Help on getting disability in Australia?

[Nightingale]

Hello!

I am applying for disability in Australia and I have already been rejected once. I was wondering if anyone here has been successful with it and if they have any hints?

Thank you!

 

[taniaaust1]

Hi Nightingale, I get disability pension for CFS. I didnt have depression or mental health stuff with that, I got it solely on the grounds of having CFS (I didnt know back then I had aspergers). They usually knocked people back the first time, you need to keep appealing.

What state are you in? Here in SA some of the centrelink places are truely terrible towards ME/CFS and I had a couple of guys at my last centrelink office (which is known as having a very bad reputation on this state) give me an extremely hard time and even vowed they would stop me from being able to get onto a disability pension (they actually then took supporting evidence out of my file before I was assessed. I finally found this out after applied under the FOA act to know what was in my file right before my third appeal which had gone to canberra).

there is some things you need to know though to be successful so I'll do another post

 

[taniaaust1]

Firstly, have you found on what grounds you were not approved? Get in writing from them why you werent approved. (sometimes they reject on very stupid grounds like the person hasnt had treatment.. when there is of cause no real treatment for ME/CFS. So you may have to show them they have wrongly knocked you back).

Secondly, if a dr has ticked the "presumptive" box instead of the confirmed box on the form, this can cause issues if the person going through your form doesnt understand that all CFS diagnoses are presumptive as they are simply based on symptoms with no actual test. (so you may need to try to educate someone or contact your local MP if you have been knocked back on that ground).

Thirdly, list ALL your symptoms on the form and dont just put CFS eg headaches, insomina, fibromyalgia etc etc in the diagnoses too. Put as many things as you can then they have to consider how each of those things lsted are affecting you. My dr had also "severe brain fog" written in the diagnoses area

What centrelink tend to keep from from the general public (and even wouldnt tell me this when I found out about it and asked) is that they use a points system when assessing.. and you need to get so many points to get approved. The points can come from the same area or different health areas. Now there is somewhere online (alex may know @alex3619 ) the actual points system they use so you could get a copy of it and mark on it the areas where you should of been given points and post it back to them showing them they didnt properly assess you.

You need to make sure when they do their assessment that those areas you get the points for are in writing or have been included with your form. (they are generally quite stupid when it comes to assessing those with CFS so it may help some if you directly help them point out things).

With this all being said, if you end up going to third appeal..your file is all sent to Canberra (which is good if they are bad towards ME/CFS people in your local office). The assessor who assessed my file in Canberra, he was very ME/CFS aware and horrified I wasnt given a disability pension immediately. (it took 9mths from when I applied to go through all the 3 appeals and get onto disability).

If you have provided them addition info.. do apply like i did under the freedom of info act for a copy of everything in your file before each assessment (in case some corrupt person there does to you what they did to me and took the info out not wanting CFS people to get disability due to the belief out there that we are just slackers and need to try harder).

When you finally get it. The very good thing is that you will get back paid to the point you first applied. That helps make the fight you need to go through to get it more worth it.

I strongly suggest to make sure they dont rope you into going through disability job places while going through these appeal process as that completely wrecked my health further and I never recovered from them doing that (they tried to get me to work for 6 hrs a week). If they try that.. keep giving them sickness certificates if you have to to say you cant work.

Note, the bad guys at my centrelink refused to take my sickness certificates.. I was stupid cause I didnt go to my MP about this but I should of done so as they would of got into trouble. I got blackmailed by them.. refusing my sickness certificates and tellling me they'd stop all payments to me if I didnt work the part time, so was forced to drive to the part time work they'd put me onto a contract to do and ended up smashing up two cars due to driving while too tired to driver. I fell asleep at a give way sign and my car rolled and smashed into another car.

Anyway, do not allow them to bully you and if they start, do contact your MP.

 

[alex3619]

I know there is a formal points system, I found it once, but I do not recall where. I think it was on a government website, presumably pension related.

