15 April 2016.
[89] Exhibit 1, T Documents, T23, page 140, DSP Medical Review Form, issue date 15 April 2016.
[90] Exhibit 1, T Documents, T25, pages 143-144, Additional Evidence for DSP Record: Dr Holthouse,
[91] Exhibit 1, T Documents, T23, page 140, DSP Medical Review Form, issue date 15 April 2016.
[92] Exhibit 1, T Documents, T31, pages 166-167, Referral letter from Dr Dickenson to Dr Ang, dated 30
Exhibit 2, Secretary's Statement of Issues, Facts and Contentions, dated 20 December 2017, para 53.
Freeman
Secretary, Department of Social Security
Freeman v Secretary, Department of Social Security [1988] FCA 294; (1988) 15 ALD 671
Shi v Migration Agents Registration Authority [2008] HCA 31; (2008) 235 CLR 286
(2008) 235 CLR 286
The Tribunal affirmed the decision to cancel the Applicant's Disability Support Pension effective 5 September 2016.