SOCIAL SECURITY - Disability Support Pension - impairment from medical conditions - prognosis was temporary - improvement expected - slow improvement - limited evidence of treatment - not fully treated and stabilised on date of claim - not able to be rated under Impairment Tables - decision under review affirmed

Names used in all published decisions are pseudonyms. Any references appearing in square brackets indicate that information has been omitted from this decision and replaced with generic information pursuant to subsection 201(1A) of the Social Security (Administration) Act 1999.

1. This review considered whether Ms Silosi met the requirements for payment of disability support pension (DSP).
2. Ms Silosi is [an age]-year-old woman who lodged an application for DSP on 27 March 2023 stating in the application that she had the medical conditions of post-traumatic stress disorder (PTSD), anxiety and depression. On 14 March 2023, a Centrelink officer found Ms Silosi was not qualified for DSP (the original decision) because her medical conditions did not attract an impairment rating of at least 20 points under the Impairment Tables. This decision was affirmed by an authorised review officer on 2 July 2025.
3. On 1 September 2025, Ms Silosi requested a review of the decision by the Administrative Review Tribunal (the Tribunal).
4. On 31 October 2025, a hearing was scheduled. Ms Silosi attended the hearing and spoke with the Tribunal by telephone conference. The Tribunal had before it a collection of documents provided by Centrelink and the applicant, a copy of which had also been provided to Ms Silosi and included Centrelink provided papers (folios 1-171), supplementary papers (folios 172-176) and documents provided by the applicant (folios A1-18). These documents collectively represented the hearing papers.
5. Relevant aspects of the evidence before the Tribunal will be referred to in the Tribunal's consideration of the issues.

1. The statutory provisions relevant to this review are contained in the Social Security Act 1991 (the Act) and the Social Security (Administration) Act 1999 (the Administration Act).
2. The issues which arise in this case are:

a) Whether Ms Silosi has any physical, intellectual or psychiatric impairment; > > b) Whether her impairments rate at least 20 points under the Impairment Tables; and > > c) Whether she has a continuing inability to work.

1. Provisions relating to whether a person is qualified for DSP and whether DSP is payable to the person are contained in Part 2.3 of the Act.
2. Subsection 94(1) of the Act states, in part, that:

94(1) A person is qualified for disability support pension if:

(a) the person has a physical, intellectual or psychiatric impairment; and

(b) the person's impairment is of 20 points or more under the Impairment Tables; and

(c) one of the following applies:

(i) the person has a continuing inability to work.

1. In accordance with subclause 4(1) of Schedule 2 to the Administration Act, the Tribunal is required to determine Ms Silosi's eligibility for DSP on 27 March 2023, being the date on which the claim for DSP was lodged.
2. The "relevant period" for this review extends for 13 weeks after the date of claim. That is, should the Tribunal conclude Ms Silosi did not meet the qualification on 27 March 2023, but did so within 13 weeks of that date, the Tribunal would consider whether the early start date rule in subclause 4(1) of Schedule 2 to the Administration Act allows the Tribunal to grant DSP from that date.

Issue 1 - Does Ms Silosi have a physical, intellectual or psychiatric impairment?

1. As stated above, paragraph 94(1)(a) of the Act provides that the first qualification for DSP is that a person has a physical, intellectual or psychiatric impairment.
2. In oral evidence at the hearing, Ms Silosi told the Tribunal that her most significant medical condition was PTSD. However she also had troubles with anxiety and poor concentration and memory. Her medical conditions caused impairment.
3. The Tribunal noted the documentation in the hearing papers including medical certificates and letters written by treating general practitioners and psychologists outlined impairment arising from medical conditions.
4. Given the consistent oral and written evidence that Ms Silosi experienced impairment arising from her medical conditions, the Tribunal found that Ms Silosi satisfied paragraph 94(1)(a) of the Act.

Issue 2 - Do Ms Silosi's impairments rate 20 points or more?

1. As stated above, paragraph 94(1)(b) of the Act provides that the second qualification for DSP is that the person's impairments rate 20 points or more under the Impairment Tables.
2. The Social Security (Tables for the Assessment of Work-related Impairment for Disability Support Pension) Determination 2011 contains the Impairment Tables and the rules for applying the Impairment Tables when deciding if a person is qualified for DSP for an application lodged on 27 March 2023.
3. An impairment rating can only be assigned to a condition if the condition is permanent for the purposes of DSP; that is, if the condition is expected to persist for more than 24 months and was "fully diagnosed", "fully treated" and "fully stabilised" on the date of claim or within the relevant period of the review, and there was unlikely to be any significant functional improvement in the condition within the next two years enabling the person to undertake work.
4. The Tribunal considered the relevant evidence.

