Decision: The Tribunal affirms the decision under review.

Names used in all published decisions are pseudonyms. Any references appearing in square brackets indicate that information has been removed from this decision and replaced with generic information so as not to identify involved individuals as required by subsections 201(1A)-201(1B) of the Social Security (Administration) Act 1999.

Disability Support Pension - rejection of claim - multiple conditions - diagnosis - fully diagnosed, reasonably treated and stabilised - decision under review affirmed

Social Security Act 1991 (Cth)

Social Security (Administration) Act 1999 (Cth)

Social Security (Tables for the Assessment of Work-related Impairment for Disability Support Pension) Determination 2023 (Cth)

Re Drake and Minister for Immigration and Ethnic Affairs (No 2) (1979) 2 ALD 634

G v Minister for Immigration and Border Protection [2018] FCA 1229

Gallacher v Secretary, Department of Social Services [2015] FCA 1123

MDXJ v Secretary, Department of Social Services [2020] FCA 1767

1. Mr HJZJ was born on 9 May 1965. On 3 May 2023 he made a claim for disability support pension. This claim was rejected by Services Australia - Centrelink (the Agency) on 11 September 2023. On 12 September 2023 Mr HJZJ sought review of the decision. On 9 January 2025 an Agency authorised review officer affirmed the decision.
2. Mr HJZJ applied to the Tribunal on 10 February 2025 for review of the decision made by the authorised review officer and on 12 May 2025 the Tribunal on first review affirmed the decision. On 23 May 2025 Mr HJZJ lodged an application for second review of the decision.
3. The application was heard on 10 February 2026. In making this decision, I have considered and taken into evidence the documents provided on behalf of Mr HJZJ and the Respondent.[1] I have also considered oral evidence provided by Mr HJZJ and the written and oral submissions made by the Respondent's legal representative.
4. For the reasons that follow, I have affirmed the decision under review.

1. Entitlement to disability support pension is governed by the Social Security Act 1991 (the Act) and the Social Security (Administration) Act 1999 (the Administration Act). In conducting the review, I may also have regard to the Social Security Guide (the Guide) where relevant, so long as what it contains is lawful. However, I am not bound to follow it.[2]
2. Subclause 4(1) of Schedule 2 to the Administration Act provides that in order for disability support pension to be granted from the date of the claim, the medical evidence must establish the entitlement within the 13-week period from the claim. Evidence of a condition outside this period may only be relevant insofar as it refers to the condition during the qualification period.[3]
3. The criteria for qualification are set out under subsection 94(1) of the Act. Subsection 94(1) requires, among other things, that a person has a physical, intellectual or psychiatric impairment (paragraph 94(1)(a) of the Act), that a person's impairment is 20 points or more under the Impairment Tables (paragraph 94(1)(b) of the Act) and that they have a continuing inability to work as defined (paragraph 94(1)(c) of the Act).
4. The Impairment Tables are contained in the Social Security (Tables for the Assessment of Work-related Impairment for Disability Support Pension) Determination 2023 (the Determination). The Determination includes directions on their application.
5. Subclause 4(1) of Schedule 2 to the Administration Act provides that in order for disability support pension to be granted from the date of the claim, the medical evidence must establish the entitlement within the 13-week period from the claim. Evidence of a condition outside this period may only be relevant insofar as it refers to the condition during the qualification period.[4]
6. The Determination states that a condition is considered a permanent condition if it has been diagnosed by an appropriately qualified medical practitioner and the condition has been reasonably treated. In respect of reasonable treatment, paragraph 8(5) of the Determination states as follows:

(5) In determining whether a condition has been reasonably treated for the purposes of paragraph 8(3)(b), the following is to be considered:

(a) what treatment or rehabilitation has occurred in relation to the condition; and

(b) whether treatment is continuing or is planned in the next 2 years and is likely to result in significant functional improvement.

