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Post by aussieinusa on Mar 9, 2014 9:11:08 GMT 7
A question that comes up regularly is, "Help!! CL have called me in for reassessment. What do I do??" It's a frightening prospect for anyone who's been on DSP for a long time to be reassessed under the new, tougher Assessment Tables that were introduced in 2011. The tables were designed to make 40% of people who previously qualified ineligible for DSP, by deeming them "well enough to work". (Though where all those part-time jobs with plenty of sick leave for people with major limitations are going to come from, I don't know.) So I figured a sticky thread with tips on what to do if you're reassessed might be useful. Anyone else who's been reassessed, add your tips and/or experiences below.Here are my tips on what to do: 1. Read the new assessment tablesThese are the official documents used to categorise and rate disability, for the purposes of deciding whether you're still eligible. (Note: Some of you won't be, and will find yourself back on NewStart. I am really sorry, and wish I had better news to share.)You can download them here: DSS web site: DSP Impairment Tables2. Gather plenty of medical evidenceYou need plenty of evidence from reputable sources documenting your diagnosis, severity, how long its been going on, etc. This is especially important if the doctors you saw in the past have moved on, and you have to go to a new doctor (or one you've only been seeing a short time) to get reports written. - Send CL a Freedom of Information request IMMEDIATELY (email: freedomofinformation@humanservices.gov.au ) asking for copies of the Treating Doctor's Report and specialist's report(s) you provided them in the past.
- Go through all your old paperwork and look for anything related to your disability. Ideally, this would include reports from doctors and specialists; surgical reports; x-rays, ultrasounds and other scans; test results; details of treatment programs you've tried in the past (e.g. the diagram sheets physios give showing what exercises you need to do); even receipts can help your case. Basically ANYTHING that shows what your condition is and what treatment you've received for it over the years.
- If you went to a special school or have evidence of accommodations made for you in workplaces or university, gather that as well.
- If you still don't have much evidence, go to your nearest Medicare office and ask them to print out all the items you've claimed, as far back as they can go. This verified which doctors you've gone to and when, and also what tests you've had done.
Hopefully this process will leave you with a big bundle of evidence, proving what's up and how long it's been going on -- and also that you've sought and tried plenty of treatments.
3. Write your own medical history Taking a full medical history, especially for someone with complex and/or long-standing health issues is a big job. Unfortunately, most doctors these days are under pressure to keep appointments to 15 minutes, maximum. So you need to do some of 'their job' for them by preparing your own medical history, as best you can, before the appointment. That way, your doctor can spend 5 minutes reading over it and the next 10 minutes of your appointment (if you're lucky to get that long) asking questions and examining you.
Take a sheet of paper and make notes: - Which doctors have you seen over the years? What was their specialty, and where did/do they practice?
- What did they diagnose you with?
- What surgeries have you had, if any? Which surgeon did them, at which hospital?
- What tests, scans or x-rays were done? What did they tell you?
- What complications did you have?
- What medication have you been prescribed over the years? For each one:
- Did it improve your condition?
- What side effects did it have?
- If you're not still taking it, why did you stop?
(e.g. finished the course / ineffective / effective but unacceptable side effects / cost / new doc changed meds / etc.)
- What other treatments have you tried? (e.g. physio, counseling, meditation etc etc etc.)
- What do you do yourself to manage your condition(s)? (e.g. daily walks)
- If you have more than one condition, how do your conditions interact?
KEEP IT TO ONE PAGE. Or an absolute maximum of two pages. They're not gonna read through 10 pages of scrawl.
Also, type it up on a computer if you can. (Even if you have to go to your local library to print it.)
4. Get your report(s)Not all doctors are familiar with writing these reports, so you do need to be clear about what it needs to say. (But don't try to tell them what to write. Firstly, it needs to document exactly what your condition is, and confirm that it's fully treated and stabilised. This is where all the documentation you've collected above comes in -- "because I say so" is not an adequate reason for them to write something in an official report. - If you want them to say you broke your back in ten places, you need to hand them an x-ray or specialist's report that says so.
