austlii:cth/ARTA/2026/478
General information, not legal advice.
ARTA
2026-03-30
Original judgment source is linked above.
...On 12 October 2018, progress notes by Dr Chen further stated that the condition was "for PRN review" (as needed review) and was "not for further injection". Dr Chen also recorded "Chinese herbal medicine" but did not elaborate further.
I believe the secretary did not correctly understand the meaning of "for PRN review". Its correct meaning should be: "for as the thing is needed review", this is usually only written when a doctor believes the patient's condition has stabilized. Which mean that the patient current condition is temporarily stable, and there is no need to schedule a follow-up appointment. In other words: 1. The condition has stabilized; 2. Treatment has been completed, and only follow-up visits are needed as required; 3. The patient needs to monitor their symptoms going forward.
After 12 October 2018, the applicant's self-treatment (pain management) includes: rest, reducing exercise, applying warm water compresses, rubbing with traditional Chinese herbal medicine wine, applying blood-activating and pain-relieving plasters, physical therapy (self-purchased a multi-functional digital therapy device), using protective gear (including tennis claw braces, thumb braces, and wrist supports), and taking painkillers as Panadol and Meloxicam. In severe cases, allergy medication may be required (allergy medication has a sleep-inducing effect and reduce pain). Attached "attachment 1", it is a digital therapy device, Chinese herbal medicine wine and blood-activating and pain-relieving plasters.
The applicant's pain management, also confirmed by PHYSIOTHERAPY REPORT of the physiotherapist Alex Chan, dated 02/09/2025.
the following medical reports on which the Respondent intends to rely.
Medical report/s addressing the Respondent's condition/s affecting the Respondent's Function/s
A medical report or other information from the Respondent's health care practitioner/s about the Respondent's condition/s affecting the Respondent's Function/s under the relevant Table/s of the Social Security (Tables for the Assessment of Work-related Impairment for Disability Support Pension) Determination 2011 as at 9 August 2022 (the date the Respondent applied for the Disability Support Pension) or within 13 weeks of that date.
-undertake a training activity for the next 2 years or
-work for at least 15 hours per week for the next 2 years.
(a) Wicker and Secretary, Department of Social Services (Social services second review) [2022] AATA 3337 at [55], where the Tribunal stated:
I do not consider I am bound to apply the reasoning or the decision in Lucas and Secretary Department of Social Services [2018] AATA 2563, in which Tavoularis SM said it would be "inappropriate" to consider a condition permanent if a pain management course has not been completed at a recognised pain clinic. I am not aware of the source of that observation. Nothing in the evidence suggested to me in any event that it would be "inappropriate" to find the Applicant's condition is not permanent because he has not sought out a pain specialist.
(b) Zaporowski and Secretary, Department of Social Services (Social services second review) [2023] AATA 4042 (Zaporowski) at [35], where the Tribunal noted that:
... a number of AAT cases where it was said that failure to attend a course in pain management indicated that the relevant condition had not been fully treated and stabilised: Newman and Secretary, Department of Family and Community Services [2002] AATA 917 (Newman); Smalldon and Secretary, Department of Social Services [2015] AATA 575 (Smalldon); Lucas and Secretary, Department of Social Services (Social services second review) [2018] AATA 2563 (Lucas); and Smyrniadou and Secretary, Department of Social Services (Social services second review) [2022] AATA 2433 (Smyrniadou). In Newman, the Tribunal noted that 3 doctors had recommendation a course of pain management. In Lucas, the treating GP had indicated that the condition was not fully treated and stabilised as further treatment, including pain management was required. In Smyrniadou, the Tribunal noted a history of referral of the Applicant for better management of her pain and a refusal to comply with the referrals. However, in Smalldon, at the second review, the Tribunal did not agree with the decision in AAT1 and held that pain management was not likely to yield significant benefit and so it was accepted that the condition was fully treated and stabilised. These cases suggest that each case must be decided on its own facts.
(c) Steffensen and Secretary, Department of Social Services (Social services second review) [2024] AATA 119 at [51], where the Tribunal stated that:
The Tribunal is not persuaded that a blanket reliance on a multi-disciplinary pain management program is reasonable treatment for all DSP applicants who suffer from chronic pain conditions.
... The specialist Dr Ding Chen told the appellant that there was no more way to heal the appellant's hand and suggested that the appellant seeking help from traditional Chinese medicine in the consultation of the last day which dated 16 October 2018. The appellant never seeing the specialist Dr Ding Chen or seeking another hand specialist after 16 October 2018.