1. Reasonable Treatment is defined under paragraph 8(7) of the Determination as follows:

(7) For the purposes of subsection 8(5) and (6), reasonable treatment is treatment that:

(a) is available at a location reasonably accessible to the person;

(c) can reliably be expected to result in a significant functional improvement;

1. Paragraph 8(6) of the Determination states that a condition is considered stabilised as follows:

(6) For the purposes of paragraph 8(3)(c) a condition is stabilised if either:

(a) the person has undertaken reasonable treatment for the condition and any further reasonable treatment is unlikely to result in significant functional improvement; or

(b) the person has not undertaken reasonable treatment for the condition and:

(i) significant functional improvement is not expected, even if the person undertakes reasonable treatment; or

(ii) there is a medical or other compelling reason for the person not to undertake reasonable treatment.

Note 1: For reasonable treatment see subsection 8(7).

1. Note 2: Degenerative conditions that result in progressive and irreversible loss of function, can be considered stabilised if reasonable treatment is not expected to result in significant functional improvement.

Do Mr HJZJ's medical conditions rate at least 20 points under the Impairment Tables?

1. I am satisfied, based on the evidence in the medical reports provided in this application, that paragraph 94(1)(a) of the Act is met, in reference to his multiple medical conditions including respiratory condition, neck and lower back pain, mental health condition, cataracts, type II diabetes, osteoarthritis of the knees, and iron deficiency anaemia.
2. At issue therefore is whether Mr HJZJ's impairments rate at least 20 points under the Impairment Tables. The Impairment Tables, as were in force at the time of the claim for disability support pension on 3 May 2023, were contained in the Determination.
3. I have considered each of the medical conditions raised by Mr HJZJ against the requirements in the Determination.

1. It is not disputed by the Respondent that Mr HJZJ has been diagnosed with lung fibrosis and pulmonary embolism conditions and that the conditions are reasonably treated, and stabilised at the time of the claim.
2. A medical certificate dated 5 September 2022 from Mr HJZJ's GP[5] indicates a date of onset of this condition of 5 August 2021 and that the condition is permanent. The GP describes that the symptoms, which includes shortness of breath on exertion and decreased exercise tolerance. The medical certificate further describes his past treatment, which included prednisolone, and Symbicort and Ventolin puffers as directed, but no current or planned treatment for the condition. A further medical certificate on 10 October 2022 from the GP[6] includes the same information. A medical certificate dated 22 May 2023[7] completed at hospital diagnoses a pulmonary embolism with shortness of breath. Mr HJZJ then presented at hospital on 23 July 2023 with an exacerbation of the condition, with a worsening exertional dyspnoea and cough. His hospital discharge[8] stated that there was 'no dyspnoea at rest, and that he can walk long distances on flat when well, but more recently needs brief rest after 50m.' At the hearing Mr HJZJ stated that he experiences shortness of breath when walking fast and climbing stairs, but could walk slowly. He stated that he doesn't do anything during the day, taking the children to school by care, which takes about 5 minutes as it is nearby.
3. He is living with his wife, as they are separated under one roof, and she is still doing all the chores and home duties. He stated that he is able to shower and dress but nothing else. He does drive his wife to do shopping and to his medical appointments, but if he has to travel far, he will take an uber. He stated that at the time of the claim he was operating a medical courier business, which he engaged other people to make deliveries. He stated that he was working about 30 hours per fortnight. He stated that he was working full-time from 15 July 2024 but was injured at work on 2 September 2024 and his hours reduced to 15 hours per week. His employment was later terminated on 7 February 2025.
4. The job capacity assessment dated 8 January 2024 confirmed the conditions of pulmonary embolism and lung fibrosis based on the medical information discussed above. They recommended the allocation of a 10 point impairment under Table 1 - Functions requiring Physical Exertion and Stamina, based on the longevity of the symptoms and that Mr HJZJ had undertaken reasonable treatment in respect of this condition, with no functional improvement expected.
5. In respect of his sleep apnoea, further reports provided dated 22 February 2025 state Mr HJZJ had bronchial asthma and moderate obstructive sleep apnoea. Mr HJZJ confirmed that his CPAP treatment commenced after 22 February 2025[9] with other medication prescribed for the treatment of his condition. I note that Mr HJZJ underwent sleep studies in 2022, as noted in the report dated 15 April 2023,[10] which were normal. It was not until 25 January 2025 that he commenced treatment with prednisone therapy and a further sleep study. Mr HJZJ took part in a further sleep study on 1 February 2025 after which CPAP therapy was recommended. The Respondent contends that the condition was diagnosed but not reasonably treated and stabilised during the qualification period.