- If you want them to say you've had four surgeries, having the surgical reports helps a lot; if not, you need to at least give them the names (hospital and surgeon) and dates, and show 'em your scars.
- If you want them to say that three years of physio failed to give you back full functioning, at a bare minimum you need to tell them the name(s) of the physios you saw, where they practice, and tell the doctor you're happy for them to contact the physio(s) to verify it.
- Etc.
Secondly, it needs to detail the specific functional impairments you have. Go back to the assessment tables and look over the sections that are relevant to your condition(s). Maybe you can't lift things. Maybe you can't walk far. Maybe you can't go places alone. Ideally, your doctors' reports need to say exactly that. Printing out the relevant pages of the assessment tables can help, to show the doctor what you need to establish in order to qualify. They can only attest to limitations that are supported by the medical evidence in front of them, though. 5. Go to your appointmentThe expert opinion of highly qualified medicos is not enough; you also have to attend a Job Capacity Assessment. - Make sure you attend your appointment
- Be as punctual as possible
- Bring all that documentation you've gathered, to prove that you're a genuine case
- Be polite
- Answer all their questions honestly
- Don't get aggressive toward the assessor, no matter what. They didn't create the system; they're just doing their jobs
6. Cross your fingers and hang in thereEven if you turn up with no arms, no legs, no eyes and no ears, it will still take them months to figure out whether you're really disabled or not. Seriously. (Or rather, it'll take them months to do all the paperwork so the file says the right things to get you payment.) Hang in there. Try not to worry about it; even those of us who easily 'passed' were kept waiting the whole 8 weeks or so before they told us.
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Post by aussieinusa on Mar 9, 2014 9:12:10 GMT 7
Note: all of the above applies to people applying for DSP for the first time, too. It's exactly the same assessment.
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Post by Denis-NFA on Mar 9, 2014 11:49:25 GMT 7
That is the best summary and I Thank you aussieinusa. In my bumbling, fumbling way I actually did do all of what you have set out. I have now been assessed under the old impairment tables and the new impairment tables and I agree with every word you have set out.
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Post by muggins on Mar 9, 2014 12:26:58 GMT 7
Great contribution, well done. But, I recently had my DSP reviewed and I was not called in to C/L for a Job Capacity Assessment. I was absolutely terrified that I would lose the dsp, but I passed quite easily and quickly. My tip would be to act the same day as you receive the letter by:- Playing out all the different scenario's in your head of what will happen at your GP and Specialist appointments. Also write down all your conditions and seek to gain as many points as possible, and don't underestimate the severity of each condition, but also be honest and truthful. There may even be a condition that you have now that wasn't present with the initial grant. Visit your GP ASAP to get the ball rolling. Keep your chin up it's not that bad.