1. Ms Silosi gave the following evidence at the hearing:

a) The decision to reject the application was wrong because she was told the decision would be made within six to eight weeks but it had taken two years. She had repeatedly asked Centrelink staff whether she needed to provide additional information and was advised the matter was being considered. However, when her claim was rejected she was told it was rejected because the law had changed a few days after she had lodged the claim and she had not taken medication to manage her medical condition. She felt this was unfair. > > b) In terms of the prognosis of her condition, she was uncertain. She felt even the treating clinicians were uncertain. She saw triggers that flared her symptoms. It had been seven years since her husband died and she still experienced daily symptoms. > > c) In terms of the diagnosis of her medical conditions, she felt this was made by her doctor who then referred her to a psychologist. > > d) In terms of treatment of her medical conditions, she had counselling when her husband died in 2018 with a counsellor, [Counsellor A]. However he moved away in 2018. She then saw psychologist [Psychologist A], but only briefly as she stopped providing face to face services due to COVID in 2021. She then started seeing psychologist [Psychologist B] in 2023. She saw clinical psychologist [Psychologist C] once in 2023 and he was very good but he was too expensive, so she remained under the care of [Psychologist B]. She felt she was better than in 2018, but still had daily symptoms. > > e) In terms of psychotherapy, she had been treated with "talk therapy." She was not aware if she had been treated with Prolonged Exposure, Cognitive Processing Therapy, or Eye Movement Desensitisation and Reprocessing therapies. She recalled one therapy was discussed with her but there was a concern it might force her to re-face fears so it did not proceed. > > f) In terms of medication to assist in managing her mental health symptoms, she had not trialled any medication. She was fearful of medication. Her husband had been on medication and also had troubles with substance abuse before he died. She would not even take paracetamol for a fever, nor antibiotics or other medications. She might have a blood test, but was in general reluctant to see any doctors. She would take her children to the doctor if they were ill and accepted they could have medication if it were indicated. > > g) In terms of specialist input into her care, she had not seen a psychiatrist. She felt a psychiatrist would force her to have medication. She had not attended an emergency department nor had an admission to assist in managing her mental health. She worried that if she needed an admission she might lose custody of her children. > > h) In regard to the Attention Deficit Hyperactivity Disorder (ADHD) diagnosis raised by [Psychologist B] in several medical certificates, where he had asked her to see her general practitioner to arrange further assessment, she stated that she had forgotten to see her general practitioner for this assessment. This was probably a result of her poor memory and concentration.

1. The functional impact of the mental health conditions was that she would have symptoms if she saw a trigger. It affected her daily activities. She had poor sleep and found it hard to get out of bed at times. Her mental health impacted upon her capacity to parent. She was hesitant to be around other people. If she needed shopping she would either do a small shop so she was in and out of the shop quickly, or she might shop on-line, or send a child into the shop with a list. She cooked meals as her children needed to eat. She was able to attend school meetings if they were of a short duration, but not if longer in duration. If longer meetings were required she might email and seek information rather than attend a longer face to face meeting.

j) She felt the barrier to work would be the social aspect of work and the barrier to study or retraining would be her poor memory and concentration. She had previously studied successfully at university and had a good memory, but it was different now. > > k) She disagreed with the Employment Services Assessor (ESA) reports dated 10 January 2023 and 12 May 2025 because she did not recall speaking with a psychologist or nurse from Centrelink. She felt the Centrelink staff used a tick box system and she may not have disclosed personal information about her circumstances as she did not see Centrelink as being a safe place. Therefore their assessments were general and not specific to her situation.

1. The Tribunal noted the following evidence in the hearing papers:

a) Medical certificates by general practitioner [GP A] dated 23 October 2020 and 9 February 2021. > > b) A medical certificate by [Psychologist A] dated 10 May 2021. > > c) Medical certificates by general practitioner [GP B] dated 8 November 2021, 18 November 2021, 5 February 2022, 9 May 2022, 12 August 2022, 7 November 2022 and 13 February 2023. > > d) ESA reports dated 10 January 2023 and 12 May 2025. > > e) The claim for DSP lodged on 27 March 2023. > > f) A letter by [GP B] dated 15 December 2021. > > g) A letter by psychologist [Psychologist B] dated 17 March 2023. > > h) Medical certificates by [Psychologist B] dated 2 May 2023, 30 November 2023, 29 April 2024, 30 July 2024, 29 October 2024, 1 February 2025, 1 May 2025 and 1 October 2025.

1. A letter by clinical psychologist [Psychologist C] dated 25 May 2023.

j) A verification medical certificated by [Psychologist B] dated 10 February 2025. > > k) A letter by [Psychologist B] dated 1 September 2025.