 

[Snow Leopard]

The process is explained here:

https://www.anao.gov.au/work/performance-audit/qualifying-disability-support-pension
http://www.welfarerights.org.au/wel...1-no-1/practitioners-guide-disability-support

The criteria is:
Have a long term condition
Be "fully treated" eg tried all available treatments and therefore unlikely to improve significantly (technically there is no evidence based treatment that shows improvements in work/study outcomes - so any rejection based on this can easily be appealed)
Attract 20 points (severe) within a single category on the impairment tables. (It used to be a total of 20 points over all categories).

Table 1 (impact on activities requiring exertion/stamina - the table relevant to ME/CFS):

There is a severe functional impact on activities requiring physical exertion or stamina.

(1) The person:

(a) usually experiences symptoms (e.g. shortness of breath, fatigue, cardiac pain) when performing light physical activities and, due to these symptoms, the person is unable to:

(i) walk (or mobilise in a wheelchair) around a shopping centre or supermarket without assistance; or

(ii) walk (or mobilise in a wheelchair) from the carpark into a shopping centre or supermarket without assistance; or

(iii) use public transport without assistance; or

(iv) perform light day to day household activities (e.g. folding and putting away laundry or light gardening); and

(b) has or is likely to have difficulty sustaining work-related tasks of a clerical, sedentary or stationary nature for a continuous shift of at least 3 hours.

Legislation/impairment tables here:
https://www.legislation.gov.au/Details/F2011L02716
Guide to the impairment tables:
http://guides.dss.gov.au/guide-social-security-law/3/6/3

 

[taniaaust1]

Single condition causing multiple impairments

(3) Where a single condition causes multiple impairments, each impairment should be assessed under the relevant Table.

Example: A stroke may affect different functions, thus resulting in multiple impairments which could be assessed under a number of different Tables including: upper and lower limb function (Tables 2 and 3); brain function (Table 7); communication function (Table 8); and visual function (Table 12).

(4) When using more than one Table to assess multiple impairments resulting from a single condition, impairment ratings for the same impairment must not be assigned under more than one Table

oh it does look like they've changed it.

Descriptors involving performing activities

(3) When determining whether a descriptor applies that involves a person performing an activity, the descriptor applies if that person can do the activity normally and on a repetitive or habitual basis and not only once or rarely.

Example: If, under Table 2, a person is being assessed as to whether they can unscrew a lid of a soft drink bottle, the relevant impairment rating can only be assigned where the person is generally able to do that activity whenever they attempt it.

https://www.legislation.gov.au/Details/F2011L02716

......

Make sure if you aren't fitting under the fatigue table.. to check that you don't fit under one of the others eg in my case I can also score 20 under the brain function table.

20

There is a severe functional impact resulting from a neurological or cognitive condition.


(1) The person needs frequent (at least once a day) assistance and supervision and has severe difficulties in at least one of the following:


(a) memory;


Example 1: The person is unable to remember routines, regular tasks and instructions.


Example 2: The person has difficulty recalling events of the past few days.


Example 3: The person gets easily lost in unfamiliar places.


(b) attention and concentration;


Example 1: The person is unable to concentrate on any task, even a task that interests the person, for more than 10 minutes.


Example 2: The person is easily distracted from any task.


(c) problem solving;


Example: The person is unable to solve routine day to day problems (such as what to do if a household appliance breaks down) and needs regular assistance and advice.


(d) planning;


Example: The person is unable to plan and organise routine daily activities (such as an outing to the movies or a supermarket shopping trip).


(e) decision making;


Example: The person is unable to prioritise and make complex decisions and often displays poor judgement, resulting in negative outcomes for self or others.


(f) comprehension;


Example: The person is unable to understand basic instructions and needs regular prompts to complete tasks.


(g) visuo-spatial function;


Example: The person is unable to perform many visuo-spatial functions, such as reading maps, giving directions (including to the person’s house) or judging distance or depth (resulting in stumbling on steps or bumping into objects).


(h) behavioural regulation;


Example: The person is often (more than once a week) unable to control behaviour even in routine, day to day situations and may be verbally abusive to others or threaten physical aggression.


(j) self awareness.


