Posted: 2025-06-21

I'm writing these in the hope that I can mostly manualise my advocacy and focus on all the other stuff.

Get it right the first time.

Disability Support Access - Common

This page is intended to teach you the principles by which attempts to access disability supports (the Disability Support Pension/DSP and the NDIS) are judged.

We'll be doing more articles on specific programs. But here is the stuff that applies to all of them.

Disclaimer

The body of Australian social security law is elaborate, tightly targeted, mature, and prescriptive.

But law it is.

Almost every issue to do with Centrelink and the NDIS is a legal issue. I am not a doctor, or a lawyer. I don't have any formal qualification in any of this.

I have a decent bit of experience doing access advocacy. Access is one of the lowest risk forms of advocacy to do, because if their access request is denied, the person hasn't lost anything (other than time and money). It is also one of the most life-changing forms of advocacy, given how hard it is to get in the door in the first place.

My approach to this, so far, has an outstanding success rate. I am going to share with you how it works. I suspect the staff in these organisations will broadly be happy about it, because higher-quality access requests will reduce the burden of untangling complex psychosocial situations. If you make it easy for them to say "tick, done" everyone wins. They must follow the law.

Access to these programs is very difficult. We have one of the most narrowly targeted systems in the world. You are really going to have to thread the needle to pull this off.

Introduction

The professionals who make decisions at Centrelink and the NDIA are referred to as delegates. They're called this because the CEO of each agency has delegated some of their statutory powers to these people. Despite legally sounding like commissioned officers, they are very much the everyday rank and file workers. Delegates are the people you need to convince during access requests.

Staff at Centrelink and the NDIA broadly want to help you. But everything they do must be absolutely legal. Our legislation is very clear about the situations under which they are allowed to provide assistance.

Our social services operate on what is referred to in logistics as a "pull" (demand-driven) system.

What this means is: nothing is automated. You don't fill out an application and get a team of professionals to visit you and do assessments.

You must get all of your assessments done on your own, and present them as a package when applying.

The pull model allows for severe inequitabilities in access to occur among vulnerable people, with the upside being that it allows the system to support many more people. It does, however, result in a staggeringly high rate of access rejections.

A common mantra among some groups is that "help is available". Anyone who has actually had to go through the process of accessing said help will not be in said groups.

In Australia, we have a very specific and narrow definition of a disability. In order to access disability supports, what you have cannot generally be classed as a medical condition.

A medical condition is something which can be treated, regardless of whether or not it has been. The disability is what's left over after treatment has been completed.

While there is some degree of flexibility for conditions which are either degenerative (examples: terminal cancer, osteoarthritis) or where fluctuation is an inherent part of them (examples: bipolar disorder, multiple sclerosis), in general you can only access disability supports when your treatment is complete.

The legislation specifically defines this as the condition being:

We're going to go through each criteria in detail.

Fully Diagnosed

The first bar you need to reach is that the disability is fully diagnosed.

This does not mean that every single condition you might possibly have has been exhaustively investigated. It means that you have a clear diagnosis which fully accounts for the disability you're trying to access help for.

In the real world, most people with disabilities have multiple conditions, and there will almost always be overlap in which conditions are causing which impairment. That's okay.

What matters is that you have a credible link between the diagnosis and the impairment. If you have that, you are probably fully diagnosed for the purpose of Australian disability law.

Achieving this diagnosis can often be very difficult for people who do not have the financial resources or life stability to build the professional relationships needed.

Reasonably Treated

The second bar you need to reach is that the disability is reasonably treated.

This bar has moved relatively recently: it used to be that you're fully treated. "Fully treated" is kind of impossible for most disabilities, because there are usually a large number of hail-Mary treatments that exist with a low percentage of success and high cost and risk. "Fully treated" was never practical to require in operational practice, so the bar was lowered.

I have heard of people who are experiencing acute psychosis as inpatients being denied NDIS or DSP claims, and talked to social workers who are slowly going mad because of it. This is the system working as designed: these people have not completed their treatment yet. We must finish treating before we can see what disability is left over afterwards.

Anyone who has had even a cursory amount of experience with mental illness knows that the notion that these illnesses can ever categorically be considered treated and stabilised is extremely questionable. Reports to this effect are creating an administrative fiction.

I have heard of clinicians who refuse to write letters saying a condition is "permanent" because they want to instil the idea that improvement is always possible. To me this sounds quite a lot like "I don't like welfare and won't help you get it" with extra steps.

When filling out reports, clinicians should be aware that if they mention any likelihood of improvement from a future treatment, they should expect the application to be denied. This applies regardless of whether the claim is realistic or not: any report indicating that there's a significant chance that the person can improve will preclude disability support access for that particular condition.

It is possible for one disability to be discounted in this way but the person still gaining access for another.

The fact that completing treatment can be very difficult when a person is on JobSeeker, has no disability supports, and is likely in unstable personal and financial circumstances is a very real problem for many.

If a report is submitted which indicates that further treatment may help, you are going to have to go and complete that treatment before coming back and trying again.

Stabilised

The third and final bar you have to reach is that the condition is stabilised.