Mental health conditions - PTSD, anxiety and depression

Were the mental health conditions expected to persist for more than 24 months?

1. The Tribunal noted there was conflicting medical evidence on prognosis.
2. The medical certificates by [GP A] dated 23 October 2020 and 9 February 2021 and by [GP B] dated 8 November 2021, 18 November 2021, 5 February 2022, 9 May 2022, 12 August 2022, 7 November 2022 and 13 February 2023 documented the mental health conditions as being an exacerbation of an existing condition and improvement was expected although prognosis was uncertain.
3. The treating psychologist [Psychologist A] documented in a medical certificate on 10 May 2021 that the prognosis was temporary.
4. The subsequent treating psychologist [Psychologist B] documented repeatedly in medical certificates dated 2 May 2023, 30 November 2023, 29 April 2024, 30 July 2024, 29 October 2024, 1 February 2025, 1 May 2025 and 1 October 2025 that the prognosis was temporary and improvement could be expected within 12 months. In a letter dated 17 March 2023 [Psychologist B] wrote that the prognosis was unclear as Ms Silosi was only commencing therapy. He wrote:

The prognosis for her recovery at this point is unclear as treatment has yet to begin.

1. The one exception to the temporary prognosis came in a verification of medical evidence medical certificate dated 10 February 2025 by [Psychologist B] who wrote on this occasion that the conditions were permanent.
2. In oral evidence Ms Silosi stated that she felt there had been slow improvement but her condition had lasted a long time and dated back to just before her husband's death when she commenced counselling. She felt her prognosis was uncertain.
3. On balance the Tribunal preferred the evidence from the medical certificates by [Psychologist B] as these were more likely to reflect prognostic considerations on the date of claim, and remained consistent across eight issued medical certificates. The Tribunal noted that some element of mental health concern might persist longer, but improvement was currently anticipated.
4. The Tribunal found that on the date of claim the mental health condition was expected to show improvement within two years.

1. The Tribunal noted that the Impairment Tables specified the requirements for a mental health condition to be fully diagnosed for the purposes of DSP for a claim lodged on 27 March 2023. The introduction to the mental health table stated:

The diagnosis of the condition must be made by an appropriately qualified medical practitioner (this includes a psychiatrist) with evidence from a clinical psychologist (if the diagnosis has not been made by a psychiatrist).

1. The Tribunal noted there was evidence of diagnostic input from general practitioners [GP A] and [GP B] who were appropriately qualified medical practitioners, but they were not psychiatrists.
2. Likewise the Tribunal noted there was evidence of diagnostic input from psychologists [Psychologist A] and [Psychologist B] that preceded the claim for DSP. However the first evidence of diagnostic input from a clinical psychologist came from [Psychologist C] on 25 May 2023. This occurred after the claim for DSP was lodged.
3. The Tribunal found the mental health condition was not fully diagnosed for the purposes of DSP on the date of claim.
4. However the Tribunal noted that the mental health condition of PTSD could be regarded as being fully diagnosed from 25 May 2023, as on this date [Psychologist C] provided diagnostic input. As this date fell within 13 weeks of the date of claim, then the Tribunal noted that should all other eligibility criteria be met, the Tribunal might consider whether the early start date rule might be applied from this date.

Was the mental health condition fully treated and stabilised?

1. The Tribunal noted that the Impairment Tables specified the requirements for a medical condition to be regarded as being fully treated and stabilised. This required the Tribunal to consider if "reasonable treatment" had been implemented that might stabilise the condition.
2. The introduction to the Impairment Tables stated:

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

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

(c) can reliably be expected to result in a substantial improvement in functional capacity; and