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Post by aussieinusa on Mar 9, 2014 16:46:32 GMT 7
Thanks for sharing your experience, muggins; you raised a really good point. Reassessment vs. reviewAt least half of the people who post here (or contact the forum admins privately for advice), who are worried about being 'reassessed' are actually being reviewed. CL doesn't bother to make the difference between the two processes clear -- especially when they're releasing info to the media. (Or to give them fair 'benefit of the doubt'... maybe the media fails to report the difference clearly.) Reassessment is the one that gets talked up a lot in the media (and on here .) Review is what actually happens more often. Why? Reassessment is the labour-intensive, time-consuming process where they completely reassess whether your disability/mental health/medical condition qualifies you for DSP. Review is a quick, simple administrative process for checking whether your personal circumstance have changed (and you didn't tell them). Whether you're still 'disabled enough' doesn't come into it, so you can ignore all of what I said above. You'll know you're being reassessed because you'll be sent a new Treating Doctor's report to have completed and MAYBE told you must attend a new Job Capacity Assessment. (I think. I haven't personally been sent the paperwork; anyone who has, please chime in!) [ETA: Experiences differ on whether people were called in for JCA; you might just have to return medical forms and any other medical evidence you want to submit]You'll know it's just a review when you're sent a form asking a bunch of personal and financial questions, with a stern letter telling you to complete and return it within about 20 days. So should you be worried? If you're being reassessed, yes, you need to take it very seriously and gather as much evidence as you can. See above. If you're being reviewed... Did you win first-division lotto and 'forget' to tell CL? Did you inherit millions and 'forget'? Did you magically become able-bodied and start working full-time, and not notify CL? Did you move in with your partner and 'forget' to notify? If you answer 'yes' to any of the above, then yes, you need to worry. If you answer the forms honestly, you'll be asked to repay a whole lot of money (out of your lotto winnings? sorry, got no sympathy for you )... and if you lie on the forms to keep getting payment, you're building a very strong case for deliberately defrauding CL. It might take a while longer for them to bring you to court over it, but when they do, you're screwed. The one exception I'll raise to the 'forgot to notify' scenario: Sometimes people face an awful tradeoff when they enter a relationship where they believe they'll be reduced to the Partnered rate, which they can't afford to live on, but their new partner doesn't have any money to make up the shortfall. So they believe it's a tradeoff between failure to notify vs. homelessness and/or starvation. CL aren't actually quite that heartless. (Surprise!) There's a little-known CL rule called 'Section 24' where, if your partner has no financial resources to contribute, you can stay on the Single rate despite being Partnered. If you're in that situation... Run, don't walk, to Welfare Rights. Now. You need them to help you through the process. If you can prove that you were eligible for Section 24 the whole time, you don't owe CL money. You just need to request clemency for your failure to notify, if you believed notifying would force you into homelessness or other extreme hardship. And good luck to you. People screw up all the time due to not fully understanding CL's various rules and regs (and that includes people employed by CL full-time and specially trained to understand their system), so tell the truth, get some help, and hopefully it'll all turn out OK for you. Just expect a few weeks or so of stress, sorting it out.
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Post by muggins on Mar 9, 2014 17:34:14 GMT 7
No,my review was medical, pretty sure its the same as reassessment. My doctor and I had to complete medical paperwork. I also had to complete medical paperwork.
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Post by muggins on Mar 10, 2014 9:54:25 GMT 7
The only place I have seen the term 'Reassessment' used in relation to the DSP is on this forum.
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Post by aussieinusa on Mar 11, 2014 4:42:05 GMT 7
No,my review was medical, pretty sure its the same as reassessment. My doctor and I had to complete medical paperwork. I also had to complete medical paperwork. OK, that's interesting. They reassessed your medical condition without ever calling you in to talk to you about it?? I've seriously attended about 5 JCAs so far; they seem to drag me in for another every time I sneeze!
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Post by aussieinusa on Mar 11, 2014 4:53:34 GMT 7
The only place I have seen the term 'Reassessment' used in relation to the DSP is on this forum. I've heard both terms used by CL. Just checked the SS Law Guide though, and they seem to refer to all the different kinds of reviews they do as 'reviews', though. (But terminology in the Guide and what gets said by CL staff in branches, call centre and letters often differ; they're trained not to talk at you in legalese because normal people speak English instead ). If anyone's interested, the relevant section of the Guide is here: guidesacts.fahcsia.gov.au/guides_acts/ssg/ssguide-6/ssguide-6.2/ssguide-6.2.5.htmlWe can quibble about terminology for days, but the main point is: if CL send you a letter saying, "we're checking if you're still eligible," DON'T PANIC. It doesn't always mean they're about to reassess your 'disabledness' under the 2011 Tables; they might just be snooping into your finances and living arrangements. And even if they are reassessing you... if you follow the advice at the very top, you should be OK.