1. I have considered the lung condition, in relation to Mr HJZJ's lung fibrosis and pulmonary embolism and the functional impact of these conditions and the impairment to be assigned, but have not considered Mr HJZJ sleep apnoea. I am not satisfied that the sleep apnoea was reasonably treated and stabilised at the time of claim or within 13 weeks of the claim on 3 May 2023. The Respondent contends that Mr HJZJ's condition of lung fibrosis and pulmonary embolism warrants a maximum impairment rating of 10 points under Table 1 - Functions requiring Physical Exertion and Stamina.
2. Based on the evidence before me, I find that Mr HJZJ experiences frequent symptoms of moderate shortness of breath when performing day-to-day activities such as walking far outside the home and needs to drive to local facilities. Mr HJZJ has shown he has been able to perform work-related tasks of a clerical, sedentary or stationary nature, as indicated by his employment from 15 July 2024 and previous self-employment work until 29 April 2023. Based on the finding above, I accept that Mr HJZH has an impairment of 10 points for the purposes of his claim on 3 May 2023.

1. Mr HJZJ confirmed at hearing that his spinal condition, which includes his neck and lower back condition was caused by an injury while at work on 2 September 2024. He consulted a spinal surgeon on 13 November 2024 who confirmed cervical degenerative disc disease with foraminal stenosis and lumbar degenerative disc disease.[11] An MRI was performed on Mr HJZJ's cervical, thoracic and lumbar spine.[12] His spinal surgeon confirmed Mr HJZJ received bilateral L4 and L5 periradicular blocks on 2 April 2025.[13] Following this treatment, further treatment including physiotherapy, exercise, and analgesics was recommended.[14] I am satisfied that the spinal condition impacting Mr HJZJ was not diagnosed, reasonably treated and stabilised at the time of the claim. Accordingly, I am unable to find that the spinal condition was a permanent condition, as required under the Determination, in order to assign an impairment rating for the condition.

1. It was contended by the Respondent that Mr HJZJ's anxiety and depression was not diagnosed, reasonably treated and stabilised during the qualification period. Mr HJZJ reported in previous discussions with the Agency and on first review having seen a psychiatrist overseas in 2018, but there is no evidence which corroborates this consultation. His GP notes a past history of depression, in the referral to the psychiatrist.[15] He consulted a psychiatrist on 15 April 2023, but did not document a diagnosis, although a medication was discussed.[16] Mr HJZJ was taken to his evidence on first review, as recorded in the decision, where he was alleged to have stated that 'his mental health condition or conditions have limited impact.' Mr HJZJ confirmed that his evidence on first review was correct.
2. Mr HJZJ was seen by a registered psychologist on 20 October 2023, after referral from his GP on 14 September 2023.[17] At this consultation Mr HJZJ is diagnosed with major depressive disorder with anxious stress and post-traumatic stress disorder. Mr HJZJ psychologist states that he attended three appointments with Mr HJZJ. Mr HJZJ confirmed that he has since stopped seeing the psychologist due to the cost. A letter from his psychiatrist, dated 24 June 2025,[18] states that he has been treating Mr HJZJ since 2023 and confirmed a diagnosis of depression. His psychiatrist states continuous treatment with paroxetine and olanzapine, but ongoing difficulties with poor mood, anxiety and a history of trauma.
3. I note the Respondent's submissions as to Mr HJZJ's consultations with the psychiatrist on 4 February 2023 and 15 April 2023, and then again on 24 June 2023. It was submitted that while he may have commenced pharmacological treatment, he had not engaged in any psychological treatment until October 2023, and therefore it was contended that Mr HJZJ's mental health condition was not diagnosed, reasonably treated and stabilised within the qualification period. I agree with this contention and find that I am not satisfied, based on the evidence of treatment before me, that the condition was not diagnosed, reasonably treated and stabilised on 3 May 2023 when he lodged his claim, ort within 13 weeks of this date.
4. While I am not satisfied that his mental health condition was not diagnosed, reasonably treated and stabilised on the date of his claim, even if I were to consider that the condition was diagnosed, reasonably treated and stabilised, I am not satisfied that this condition could be assigned more than nil points under Table 5 - Mental Health Function, as Mr HJZJ's evidence both on first review and before me was that the condition had limited impact on his function.