Example: The person lacks awareness of own limitations, resulting in significant difficulties in social interactions or problems arising in day to day activities

Interesting, I used to qualify under 3 different tables (60 points) but cant only see two tables where I do. I wonder what is gone.

 

[Nightingale]

Wow! Thank you guys so much for all the information! The tables are really helpful, but how did you put them into your submission? Did you just explain the severity of your symptoms so they matched the regulations in the tables or did you need doctor's evidence to put you in that category? I just really don't want to get knocked back again! Also, what medical evidence did you provide? I have a lot of discharge summaries from hospital as I have MCAD and IA, but I don't have a lot of reports from my doctors.
Thank you so much again! This has been so helpful!

 

[Sea]

The impairment tables and the guide to the impairment tables that Snow Leopard linked above are imperative to understand. It is worthwhile seeing where you fit and taking that information to your doctor when you go to discuss the necessary paperwork.

Although it isn't evidence it is also worth using the information in the tables to understand what Centrelink is looking for and noting in your personal impact statement the limitations you have in everyday life. Centrelink is more concerned with what you can/can't do than they are with symptoms.

Discharge summaries won't be enough. You need a doctor to write a medical evidence letter (it's not even a fill in form anymore). It is not a requirement by law but Centrelink is much more inclined to accept evidence from specialists than from a gp. It's a good idea to have your diagnosis confirmed by a specialist and have them write a report as well as the more detailed one from your general doctor.

The letter will need to state:
- what your diagnosis is
- that your condition is fully treated and stabilised (ie all possible/reasonable treatment has been tried)
- what treatment has been tried
- that no further treatment is possible/reasonable/expected to make a diference
- that there is no expected improvement for at least 2 years
- how your symptoms affect your ability to function

The effect on your ability to function is the one where you need to have a discussion with your doctor and make clear to them what your limitations are and why. Doctors don't like to give a prognosis that you won't improve. They think it will depress us, but this is one instance where they need to be realistic.

Be prepared to show how you compensate but still are limited.
For example: for memory difficulties if that applies to you, show how you use lists, alarms etc but still can't overcome not being able to hold a thought in your head long enough to complete a task.

Centrelink's focus is always on what ability you have, rather than on what your limitations are, and they look for ways to 'overcome barriers' to work through accommodations or retraining in a different sphere. This works well for physically disabled people or even someone with significant fatigue but it doesn't cater well for our limitations. It is up to you to show them (with medical evidence, personal impact statement and possible interview) if it is impossible for you to be a reliable worker even part time with help.

Attract 20 points (severe) within a single category on the impairment tables. (It used to be a total of 20 points over all categories).

A total of 20 points across the tables meets one of the criteria to qualify for dsp. The second criteria is a continuing inability to work. A wheelchair bound person for example may well attain 20 or more points and yet still have an ability to work given the right training and support. That's where the job capacity assesment comes in.

A total of 20 points on one table will exempt you from the requirement to participate in a POS (a rather unfortunate acronym for program of support )

You need to know why you've been rejected and analyse whether you are better to appeal or to begin a new claim. Appealing means that if you are successful your payment is backdated to the time of your original claim whereas a new claim would only be paid from the date of that claim.

It is only worth appealing though if you have a good case that they have misapplied the law or failed to take your evidence into consideration, which is why you need to know why you were rejected. The appeal is only to determine if Centrelink made the correct decision with the evidence they had. You can't appeal and include new information unless Centrelink somehow prevented you from showing your evidence the first time.

If your application didn't really fulfil their criteria you would be better to start again with a much better prepared claim.

 

[Snow Leopard]

Wow! Thank you guys so much for all the information! The tables are really helpful, but how did you put them into your submission? Did you just explain the severity of your symptoms so they matched the regulations in the tables or did you need doctor's evidence to put you in that category?

The tables were a bit different when I applied (for the second time - first time knocked back due to lack of evidence that it was a 'long term' condition).

@Sea's explanation is an excellent start and you can get advice from your local ME/CFS society too.

 

[RogerBlack]

As a general note - though not in .au - UK - much of this is looking very familiar.
Don't skip anything.
Consider each possible area you may gain points, not as you feel about it, but as someone following you who does not know you 24*7 for a couple of weeks would write about it.

