3.6.1.12 Qualification for DSP - 15 Hour Rule

Topic applies to

This topic summarises qualification criteria for DSP that apply to:

• DSP recipients whose payment start date is after 30 June 2006 and those whose start date on DSP is between 11 May 2005 and 30 June 2006 and have been reviewed after 30 June 2006, and

• people who make a claim, or are taken to have made a claim for DSP on or after 3 September 2011.

Qualification for people whose start date on DSP was prior to 11 May 2005 is covered separately in 3.6.1.10.

Overview of changes to DSP qualifications 2006 - 2011

Generally, to qualify for DSP a person must, among other things, have a CITW (1.1.C.330). Elements of the CITW criteria that have changed since 2006 include the following:

• From 1 July 2006, to have a CITW, a person must, among other things, be unable to work for 15 (previously 30) hours or more per week in the next 2 years. This is referred to as 15 hour rule.
• From 3 September 2011, new DSP claimants:
  • who do not have a severe impairment must demonstrate that they have actively participated in a program of support (POS) (1.1.A.30), in addition to meeting the existing CITW criteria, including the 15 hour work ability rule, and
  • who have a severe impairment (1.1.S.127) are required to meet the existing CITW criteria, including the 15 hour work ability rule, but are not required to demonstrate that they have actively participated in POS.

This requirement does not apply to DSP reviews (6.2.5.03), notwithstanding whether the date of claim or grant was before, on or after 3 September 2011. Consequently, it also does not apply to appeals against a decision to cancel DSP following a review.

Example: Mark lodged a claim for DSP on 3 August 2011. His claim remained undetermined until 22 September 2011. When determining the claim the delegate applies the DSP qualifications in place between 1 July 2006 and 2 September 2011, inclusive. This is because the claim was made before 3 September 2011.

However, any person who loses DSP eligibility that is not restored as a result of an appropriate review or appeal process and who subsequently reclaims DSP on or after 3 September 2011, is to be assessed under the post 3 September 2011 rules. This is because any reclaims (notwithstanding reasons for cancellation) are treated as new claims.

Example: Rose had her DSP cancelled on 6 April 2011 as a result of a medical review. Her case was then reviewed by an ARO (1.1.A.350), who upheld the cancellation decision. She then appealed to SSAT which also upheld the cancellation decision. The SSAT decision was delivered on 10 August 2011 but Rose did not re-apply for DSP until 21 September 2011. In considering Rose's case, the delegate applies the post 3 September 2011 DSP qualification criteria. This is because her (re)claim is made after 3 September 2011.

Act reference: SSAct section 94(3A) If a person is receiving DSP and the Secretary gives the person a notice…

SS(Admin)Act section 12 Deemed claim in certain cases, section 13 Deemed claim-person contacting..., section 15 Deemed claim-incorrect or inappropriate claims..., Schedule 2 clause 4 Start day-early claim

Qualification (1.1.Q.10) criteria

To qualify for DSP, a person must meet the criteria listed in the following table. Where more detail about a criterion is required, the second column indicates where you will find this.

Note: When assessing qualification for DSP, the requirement for the person to have an impairment rating of at least 20 points under the Impairment Tables and the requirement for the person to have a CITW, are of equal importance.

Explanation: Some people will have an impairment rating of at least 20 points, but will not be qualified for DSP because they do not have a CITW.

In limited circumstances, a person may be taken to have 20 points under the Impairment Tables and a CITW without further assessment where the available medical evidence indicates clear qualification and if all other qualification criteria are met. This is known as a manifest (1.1.M.30) grant.

Act reference: Social Security (Tables for the Assessment of Work-related Impairment for Disability Support Pension) Determination 2011

SSAct section 94(1) Qualification for DSP-continuing inability to work, section 94(2) Meaning of continuing inability, section 95(1) Qualification for DSP-permanent blindness

SSAct pre-1 January 2012 Schedule 1B Tables for the assessment of work-related impairment for DSP

SSAct pre-3 September 2011 section 94(1) Qualification for DSP-continuing inability to work, section 94(2) Meaning of continuing inability, section 94A Qualification for DSP-person transferring to that pension, section 95(1) Qualification for DSP-permanent blindness

Policy reference: SS Guide 3.6.2.20 Manifest Grants & Rejections for DSP, 3.6.2.100 DSP Assessment of Impairment Ratings, 3.6.2.110 DSP Assessment of Continuing Inability to Work - 30 Hour Rule, 3.6.2.112 DSP Assessment of continuing Inability to work - 15 Hour Rule, 1.1.R.133 Relevant minimum wage (DSP, MOB, Partial capacity to work & CA)

Proper claim

A person must lodge a proper claim before DSP can be granted. A person cannot lodge a proper claim for DSP if they are over age pension age.