(9) There is no Table dealing specifically with pain and when assessing pain the following must be considered:
(a) acute pain is a symptom which may result in short term loss of functional capacity in more than one area of the body; and
(b) chronic pain is a condition and, where it has been diagnosed, any resulting impairment should be assessed using the Table relevant to the area of function affected; and
(c) whether the condition causing pain has been fully diagnosed, fully treated and fully stabilised for the purposes of subsections 6(5) and (6).
0 There is a no functional impact on activities using hands or arms.
(1) The person can pick up, handle, manipulate and use most objects encountered on a daily basis without difficulty.
5 There is a mild functional impact on activities using hands or arms.
(2) 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.
(1) The person has difficulty with most of the following:
(a) picking up a 1 litre carton full of liquid;
(b) picking up a light but bulky object requiring the use of 2 hands together (e.g. a cardboard box);
(c) holding and using a pen or pencil;
(d) doing up buttons or tying shoelaces;
(e) using a standard computer keyboard;
(f) unscrewing a lid on a soft-drink bottle.
(a) the person has limited movement or coordination in both arms or both hands, or has an amputation rendering a hand or arm non-functional;
(b) the person has severe difficulty handling, moving or carrying most objects even when using or waring any prothesis or assistive device that they have and usually use;
(c) the person has difficulty using a computer keyboard despite appropriate adaptions;
(d) the person has severe difficulty using a pen or pencil
(e) the person has severe difficulty turning the pages of a book without assistance.
(Mr TFPS) suffers from chronic lumbar back pain. A previous CT lumbosacral spine demonstrated moderate central canal stenosis at the L4/5 level, with effacement of the lateral recesses and bilateral impingement of the descending L5 nerve roots. Clinically, he has difficulty with prolonged sitting, standing, bending, lifting items over 2 kilograms, and walking more than 100 metres without resting. These limitations algin with a moderate to severe functional impairment of the spine, and warrant 10 points under Table 4.
(a) There is no evidence that Mr TFPS has been reviewed by a specialist or referred for pain management;
(b) It is accepted that Mr TFPS has had physiotherapy sessions but contends that a CT-guided epidural or a selective perineural injection, as recommended by radiologist Dr Chew on 11 July 2024, after the qualification period, are reasonable treatments that could result in functional improvement.
Issue 3: Can an impairment rating of 20 points or more be allocated for Mr TFPS' 9 August 2022 claim?
Issue 4: Does Mr TFPS have a continuing inability to work for the purposes of his 9 August 2022 claim for disability support pension?
[1] Services Australia delivers social security payments and services and is overseen by the Department of Social Services. The Respondent is responsible for the overall management and administration of the Department of Social Security. Centrelink is the Government Agency that delivers social security payments and services as part of Services Australia and as the Agency with whom pension and benefit applicants/recipients interact, the Respondent may be variously referred to as Centrelink or the Respondent throughout these Reasons.
[2] On 14 October 2024, the AAT became the Administrative Review Tribunal (the Tribunal). Under the transitional provisions in the Administrative Review Tribunal (Consequential and Transitional Provisions No. 1) Act 2024, proceedings in the AAT that were not finalised before 14 October 2024 are taken to be continued and finalised by the Tribunal. Anything done in relation to the proceeding before 14 October 2024 is taken to have been done by the Tribunal.
[11] TD Pages 77, 79, 81, 83, 88, 90, 107, 109, 111, 113 and 115.
[44] Paragraph 4.27 of the Respondent's SFIC, Exhibit R3.
[45] Paragraph 4.32 of the Respondent's SFIC, Exhibit R3.
[46] Paragraph 4.34 of the Respondent's SFIC, Exhibit R3.
[47] See _Newman and Secretary, Department of Family and Community Service_s [2002] AATA 917 at [31]- [32], Smalldon and Secretary, Department of Social Services [2015] AATA 2 at [16] and Lucas and Secretary, Department of Social Services [2018] AATA 2563 at [51]- [52].
[48] Paragraph 4.42 of the Respondent's SFIC, Exhibit R3.
[49] Paragraph 4.34 of the Respondent's SFIC, Exhibit R3.
[50] Paragraphs 4.45 and 4.46 of the Respondent's SFIC, Exhibit R3.
[51] Paragraph 4.42 of the Respondent's SFIC, Exhibit R3.
Lucas and Secretary, Department of Social Services (Social services second review) [2018] AATA 2563
Smyrniadou and Secretary, Department of Social Services (Social services second review) [2022] AATA 2433