Can they make a reasonable case that you can't do it to the required standard, even if you don't agree.
'But I'm managing to do X, then skip it' is a problem, when it's often way too easy to realise how far your standards of 'managing' have slipped.
Good luck.

 

[taniaaust1]

Wow! Thank you guys so much for all the information! The tables are really helpful, but how did you put them into your submission? Did you just explain the severity of your symptoms so they matched the regulations in the tables or did you need doctor's evidence to put you in that category? I just really don't want to get knocked back again! Also, what medical evidence did you provide? I have a lot of discharge summaries from hospital as I have MCAD and IA, but I don't have a lot of reports from my doctors.
Thank you so much again! This has been so helpful!

Unfortunately I didn't know about the tables when I was going for my disability pension and when I did find out, Centrelink lied to me about them and two (maybe 3) people from there told me there was no such thing, so I couldn't use them to argue that I qualified for a disability pension based on them.

You could use this table to get a dr to write a letter you can add to your current application when you appeal and make sure he includes writing about things which you cant do which will fit with their table.

but its really important to find out one what grounds you were rejected cause they may of rejected you on a different stupid grounds you'll have to provide info for eg if it was lack of treatment or whatever. (the first time I got rejected they rejected me on 3 different stupid things).

 

[taniaaust1]

Be prepared to show how you compensate but still are limited.
For example: for memory difficulties if that applies to you, show how you use lists, alarms etc but still can't overcome not being able to hold a thought in your head long enough to complete a task.

Centrelink's focus is always on what ability you have, rather than on what your limitations are, and they look for ways to 'overcome barriers' to work through accommodations or retraining in a different sphere. This works well for physically disabled people or even someone with significant fatigue but it doesn't cater well for our limitations. It is up to you to show them (with medical evidence, personal impact statement and possible interview) if it is impossible for you to be a reliable worker even part time with help.

what Sea says here is very important.. as if they think there is any chance you can work part time they will send you to the disability job centre. So make sure you put in writing how you are affected by your illness in all the ways you can think of and include it in your file (along with listing what you have tried which haven't worked). Do not trust the disability assessors though Centrelink and the gov disability job places to provide good notes on what you can and cant do as they usually leave a lot out or if they don't believe in this illness they may be so biased they purposely leave out what you are saying.

A total of 20 points across the tables meets one of the criteria to qualify for dsp.

@Sea it appears from reading it that they have changed things as it says now that you cant use more then one table for points for the same illness.

It is only worth appealing though if you have a good case that they have misapplied the law or failed to take your evidence into consideration, which is why you need to know why you were rejected. The appeal is only to determine if Centrelink made the correct decision with the evidence they had. You can't appeal and include new information unless Centrelink somehow prevented you from showing your evidence the first time.

I was allowed to add new evidence into the appeals to support my case more (in fact the Canberra assessor who was about to assess I think held off a little to allow me more time to get more stuff in..he was very good) and getting the back pay was great.

If the thread poster had an appointment with a Centrelink assessor (an assessment) and that person failed to note down in the appointment and ignored the issues the person has and completely ignored it all (which they usually do when dealing with us) or if they have simply ignored stuff which was put in, the thread poster should have every grounds to be able to appeal and receive back pay from when first applied.

 

[Sea]

@Sea it appears from reading it that they have changed things as it says now that you cant use more then one table for points for the same illness.

No, you can't use more than one table for the same symptom. That's so that you don't double up on points for the same limitation. If for example you cannot walk very far because of fatigue, but you also cannot walk very far because of spinal issues you can't use the tables in such a way that you count that twice. The limitation is what is counted not the illness that causes it.

You definitely can use more than one table for the same illness to cover the different limitations it imposes on you

 

[taniaaust1]

No, you can't use more than one table for the same symptom. That's so that you don't double up on points for the same limitation. If for example you cannot walk very far because of fatigue, but you also cannot walk very far because of spinal issues you can't use the tables in such a way that you count that twice. The limitation is what is counted not the illness that causes it.