This means that the effect of the treatment has fully manifested and that there are no expectations that your condition will improve later.

This doesn't necessarily mean that a specific period of time has passed - simply that you have fully recovered from the treatment process and you're not healing from surgery or otherwise in a state where you might improve further.

Some conditions naturally fluctuate over time even with treatment, and this is taken into account when doing access requests. Some conditions are degenerative and will only ever get worse, and it is sometimes a shitshoot trying to do access for them.

Evidence

Next we're going to take a look at the different flavours of evidence needed.

To have a high probability of a successful access request, you want to have at least one item from each category, and they must all line up and be consistent with one another.

Applicants often ask whether they have to do all of this. That really comes down to whether or not they want their application to succeed.

General Medical Evidence

The first, and most straightforward piece of evidence you'll need is general medical evidence.

This almost always manifests as a report from your GP.

There has been a fantasy among some right-aligned commentators that you can get DSP/NDIS access simply by sweet talking your GP into writing the right note. This is preposterous. The role of your GP in disability support access is to eliminate the possibility of any obvious medical condition which might be treatable.

If you are accessing strictly for a physical condition, you will want to do a quick once-over to exclude any undiagnosed/untreated mental health conditions.

Similarly, if you are accessing strictly for a mental illness, you will want to do a quick physical to exclude any undiagnosed/untreated physical health conditions which might account for the impairment.

If you are accessing for a combination of both, you are most likely to succeed if you demonstrate that both are fully diagnosed, reasonably treated and stabilised.

Unless you are accessing supports specifically for substance use disorder, your GP should testify that you are not misusing alcohol or drugs. If you are misusing them, you should stop first, so you can demonstrate that this is legally a disability and not simply the product of your usage.

Your GP's note should also include an assessment that there are no ephemeral factors they know of which may cause your impairment to improve in the future.

Specialist Medical Evidence

The crux of your application will be the specialist evidence.

The exact criteria for this evidence are different between the NDIS and DSP. I've written about those separately.

Generally you want this evidence to be written by a medical specialist who works with the type of disability you have.

You can sometimes use a hospital report - you can FOI records from inpatient units.

Sometimes this evidence can be provided by a social worker.

For psychosocial conditions, I like to use a neuropsychologist as a second source of specialist evidence if finances allow - this is considered high quality evidence.

Psychologists are acceptable here, though they're considered second-tier to psychiatrists. For some reason clinical psychologists are seen as superior to other registered psychologists, though in reality this is an absurd distinction.

If you're reading the above and thinking "that's a whole lot of highly qualified experts that I can't afford", that's completely reasonable. Funding this process is often a major hurdle for many people accessing support.

A Mental Health Care Plan gives you 10 sessions per year with a psychologist subsidised, but there will usually be a significant out-of-pocket expense.

Functional Evidence

One of the most common forms of evidence that people neglect to include in applications is functional evidence. This is almost always provided by an occupational therapist. For the NDIS in particular, OT evidence is extremely high value.

NDIS clients are extremely profitable, and it is in the OT's interests to pull off a successful access request if it means the prospect of ongoing business.

In essence, this evidence is to map the symptoms described by your specialists to the actual impairments when you're engaging in everyday tasks.

There is a range of assessments they can do to this effect. Depending on the nature of your disability, this may range from simply asking you questions and ticking boxes to physical functioning tests.

A GP can write a Management Plan (GPMP) which gives you 5 rebated sessions with an OT, though the rebate is very small. You will have to pay out of pocket for an OT. The cost will be non-trivial.

Again, this is the one most people want to skip. Don't.

Contextual Evidence

A type of evidence that doesn't get a lot of airplay is contextual evidence. This can be extremely valuable for decision makers.

Most commonly, this takes the form of describing the applicant's work/study history and care arrangements.

If they have not ever held down a job, that is significant.

If they have struggled to complete studies, that is also significant.

If they were working but can't anymore, explaining why is important. Colleagues can write a note detailing what they saw.

If they have successfully been living alone with absolutely no intervention from friends or family, how do we argue they need care?

The NDIS does not require participants to be out of work to access it, but their work history will be a factor when determining impairment. If the person has a high-flying professional career, they are going to have to explain how they've been doing that without support.

Informal Evidence

The final evidence type I recommend including is informal, meaning friends/family/carers.

This will effectively just take the form of a statement describing what the day-to-day life of the applicant is like, and how the people around them provide support.

It doesn't have to be a large essay - half a page is fine.

Do not suggest supports they need or should receive. That is decided later in the process. You are arguing for them entering the system and getting any help at all.

You can include your concerns about what'll happen if they don't receive support too.

Long COVID

One of the most common causes of disability is long COVID. It can absolutely ruin your life, and it's a special case worth discussing.

You cannot access disability support for long COVID alone.

There are two basic reasons for this:

The Federal budget cannot in fact sustain providing disability supports for such a common and debilitating condition. Delegates are aware of this and even if you manage to nail down a specific form of damage that's been done to your body, they will be extremely gun-shy about opening these floodgates.

Is this unfair? Yes.

As a matter of public policy, I am not aware of a solution.


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There is justice in this world, but you will not find it in the legal or medical systems.