austlii:cth/ARTA/2025/793
General information, not legal advice.
ARTA
2025-06-19
Original judgment source is linked above.
In the Tribunal's consideration as to whether a condition has been stabilised and is likely to persist for the foreseeable future, the Tribunal must look at the situation as it was, and the evidence that was available, at the time of the application for DSP (and the subsequent 13 weeks). Any subsequent evolution of a particular condition might be relevant to any weight the Tribunal places on competing prognostications or on an assessment of the quality of the medical reports provided (most notably where evidence indicates that the creator of a medical report may not have had access to all relevant information or may not have turned his or her mind to all the relevant issues). This point is important as it is quite frequently the case that appeals on DSP decisions arrive at this Tribunal twelve or more months after the initial DSP application was refused. In many instances, the natural course of illnesses or injuries has then become more obvious, thereby confounding the professional opinions honestly proffered by thorough and conscientious treating doctors. If a medical condition has progressed since the time of the original DSP application, then it is up to the Applicant to make a new DSP application. It is not open in law for this Tribunal to use any evidence of such progression to directly award a DSP because of those changed circumstances.
[t]he Applicant's entitlement to a pension must be considered as at the date of her claim, namely, 3 May 2004 and a period of 13 weeks thereafter. Any subsequent change in her health is irrelevant to the questions which arise in this proceeding except insofar as it may cast light on the position at the relevant time.
It is, I think, important to realize that 'temporary' is used by Centrelink in this context in a special sense. It is a shorthand way of describing a condition which is not, at that time, capable of being regarded as being permanent. That judgment is to be made on the basis of the material capable of throwing light on the issue of whether the conditions were, at the relevant time, fully documented and diagnosed conditions which had been investigated, treated and stabilised.
It is not to the point that they may have answered that description at a later time. Nor is it to the point, for present purposes, that the point at which the conditions could have been investigated, treated and stabilised at an earlier time had Centrelink acted in a different manner. The Parliament has determined that disability support pensions are to be paid when certain qualifying criteria are satisfied. The evident legislative intent is that disability support pensions be paid only when the disabling condition has reached the stage where it can be regarded as being permanent and having a permanent impact upon normal function as it relates to work performance.
The language in clauses 6(5) and 6(6) of the 2011 Determination is forward-looking. With respect to whether a condition was fully stabilised, for example, the question for the Tribunal is whether "any further reasonable treatment is unlikely to result in significant functional improvement to a level enabling the person to undertake work in the next two years". While hindsight may suggest that treatment did not result in improvement within two years that is not the question for the Tribunal to determine. The legislation requires the Tribunal to consider the treatment that has taken place, and was intended to take place, and the likely effect of that treatment, at the time of the claim and in the 13 weeks thereafter.
For that reason, evidence of treatment, and the efficacy of that treatment, after the relevant period is not directly relevant to the Tribunal's decision.
I ceased working on 1/8/2022 and since that day I have to [sic] returned to work.
The reason I ceased is that I have been unable to sustain work activities or other tasks for more than 3 hours a day, due to my medical conditions.
My medical conditions affect my quality of life. Such as;
My lower abdominal pain is effecting [sic] my work in many ways;
The Applicant's physical, intellectual or psychiatric impairments
Impairment ratings in respect of the Applicant's conditions
Symptoms: The client reported fainting episodes, with last episode falling in the bathroom a few months ago. The client reported she has effects from medication such as dizziness. The client reported ongoing lower back pain, difficulty walking due to pain. The client reported daily accidents and requiring to use continence aids. The client reported her anxiety and pain affects her ability to change the continence aids and she requires the assistance of her children to do this at times. Dr indicates bladder and bowel control issues with difficulties and episodes once per week...
Treatment: The client reported she had many surgical interventions with the last surgical intervention 2 years ago, the client reported she has iron infusions every 2 months, the client reported specialist reviews every few months, the client takes medication (Promil). The client reported she completed exercises, pelvic floor physiotherapy etc. Dr [HN], Obstetrician and Gynaecologist, 02/01/21 indicates 'medical treatment has been reasonably effective (Implanon).
The condition has been in place for in excess of five [y]ears and its extent is fully diagnosed treated and stabilised with quite a quantum of negative impact on her life. The continuous bleed makes her go to [t]he toilet frequently with frequent hand washing that further exacerbates her eczema and has negative psychosocial impact on her self image and worthiness. She has fainted intermittently during period where her iron dropped and became anaemic. She has required iron infusion repeatedly over the years.
She also continues to suffer from recurrant [sic] heavy bleeding to the extent that it caused her iron deficiency and anemia and this is difficult to address and she has been seen by multiple gynecologists [sic] and none of which have had the courage to advice [sic] operative intervention to remove the uterus however various medical treatments are in place with little success at controlling the bleeding she has had to have multiple iron transfusions in order to maintain and treat the iron deficiency that has been caused by this. It is undoubtedly this iron deficiency contributes to the ongoing tiredness and fatigue and difficulty in being able to concentrate and probably also contributes to the headaches that she frequently comes with this also is one factor in making her unable to cope with many of her demands and responsibilities.
[s]he also has a separate problem to do with pelvic floor dysfunction which is causing her Incontinence of significant nature this restricts her ability to go anywhere an maintain herself she has been treated by Dr [KM] who's a specialist in this field and is currently on treatment with vesicare and is using a vaginal ring to lift the bladder and maintain the pelvic floor in a taught [sic] position this has not completely relieved her symptoms in her symptoms and she remains somewhat distorted because of her constant fear of being embarrassed in public ... There is another dimension to the urinary difficulty control is that she has incomplete bladder emptying and that causes her to have residual urinary contents in the bladder causing her to get recurrent urinary tract infections as well.
[C]lient reported difficulty managing stress, poor sleep, reduced concentration, difficulty socialising, thinking, negative thought patterns, phobia, anxiety regarding tunnels, looking around due to paranoia. The client reported stress also exacerbates her skin condition, and results in skin irritation when stressed. The client takes Zyrtec and it assists her with 'calming down'.
Treatment: The client reported she has taken anti-depressants and due to being allergic, the client has stopped taking medication due to the effects and allergic reactions. The client reported this was prescribed by her GP.
The client reported she still sees Mr [Dr JS], Psychologist every few months for treatment or as needed.
She continued to suffer from sciatica that occurs the recurrently affecting her lower back and causing radiation of pain to the left leg and often makes unable to mobile effectively and address many of her home calls as well as being able to be involved in work and this has led to her becoming unemployed until a degree difficult to employ investigation of this had been in the past and it's due to a disc compression of the outgoing fibers which is not available to surgical intervention this has also been complicated with the development of chronic pain and other depressive manifestations that occurred following the ongoing marital discomfort.
The extent of permit from this is the it is difficult for her to stand for periods greater than 10 to 15 minutes because of the severity of the pain and anyways you can manage is to sit down and this further makes it impossible for her to squat kneel or handle heavy objects significantly
She has had multiple treatments including muscle trees and remains unable to function despite all these.
Harris
Secretary, Department of Employment and Workplace Relations
Bobera and Secretary, Department of Families, Housing, Community Services and Indigenous Affairs [2012] AATA 922
Coates and Secretary, Department of Employment and Workplace Relations [2006] AATA 938
Fanning and Secretary, Department of Social Services [2014] AATA 447
Harris v Secretary, Department of Employment and Workplace Relations [2007] FCA 404