austlii:cth/ARTA/2025/1264
General information, not legal advice.
ARTA
2025-07-21
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). His 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.
In my view, in the case of DSP, it is implicit in Clause 4 of Schedule 2 of the Administration Act that an applicant must be qualified for DSP on the date of claim or with the period of 13 weeks following. Evidence, such as medical reports, that come into being after the relevant period may still be relevant, but only in so far as they are referrable to the applicant's condition during the relevant period.
This is supported by the judgment of Gyles J in Harris v Secretary, Department of Employment and Workplace Relations [2007] FCA 404. Gyles J stated at [1] that as an applicant's entitlement to DSP must be considered at the date of claim and within the 13 week period, "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".
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" (emphasis added). 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.
The Applicant's physical, intellectual or psychiatric impairments
[The Applicant] stated that his current treatment consists of physiotherapy, medication in the form of self-guided exercises provided from the therapist, Tramadol 50mg twice daily and Panadol 500mg.
With respect to the cervical spine, [the Applicant] stated that he still has a constant dull ache that increases to pain localised to the base of the cervical spine. He stated that the discomfort radiated to up into the head. He stated that the discomfort was aggravated by looking right, prolonged computer work and looking down. [The Applicant] described stiffness in the morning on waking that improved with movement and warmth. He described decreased range of motion in the cervical spine affecting all planes. [The Applicant] denied any altered sensation or loss of strength in the upper or lower limbs. [The Applicant] denied any lower tract symptoms such as relevant bladder or bowel changes, saddle anaesthesia, sexual dysfunction, or lower limb neurological changes.
With respect to the right shoulder, [the Applicant] stated that he still has a constant dull ache that increases to pain localised in the top of the shoulder lateral aspect of the shoulder. He stated that the discomfort radiated to into the upper arm into the neck. He stated that the discomfort was aggravated by lying on the shoulder reaching behind pushing, pulling, reaching overhead and repeated movement. He denied any concerns regarding range of motion in the shoulder.
With respect to the right wrist, [the Applicant] stated that he still has a constant dull ache that increases to pain localised to the dorsum of the wrist. He stated that the discomfort radiated to middle finger and index finger. He stated that the discomfort was aggravated by vibration, forceful gripping and rotating the wrist, lifting, carrying, bending the wrist. He denied any concerns regarding range of motion in the wrist.
With respect to right upper limb sensation, he described 'pins and needles' sensation, affecting the median nerve distribution (thumb and first three fingers).
With respect to the right knee, [the Applicant] stated that he still has intermittent pain localised to underneath the patella. He denied any radiation of the pain. He stated that the discomfort was aggravated by prolonged walking, climbing stairs, squatting and kneeling. He denied any concerns regarding range of motion in the knee. [The Applicant] denied any altered sensation or loss of strength in the knee. Despite his ongoing limitations, [the Applicant] denied any difficulty with squatting kneeling though these activities do cause discomfort.
With respect to his activities of daily living [the Applicant] reported the following:
Self care: No reported impairment of ability to perform activities of self care.
Household duties: Unable to perform some activities of household duties without assistance. His children assist with these activities.
Hobbies: Unable to perform some outdoor duties or recreational activities, including mowing, and hobbies of motorcycle riding, camping and fishing, and also difficulty shooting pistols and rifles.
There is upper limb paraesthesia. Headaches are sub-occipital, radiation to the front of the head. They occur once or twice each week. Aggravating factors for [the Applicant] include lifting activities or static postures of the head and neck. Checking blind spots when driving can be problematic. Overhead activities are pain provoking.
[The Applicant] experiences ongoing right upper limb pain (of the wrist and shoulder). He finds he is weaker. There is pain in the posterolateral aspect of the shoulder (radiating into the interscapular region). There is pain is in the dorsal aspect of the wrist. It feels stiff and can swell. The pain can radiate into the dorsal aspect of his fingers. There is a loss of sensation in the palm. Aggravating factors include forceful or repetitive use of the afflicted arm. Unilateral or bilateral lifting activities are now restricted, particularly above chest height. Overhead activities can be painful. Rolling on to the shoulder in bed causes pain and sleep disturbance. Opening jars is difficult. Vibration is aggravating to his symptoms.
The claimant's knee pain is of an oscillating nature. There is intermittent swelling and clicking. The knee feels stiff, and it can lock. Aggravating factors include extended periods of standing, walking on stairs or uneven ground, squatting or kneeling and lifting activities. So that he might modulate his pain, [the Applicant] will use medication, heat and rest. He frequently rests in a recliner chair, supporting his neck and elevating his knee.
The claimant is ambidextrous. He writes with his left hand but is otherwise reliant on his right hand. Cervical flexion and extension is restricted. He describes pain with cervical rotation. Static neck tolerances are compromised. This adversely affects his capacity for computer activity or driving. Flexion and abduction of the right shoulder is restricted at end range. The right wrist has a reduced range of motion in flexion and extension. Forward or overhead reach activities are limited by cervical spine and right upper limb dysfunction.
Knee extension is normal. Flexion is limited at end range. He describes that he often limps with long periods of walking. There are difficulties traversing stairs or uneven ground. The claimant suffers increased knee pain with long periods of standing or walking. He experiences stiffness when moving to stand (particularly after sitting for a period). Where possible, he alternates postures between standing and sitting. There are difficulties with crouching and kneeling. Activities below waist height, above chest height or in front of the body are now problematic.
[The Applicant] reported he consulted a spinal specialist in 2021 and early signs of arthritis has been identified in his left hip.
[The Applicant] advised he self-manages his pain and is able to undertake household tasks, but with constant pain.
[The Applicant] reported he continues to experience panic attacks, insomnia, flashbacks of fatal car accident, "always sees the face of the other driver", always drained and tired and don't like being around people.
[The Applicant] advised he experiences constant headaches for which he takes Nurofen.
[The Applicant] stated he is in the process of changing his antidepressant medication and his GP has suggested trialling medicinal cannabis.
Medical evidence suggested limited treatment over the last couple of years.
Bobera and Secretary, Department of Families, Housing, Community Services and Indigenous Affairs [2012] AATA 922
Fanning and Secretary, Department of Social Services [2014] AATA 447
Harris v Secretary, Department of Employment and Workplace Relations [2007] FCA 404