You definitely can use more than one table for the same illness to cover the different limitations it imposes on you

thanks.. it reads confusingly then. The term "condition" they use could mean "symptom" or the disease of the person.

 

[Nightingale]

Again, thank you guys so much for these responses, they have been really helpful. There's so much I didn't know the first time around.

I think I was rejected because I didn't reach twenty points of impairment. Reading the tables now, I think I really should have. But I don't really know how to convey my level of disability in my submission. My doctor's have written reports, but it still doesn't really convey that I can't walk for long periods, shower without help, etc etc. And I have a few specialist reports, but they're also pretty scant.

Also, my GP just filled out one of the centrelink medical certificates. Are these of any use at all?

Again, thank you so much!!

 

[Snow Leopard]

Also, my GP just filled out one of the centrelink medical certificates. Are these of any use at all?

I believe those are only useful for (temporarily) avoiding job-search for medical reasons if you are on Newstart.

Despite what some people say, a majority of people are approved on appeal, provided they have a legitimate claim.

 

[purrsian]

I'm going to talk to my doc about this in my next appointment, it's something I've been wanting to do for a while. However, I haven't seen any specialists as there aren't really any who can help me. I don't have GI issues, pain issues, etc. I am going to see a neurologist for my POTS in October, but I wasn't actually going to apply for disability regarding POTS as it's still a newish diagnosis and I haven't tried meds yet (that's next thing to try). Is it very detrimental to my chances if I haven't seen any specialists yet, and is there any that could help anyway? I've been sick for over ten years, never been able to work full time and always struggled with even part time work. Despite that, there's not really much that a specialist could do because my main problems are the good ole PEM, fatigue and weakness.

And @Nightingale have you heard back about it yet? I hope you managed to appeal the initial decision!

 

[knackers323]

i think things are different now and are harder but about ten years ago i seen prof. lloyd in sydney.

useless for cfs, an arrogant, smartarse, unwilling to look into anything that i said had given me benefit previously.

called himself the preeminant authority in cfs in the country but all he was willing to offer me was antidepressants and cbt, even though i told him id tried these things numerous times and they dont work.

he did however seem to acknowledge that i was unwell and limited enough that i couldnt work without torturing myself further and making things worse so gave me a report that satisfied centrekink for dsp.

so he was good for something i guess. but he will sting you for it. was about $320 back then.

wonder if he even considered that that 20 min or so just cost me almost two weeks income?

who cares i guess

he then lost me again by saying he wanted to see me working again within 18 months.

sure me too.

but how did he expect this to happen with a lousy half assed tx that id explained id tried and did not work?

i thought you had to be intelligent to be a prof.

so if you and your pockets can handle dealing with a jerk for 20 min this might be the way to go.

good luck

 

[purrsian]

i think things are different now and are harder but about ten years ago i seen prof. lloyd in sydney.

useless for cfs, an arrogant, smartarse, unwilling to look into anything that i said had given me benefit previously.

called himself the preeminant authority in cfs in the country but all he was willing to offer me was antidepressants and cbt, even though i told him id tried these things numerous times and they dont work.

he did however seem to acknowledge that i was unwell and limited enough that i couldnt work without torturing myself further and making things worse so gave me a report that satisfied centrekink for dsp.

so he was good for something i guess. but he will sting you for it. was about $320 back then.

wonder if he even considered that that 20 min or so just cost me almost two weeks income?

who cares i guess

he then lost me again by saying he wanted to see me working again within 18 months.

sure me too.

but how did he expect this to happen with a lousy half assed tx that id explained id tried and did not work?

i thought you had to be intelligent to be a prof.

so if you and your pockets can handle dealing with a jerk for 20 min this might be the way to go.

good luck

Sounds like that was a fun appointment! I'm in Brisbane, so bit far for me lol I've often wondered if I should travel interstate for the experts in Sydney/Melbourne, but then I hear dodgy things about most anyway!

My GP is going to help me out, although says not to get my hopes up. I'm going to print off the tables linked above and mark what I think my capabilities are, to help her get an idea.