1. In respect of Mr HJZJ's cataracts, he confirmed the condition was not treated at the time of the claim. I note that he was referred to an ophthalmologist on 11 July 2023.[19] The ophthalmologist recommended on 5 September 2023 that Mr HJZJ have right cataract surgery due to 'significant reduced vision'.[20] On 27 August 2025 Mr HJZJ had left cataract surgery.[21]
2. According to the Determination, Table 12 is to be used to assess a functional impairment involving visual function. However, I find that the condition cannot be considered because the condition was not reasonably treated and stabilised as at the date of the claim. Accordingly, I am unable to find that the cataracts can be assigned an impairment rating under the Determination.

1. Mr HJZJ's medical reports also discuss his type II diabetes, osteoporosis and iron deficiency anaemia. The reports provided indicate that Mr HJZJ has medical certificates dated 2 September 2022 and 10 October 2022 confirming a diagnoses of type II diabetes mellitus.[22] The condition is further referenced on 25 January 2025 and reported that Mr HJZJ 'does have a past history of type II diabetes mellitus, however, now it is better controlled.'[23] There is no evidence of treatment or functional impact of this condition. In the absence of any evidence, I cannot assign an impairment rating.
2. Similarly to the above, his GP confirms on 5 September 2022 and 10 October 2022[24] that Mr HJZJ has osteoporosis. However, there is no referral for specialist treatment, or information regarding treatment or the functional impact of this condition. On this basis, in the absence of any evidence, I cannot assign an impairment rating.
3. There is no diagnosis of iron deficiency anaemia for Mr HJZJ prior to 16 April 2024.[25] I find that the condition cannot be considered because the condition was not reasonably treated and stabilised as at the date of the claim. As such, no impairment rating can be assigned.

1. As stated above, it is an essential criterion for qualification for disability support pension that a person's impairment is of 20 points or more under the Impairment Tables as per paragraph 94(1)(b) of the Act. Based on the findings above, while I accept that Mr HJZJ has a number of medical conditions which seem to be affecting his wellbeing and ability to function, I am not satisfied that the conditions are such that impairment points greater than 10 points could be assigned under the impairment tables on the basis of these conditions for the purposes of his 3 May 2023 claim.
2. As I have not been able to assign an impairment rating of 20 points or more, it is not necessary to consider whether during the qualification period Mr HJZJ had a continuing inability to work within the meaning of paragraph 94(1)(c) of the Act.
3. Accordingly, I affirm the decision under review.

[1] Hearing Bundle comprising of first review documents (171 pages); ARTF1 to ARTF8 (26 pages); Mr HJZJ's documents A1to A11 (34 pages); the Respondent documents R1 to R4 (308 pages).

[2] Re Drake and Minister for Immigration and Ethnic Affairs (No 2) (1979) 2 ALD 634; G v Minister for Immigration and Border Protection [2018] FCA 1229; MDXJ v Secretary, Department of Social Services [2020] FCA 1767.

[3] See Gallacher v Secretary, Department of Social Services [2015] FCA 1123.