Medical Factors

Last amended: 15 August 2022

Medical examinations

To determine a person's incapacity for work, consideration is to be given to medical factors only. It is important that evidence is available to identify the disability/disabilities causing incapacity for work. For ISP this is normally gathered from the GARP forms generated by MAGPIES and the Work Test Questionnaire form D0570.  For invalidity-ISS this information is obtained using the Medical and Work Details form D0571.    

Evaluation by treating doctor

Usually the treating doctor is the appropriate person to evaluate and advise on the effects of disability/disabilities on the person's employability and is asked to comment on things like:

• the nature of the disability,
• treatment provided or available,
• whether any incapacity is likely to continue indefinitely,
• how the disability affects capacity to work,
• whether the disability alone prevents the person from working,
• the manner in which the disability manifests itself,
• the period of time the person has suffered from the disability, and
• the combined effect of all disabilities (if there is more than one).

Initial medical assessment protocol

Before applying the Repatriation Commission approved guidelines, an initial diagnosis would have been received from the treating doctor and the veteran would have undergone a medical assessment to ascertain GARP impairment points and/or an assessment of ability to work.    

Independent medical assessment

If further evidence is required in order to make a decision, the decision maker has the discretion to send the claimant for an independent medical assessment. The following points are guidelines on when that discretion might be exercised:

• the veteran is in receipt of JobSeeker from Centrelink (recipients have to declare that they are fit and able to work, and willing to look for work) and may suggest that they are capable of working more than 8 hours per week,
• the veteran is still employed with a retirement date in the future (e.g. voluntary redundancy cases),
• the veteran has travelled some distance to visit a doctor (this might suggest that the veteran is seeking a more favourable medical assessment),
• the Disability Compensation Payment model for diagnosing psychiatric conditions is not satisfied. 'Diagnostic Guidelines for Psychiatric Assessment and Reports' and the 'Second Opinion Protocol for Psychiatric Cases' provide guidelines on the provision of psychiatric reports that are of a suitable standard. These documents can be accessed via Start\Departmental\Applications\CCPS\CCPS Research Library (read here). Delegates should also refer to the Commission Guideline for Psychiatric Compensation Claims available in the Reference Library,
• the new claim application raises other medical questions.     
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Factors determining capacity for work – service pension

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For service pension purposes, in deciding whether a disability/disabilities affects a person's capacity for work, factors such as the following are taken into account:

• the work that the veteran might reasonably be expected to undertake possibly with retraining, given their skills, qualifications and experience;
• whether the work is actually undertaken and is not uncommon in the Australian workforce;
• whether the work is of a kind for which award wages are, or could reasonably be expected to be, paid.

Work in this context is not necessarily limited to:

• the particular type of job that the veteran has previously undertaken; or
• work readily available to the veteran at this time or in the veteran's local area.

Factors determining capacity for work – invalidity ISS

For invalidity ISS purposes, in deciding whether a medical condition is affecting a person's capacity to work for at least 30 hours per week at award wages or above, factors such as the following are taken into account:

• physical and intellectual characteristics that would be required to perform the work, and the person's ability to demonstrate those characteristics, both at present and in the future,
• the ability to:

• regularly report to work,
• persist at work tasks,
• understand and follow work instructions,
• communicate with others in the workplace,
• travel to and from work, and move around at work,
• manipulate objects at work,
• exhibit appropriate work behaviour,
• undertake a variety of tasks and to alternate between tasks,
• lift, carry and move objects at work,

• whether attendance at medical appointments/treatment interferes with their ability to work,
• whether the person is fit for any work, either skilled or unskilled, without needing preparatory training other than on-the-job training. This may involve consideration of:

• the person's work history,
• the person's level and type of education and training history,
• work which would be suited to the person's work skills,

The person needs to have, or have the potential to acquire, all the characteristics necessary to perform the work.

Factors not taken into account –invalidity ISS

The following factors are not to be considered in the assessment of permanent incapacity for ISS purposes:

• the availability of the person's usual work in the locally accessible labour market,
• the person's  motivation to work or train, except when medical evidence indicates that the lack of motivation is directly attributable to the impairment.