Rachel Siewert (WA, Australian Greens) Share this | Link to this | Hansard source

Tonight I rise to speak on the Liberal government's 2015 changes to the medical assessment process for those applying for the disability support pension, which I will refer to as the DSP from now on. The National Social Security Rights Network's report Disability Support Pension (DSP) Project: A snapshot of DSP client experiences of claims and assessments since the 2015 changeswas released earlier this year and looks at the impact changing the medical assessment processes has had on the DSP claimants. The findings are derived from a casework snapshot analysis of DSP client experiences of claims and assessments from one of the National Social Security Rights Network's member centres, Basic Rights Queensland Inc. The snapshot included 22 clients who appealed to the Administrative Appeals Tribunal, commonly known as the ATT, after the Department of Human Services decided to reject their DSP claims.

The two key changes to the medical assessment process occurred in 2015. The first was the removal of the treating doctor's report, which initially only applied to new claimants under 35 living in metropolitan areas, but was later extended to all new claimants. This was a medical report form for treating health professionals, which was designed to extract the specific medical information relevant to assessing medical qualifications for the DSP. Treating health professionals were able to claim under a Medicare item for completing the report when done during consultation. By removing the treating doctor's report it made it more difficult for claimants, and treating health professionals, to understand what information to provide to support a claim. Another consequence was that suitable claimants were less likely to be successful due to the greater reliance on raw medical evidence to address DSP eligibility.

Of the 22 clients included in the snapshot 17 of them were successful in their appeal to the Administrative Appeals Tribunal. As the report says:

Most of these claimants who were successful on appeal were able to persuade the AAT of their DSP medical eligibility on the basis of additional evidence obtained after the decision of the Authorised Review Officer (ARO) and after the claimant sought legal advice.

The second key change was the introduction of the disability medical assessment. The requirement for a second medical review by a government contracted doctor for those under 35 years of age and living in metropolitan areas. The disability medical assessment occurred only when the job capacity assessors had determined that a person was medically eligible for the DSP. Again, this was eventually extended to all new DSP claimants. This additional step has seen an increase in the claim assessment time.

The snapshot included four clients who were referred for a disability medical assessment, which generally occurred within two months of the job capacity assessment in those cases. The report highlights instances of the direct medical assessment being undertaken without proper consideration of the claimant's impairments, resulting in DSP claims being rejected, only to be overturned on appeal.

It should be noted that the government introduced changes to the medical assessment process in mid-2017, specifically the pilot of a new streamlined process which includes the introduction of a new questionnaire and the bringing forward of assessments of medical eligibility. While the report says that the new guide and questionnaire for claimants and treating health professionals go some way to addressing their concerns, it also says that the issues raised by their casework data remain relevant to the newly introduced process. Furthermore, the report provides numerous recommendations which cover better communications with DSP claimants, improvements in medical assessment, the appeals process and the date of being deemed eligible, improvements to the program of support and, finally, a requirement for the Department of Social Services and the Department of Human Services to regularly publish comprehensive data about the DSP program.

The National Social Security Rights Network produced a second report, a member centre survey, on the experiences of clients when claiming DSP. It further explored the impact of the 2015 changes, which I have just talked about. This report is a representation of 100 responses to the survey of member centre clients on their DSP claim experience post these changes in 2015. There were 79 respondents who made claims between 2015 and mid-2017. The survey also included clients who made a claim for DSP after 1 June 2017, when the so-called streamlined claims pilot was announced. There were 21 responses received from clients who claimed the DSP after that date. The survey was conducted in October last year and it assumed that the streamlined claims process was introduced across the board for all DSP claimants after 1 June.

The survey asked questions about how clients were guided in making their claims if they had provided their treating health professionals with information on claims for DSP and if they had encountered any obstacles in getting the medical evidence. The survey responses show that 71 per cent of respondents did not pass on Centrelink information guides to their doctors. The report explains that due to the removal of the treating doctor's report there was less information available for clients to actually pass on. Interestingly, 16 of those respondents who claimed for DSP after the new questionnaire was introduced as part of the streamlined process indicated that they did not provide any information guides or a checklist to their doctors. As a percentage, that is 76.19 per cent of this group of respondents, which is slightly higher than the 71 per cent of all respondents. With regard to access to medical evidence, the respondents had the options of 'very easy', 'easy', 'neither easy nor difficult', 'very difficult' and 'not applicable'. The option with the highest number of responses was 'very difficult' with 29, followed very closely by 'difficult' with 28 responses. The weighted average of the responses was 3.74, which was between the options of 'neither easy nor difficult' and 'difficult'.

While the National Social Security Rights Network thought the new questionnaire would remove the additional burden on clients of pursuing additional evidence such as written reports to support their claims, the survey results indicate that there has been no major change, as the weighted average of responses only dropped to 3.4. As the report says:

… our survey results show that there has been no significant change in the perception of the ease or difficulty in obtaining medical evidence after the streamlined process was introduced.

The Australian Greens call on the government to read these reports and take action to improve the claims and assessment processes for DSP claimants. We also encourage the government to evaluate any further changes to ensure that they yield more positive results for this group of people. The government has been taking a series of measures that significantly impact on those people who are either on DSP or applying for DSP. It is clear that the streamlined process hasn't been as helpful as the government thought it might be and that people have been facing serious barriers to claiming the DSP.

Given that 17 of the 22 actually took an appeal to the AAT, I wondered as I was reading this report how accurately people were being assessed for the DSP. I also wondered what result we would see if everybody whose application for the DSP had been rejected sought to take that decision to the AAT. I strongly believe that we would see a hell of a lot more people get the finding overturned and have access to the DSP.

The process was designed to make things much more difficult for people who were applying for the DSP, and, in fact, the government has achieved that objective. That does not reflect the need in the community of people with disability to have access to the DSP. You will see a number of speeches by me in this place in the future on this issue because I am seriously concerned about how people with disability are accessing the DSP and the supports that they aren't getting in terms of being able to have quality of life.