1. The Tribunal noted that on 17 March 2023, only 10 days before the claim for DSP was lodged, [Psychologist B] wrote in a letter that psychological therapy had not yet started and the prognosis remained unclear.
2. Prior to this letter, the only medical evidence of psychological treatment was a single medical certificate from psychologist [Psychologist A] and this was dated nearly two years earlier on 10 May 2021. At that time [Psychologist A] felt the condition was temporary and would resolve within 3 months. The therapy listed at that time was cognitive behavioural therapy and the diagnostic formulation at that time was of an adjustment disorder with anxiety and depression.
3. Several medical certificates documented counselling or psychologist therapy but no details were available of the dates of therapy, duration of therapy and types of therapy implemented.
4. In oral evidence Ms Silosi stated she saw a counsellor when her husband died in 2018. However this then ceased as the counsellor moved away. She then briefly saw [Psychologist A] in 2021 but therapy ceased due to COVID. She only really commenced more prolonged psychotherapy under supervision of a psychologist in March 2023, around the time she lodged the claim for DSP. However the therapy had largely been confined to talk therapy.
5. The Tribunal noted that at the time of claim there had been limited psychotherapy and certainly no evidence of sustained engagement in relevant psychotherapy for PTSD such as Prolonged Exposure, Cognitive Processing Therapy, and Eye Movement Desensitisation and Reprocessing. Therapy with a new psychologist was just commencing.
6. The Tribunal further noted that there was no evidence of specialist input into care nor of relevant psycho-medication trials. Both review by a specialist psychiatrist and psychopharmacy trials represented reasonable treatment that might be implemented to help stabilise symptomatology and lead to functional improvement within the next two years.
7. The Tribunal noted the letter from [Psychologist B] dated 1 September 2025 and oral evidence from Ms Silosi stating that Ms Silosi was reluctant to trial medication as she had children and that there was a concern medication might aggravate her traumatic exposure. However the Tribunal felt that it was premature to draw such a conclusion without a review by a psychiatrist who would be better placed to explain the potential risks and benefits of medication trials. The Tribunal noted that being a mother to children was not a contraindication to medical therapy, and concerns over medication were best resolved by speaking with a specialist psychiatrist who was experienced in the actual prescribing of such medication.
8. The Tribunal found the mental health conditions were not fully treated and stabilised on the date of claim for DSP, nor within 13 weeks of the date of claim because there was limited evidence of relevant sustained psychological therapy directed towards the diagnoses of PTSD, anxiety and depression being in place at that time of claim in March 2023, and no evidence of review by a psychiatrist nor of relevant psycho-medication trials having been attempted. These measures represented reasonable management.

1. The Tribunal has found that the mental health conditions had a temporary prognosis and were not fully diagnosed, treated and stabilised on the date of claim for DSP. It follows that the functional impact of the mental health conditions cannot be rated under the Impairment Tables.

Attention deficit hyperactivity disorder (ADHD)

Was the ADHD expected to persist for more than 24 months?

1. The Tribunal noted the only evidence of ADHD came from medical certificates written by [Psychologist B]. In the medical certificates by [Psychologist B] dated 2 May 2023, 30 November 2023, 29 April 2024, 30 July 2024, 29 October 2024, 1 February 2025, 1 May 2025 and 1 October 2025 it was documented that the prognosis was temporary and expected to improve. However, in the verification of medical evidence by [Psychologist B] dated 25 May 2023 he wrote the prognosis was more than 24 months.
2. The Tribunal noted the inconsistent evidence from [Psychologist B], but on balance felt that with finalisation of a diagnosis and management there was likely to be improvement within two years and so accepted the evidence from the eight medical certificates.
3. The Tribunal found that on the date of claim the ADHD was expected to show improvement within two years.

1. The Tribunal noted that the Impairment Tables specified the requirements for a mental health condition to be fully diagnosed for the purposes of DSP for a claim lodged on 27 March 2023. The introduction to the mental health table stated:

The diagnosis of the condition must be made by an appropriately qualified medical practitioner (this includes a psychiatrist) with evidence from a clinical psychologist (if the diagnosis has not been made by a psychiatrist).

1. The Tribunal noted there was no evidence of diagnostic input from appropriately qualified medical practitioners. The medical certificates from the treating psychologist stated that Ms Silosi should see her general practitioner to follow up on this condition.
2. Likewise the Tribunal noted that whilst there was evidence of diagnostic input from [Psychologist B] that preceded the claim for DSP, there was no diagnostic input from a clinical psychologist. The letter from clinical psychologist [Psychologist C] dated 25 May 2023 did not discuss the diagnosis of ADHD.
3. In oral evidence Ms Silosi stated she had not yet seen her general practitioner to arrange further assessment for a possible diagnosis of ADHD.
4. The Tribunal found the ADHD was not fully diagnosed for the purposes of DSP on the date of claim.

1. The Tribunal has found that the ADHD had a temporary prognosis and was not fully diagnosed on the date of claim for DSP, it follows that the functional impact of the ADHD cannot be rated under the Impairment Tables.

1. The Tribunal has found that Ms Silosi has no medical conditions able to be rated under the Impairment Tables. Therefore, she failed to satisfy paragraph 94(1)(b) of the Act.

Issue 3 - Does Ms Silosi have a continuing inability to work?

1. As the Tribunal has found Ms Silosi did not satisfy paragraph 94(1)(b) of the Act, it did not proceed to consider if she had satisfied paragraph 94(1)(c) of the Act.

The decision under review is affirmed. This means the review is not successful.