Medical rules and the Impairment Tables
Services Australia assesses DSP claims in two stages. First it checks whether you meet the manifest medical rules. If you do not, it checks the general medical rules. Both stages turn on evidence, not on how a condition is described in a single letter.
Manifest medical rules
Some people can be assessed as manifestly eligible without a full general medical assessment. The categories include people who are permanently blind, people with a terminal illness, people with an intellectual disability with an IQ below 70, people who need nursing-home level care, people with category 4 HIV or AIDS, and people receiving a Department of Veterans' Affairs Totally and Permanently Incapacitated pension. Manifest eligibility still needs medical evidence confirming the category; it does not remove the age, residence, income, or assets rules, except that permanently blind recipients are exempt from the DSP income and assets tests.
General medical rules
Under the general rules your condition must be fully diagnosed, reasonably treated, and stabilised. In plain terms, that means doctors have identified the condition, all reasonable treatment has been tried or properly ruled out, and the condition is as good as it is likely to get with current treatment, so further treatment is not expected to significantly improve your work capacity within the next two years. The impact must be likely to persist for more than two years, must rate at least 20 points under the Impairment Tables, and must stop you from working at least 15 hours a week in the next two years, even with training.
The Impairment Tables
The Impairment Tables are the official scoring system Services Australia uses. There are tables for different areas of function, including physical functions such as moving around and using arms, sensory functions such as seeing and hearing, and mental health functions such as concentration, social interaction, and behaviour. An assessor rates the functional impact of each condition against the relevant table, and the points are added up. You need 20 points in total.
How those points are spread matters. If you score 20 points under a single table, that is generally enough on the points question, subject to the other rules. If your 20 points come from adding points across several tables, Services Australia may require you to complete a Program of Support before DSP can be granted. The work capacity page explains that program.
What good medical evidence looks like
Strong evidence describes function, not just diagnosis. A useful report says what you can and cannot do in a day, how long you can sustain an activity, whether symptoms fluctuate, what treatment has been tried and what it achieved, and why further treatment is unlikely to change your work capacity. Specialist reports, test results, hospital records, and treating doctor records all help. For mental health conditions, evidence from a psychiatrist or registered psychologist carries particular weight. For sensory conditions, reports from an ophthalmologist or audiologist may be required for the relevant table.
Evidence should be current and relevant to your present circumstances. An old assessment that no longer reflects your condition, or a letter that only names a diagnosis, will usually lead to further questions or a Job Capacity Assessment that reaches its own conclusions. If you have new evidence that you have not already given Services Australia, you can take it to your assessment appointments.