Act reference: SS(Admin)Act Part 3 Division 1 Claim for social security payment or concession card

Policy reference: SS Guide 8.1.1 Claim Lodgement Provisions

Residence qualification criteria

To satisfy the residence criteria when claiming DSP, the person must have:

• been an Australian resident at the time when the CITW or permanent blindness occurred (a person's CITW arises at the time of the incapacitating accident regardless of the age of the person when this occurred. For people with severe congenital abnormalities CITW occurred at birth), OR
• 10 years of qualifying residence, OR
• a QRE (i.e. reside in Australia and are either a refugee or a former refugee), OR
• been born outside Australia and be a dependent child of an Australian resident at the time when the CITW or permanent blindness occurred, and have become an Australian resident while still a dependent child of an Australian resident.

Ten years qualifying residence is satisfied if the person has been an Australian resident for:

• at least 10 years at any point in the past, OR
• 2 or more periods that in total exceed 10 years, AND at least one of those periods is of 5 years duration or more.

To remain qualified for DSP, a recipient must be an Australian resident (1.1.A.330) or be exempted from the requirement to be an Australian resident because they are entitled to indefinite portability.

It may also be possible for the person to qualify for DSP under the terms of an international agreement (1.1.A.120). The international agreements are found in the SS(IntAgree)Act.

Act reference: SSAct section 7 Australian residence definitions, section 7(6) A person has a qualifying residence exemption, section 7(6B) A person is a refugee, section 94(1) Qualification for DSP-continuing inability to work, section 95(1) Qualification for DSP-permanent blindness, section 1218AA Extended portability period for DSP

Policy reference: SS Guide 3.1.1.10 Residence Requirements, 7.1.1.10 Overview of Portability Legislation, Part 10 Australian Social Security Agreements

Working credit balance prevents loss of qualification

A DSP recipient who has a working credit balance and commences employment on a long term basis which means they no longer meet the CITW criterion, is treated as still being qualified for DSP for the period it takes to run down their working credit balance. This allows the recipient to benefit from their working credit balance - providing encouragement to recipients to take up a job.

This treatment will continue until the earliest of:

• their working credit balance is reduced to nil, or
• qualification (other than related to the employment) is lost, or
• payability (other than related to employment income) is lost.

Note:

• DSP-permanent blindness recipients can accrue and deplete working credits if their income details are obtained for the purpose of paying RA.
• Australian Disability Enterprise wages are employment income and any available working credits will be used to offset this employment income under the income test.

See 3.6.1.102 for information on the treatment of recipients who commence employment on a long term basis which provides further encouragement to recipients to take up work.

Act reference: SSAct section 1073J Working credit balance prevents loss of qualification in certain cases

Policy reference: SS Guide 3.1.11.30 Working Credit Depletion

Failure to comply

A recipient will be disqualified from DSP, if they are awaiting determination of their claim and they fail to comply with a notice from Centrelink requesting them to:

• contact a specified officer of the department, OR
• attend an interview at a specified location, OR
• complete a questionnaire, OR
• attend a medical, psychiatric or psychological examination, OR
• provide a report from a previous examination by a medical practitioner.

Act reference: SS(Admin)Act section 64 Effect of failing to comply with requirement to attend Department etc.

Policy reference: SS Guide 3.6.1.90 Notification & Recipient Obligations for DSP, 3.6.2 Assessment for DSP, 6.2.5 Disability & Carer Reviews

Comparable foreign payment (1.1.C.230)

If a person claims DSP and they or their partner may be entitled to a CFP, they are required to take reasonable action to obtain the foreign payment. If they fail to take reasonable action to obtain the CFP within the specified period, their claim may be rejected.

Act reference: SS(Admin)Act section 66 Notice to obtain foreign payment, section 40 Rejection of claim for failure to obtain foreign payment

Policy reference: SS Guide Part 7 Portability & CFP

Qualification for DSP under SSAct section 94A

SSAct section 94(A) was repealed effective from 3 September 2011. This means that people whose DSP date of claim is on or after 3 September 2011, will no longer be able to qualify for DSP under this section.

Note: There are some saving provisions that allow for section 94(A) to be applied in limited circumstances. These provisions are covered in 3.6.1.45.

Act reference: 3.6.1.45 Qualification for DSP - After 2 Years on Income Support with Suitable Training

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Last reviewed: 9 February 2012