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How do I claim disability benefits?

If you have become disabled, you may be wondering if you qualify for disability benefits, and if so, how to apply. Here’s what you need to know about claiming disability benefits in Australia.

Australia has set parameters for being declared disabled, and a point system for impairment. You’ll typically need an exam to provide medical evidence for your claim. If your doctors and evaluators agree your impairment qualifies for disability, you can apply for a disability support pension (DSP.)

You may also be able to qualify for disability payments through disability insurance. Part of your employment income pays for superannuation fund policies for total and permanent disability (TPD.) If you sustained an injury or illness which has left you completely disabled, this can be another avenue to pursue.

Do you have a disability that qualifies for a pension?

Disability will need to either meet manifest or general medical rules for you to qualify for a disability support pension. (There are also non-medical rules that must be met, you must meet all medical and non-medical rules to qualify).

General medical rules for disability:
  • Doctors expect that your condition will last more than 2 years
  • You have been fully diagnosed, and your condition has been treated and stabilised
  • You have an impairment rating of 20 points or more
  • In the next 2 years, your condition will stop you from working at least 15 hours a week
 
Manifest medical rules for disability:
  • Permanent blindness
  • Requirement for nursing home level care
  • Terminal illness (with an average life expectancy of less than 2 years)
  • An intellectual disability with an IQ of less than 70
    Category 4 HIV/AIDS
  • Already receiving a Department of Veterans’ Affairs special rate disability pension (totally and permanently incapacitated)

 

If you don’t meet the medical rules for disability under the DSP, you don’t qualify for a pension. However, you may qualify to file a disability claim with your employer, especially if your disability was caused by an accident at work. You can also pursue claims under various insurance policies you may hold or through your super.

How can you make a disability support pension claim?

If you meet the medical rules for a disability support pension, you can move forward to see if you meet the non-medical rules. You have to meet all non-medical rules to qualify for a disability pension:

  • Make your benefit claim when you are between 16 and Age Pension age
  • Meet residency rules typically 10 years of uninterrupted residence; exceptions apply)
  • Meet the income and assets tests (You may qualify for a reduced benefit if your income is within certain parameters)

Having a disability attorney on your side can help you as you navigate the disability payment system. We can help you collect your proof of disability, and documentation showing that you meet all medical and non-medical rules.

If you don’t meet the above non-medical rules, and there are no exceptions that apply to you. You won’t qualify for DSP. However, don’t give up on a disability pension just yet. If you don’t qualify for DSP, you may qualify for a disability living allowance through another program.

For example, Australia’s JobSeekers program can provide a disability allowance if you are unable to work because of sickness or injury for a time, and are trying to get another job. You may also qualify for programs set up to incentivize employers to hire someone with a disability.

What happens once you file a disability claim?

Once you submit your claim for DSP, you may be asked for supporting documentation and medical evidence. Your disability lawyer can help you with this process.

Once your claim is approved, you should receive payments fortnight, and you can use these as income protection while you are unable to work. You may still qualify for a reduced disability payment if you are able to return to work but under reduced hours.

In most cases, if you can no longer do the work you did before, you will be required to continue to look for work that you can do under your new circumstances for a specific period of time, or until you are declared unable to work permanently.

How much you can get in disability support pension payments varies depending on your situation. Typically, if you are single, over the age of 21, and are not supporting a child. Your pension would be roughly $950.00 per fortnight.

If you don’t qualify for a DSP, you may still qualify for an allowance through JobSeekers or another government program. You can also pursue a TPD claim if you have medical evidence to support a claim of total and complete disability.

Working with a disability lawyer on your claim

If you apply for the disability support pension but have your DSP claim denied, don’t give up. If you believe your DSP claim should not have been denied, you can appeal. We can help you file your appeal and support you through the process on a no-win, no-fee basis (meaning if you don’t win your appeal, you don’t owe us a legal fee).

The steps for appealing a DSP rejection include showing medical evidence that supports your claim, and documentation that you meet all medical and non-medical rules for receiving the benefit.

If your DSP claim was rejected, and your health condition has worsened since then, you may need to pursue a completely new claim. This can apply if your level of impairment has increased, or you have gone from being able to work part-time or pursue a new career to being completely disabled.

Don’t forget, if you have a total and permanent disability, you can also apply for TPD payments through your super fund. Our team can also help you with TPD claims and appeals. It’s advisable to have a disability claims lawyer on your side when filing any sort of claim, to help you ensure that you make the best case possible and increase your chances of a favorable decision.

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Gerard Malouf & Partners
 — Personal Injury Compensation Lawyers

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