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Post by muggins on Mar 11, 2014 5:26:40 GMT 7
No,my review was medical, pretty sure its the same as reassessment. My doctor and I had to complete medical paperwork. I also had to complete medical paperwork. OK, that's interesting. They reassessed your medical condition without ever calling you in to talk to you about it?? I've seriously attended about 5 JCAs so far; they seem to drag me in for another every time I sneeze! Anyone on the dsp can be medically reviewed every 2 years. They don't need to call you into C/L to determine if you are still eligible for dsp. Maybe I just got lucky because of C/L's current exhaustive workload or maybe C/L was just being economical.
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Post by muggins on Mar 11, 2014 5:44:42 GMT 7
I've heard both terms used by CL. Just checked the SS Law Guide though, and they seem to refer to all the different kinds of reviews they do as 'reviews', though. (But terminology in the Guide and what gets said by CL staff in branches, call centre and letters often differ; they're trained not to talk at you in legalese because normal people speak English instead ). If anyone's interested, the relevant section of the Guide is here: guidesacts.fahcsia.gov.au/guides_acts/ssg/ssguide-6/ssguide-6.2/ssguide-6.2.5.htmlWe can quibble about terminology for days, but the main point is: if CL send you a letter saying, "we're checking if you're still eligible," DON'T PANIC. It doesn't always mean they're about to reassess your 'disabledness' under the 2011 Tables; they might just be snooping into your finances and living arrangements. And even if they are reassessing you... if you follow the advice at the very top, you should be OK. I'm not quibbling about terminology. Just don't want folks to get confused. Also, C/L can send out medical review letters every 2 years, they don't send letters titled medical reassessments. And in fact, if you receive a medical review letter, it does mean you are being reassessed for your eligibility under the 2011 Tables. So take this very seriously. I think what you are referring to is a Change of Circumstances Letter.
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Post by Denis-NFA on Mar 11, 2014 6:16:03 GMT 7
Dear mugginsWhat aussieinusa has set out above is very genuine but it is not meant to be the rule but merely a helpful guide. I think we can all give exceptions to the rule.
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Post by muggins on Mar 11, 2014 6:52:24 GMT 7
Dear mugginsWhat aussieinusa has set out above is very genuine but it is not meant to be the rule but merely a helpful guide. I think we can all give exceptions to the rule. I appreciate aussieinusa's contribution, it's just that this whole Reassessment V's Review thing was confusing the hell out of me. I also appreciate that aussieinusa has come forward and admitted that the term "Reassessment" is not used by C/L. It takes backbone to do that, thumbs up!
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Post by Deleted on Mar 11, 2014 7:20:30 GMT 7
Great post Aussieinusa, it will be useful for when l get the dreaded phone call or letter calling me in for re-assessment
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Post by Banjo on Mar 11, 2014 7:23:31 GMT 7
The only place I have seen the term 'Reassessment' used in relation to the DSP is on this forum. I've heard both terms used by CL. Just checked the SS Law Guide though, and they seem to refer to all the different kinds of reviews they do as 'reviews', though. (But terminology in the Guide and what gets said by CL staff in branches, call centre and letters often differ; they're trained not to talk at you in legalese because normal people speak English instead ). If anyone's interested, the relevant section of the Guide is here: guidesacts.fahcsia.gov.au/guides_acts/ssg/ssguide-6/ssguide-6.2/ssguide-6.2.5.htmlWe can quibble about terminology for days, but the main point is: if CL send you a letter saying, "we're checking if you're still eligible," DON'T PANIC. It doesn't always mean they're about to reassess your 'disabledness' under the 2011 Tables; they might just be snooping into your finances and living arrangements. And even if they are reassessing you... if you follow the advice at the very top, you should be OK. We argued over the terms "indefinite" and "unlimited" for portability for a while but the fact is that While it states "unlimited" in the legislation, the Guide to Social Security Law uses "indefinite.
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