Cancer patients and those with acquired brain injuries were among the worst affected by Coalition reforms to the disability support pension that saw an overall increase in denied claims and a blowout in processing times, a new report shows.
The report by management consultants Health Outcomes International, commissioned by the federal government in response to an audit office report, examined the revised pension assessment process brought in under Tony Abbott’s prime ministership in 2015.
The changes included using “government-contracted doctors” to assess applicants and requiring them to provide existing medical evidence rather than a report from their own doctor. These followed sweeping changes to the eligibility criteria introduced by the Gillard government in 2011.
Health Outcomes International found all disabilities had “higher rejection rates post implementation of the 1 July 2015 changes”.
For example, among people with cancer, rejection rates increased to 60%, up from 47% before the reforms, while for those with musculoskeletal or immune system conditions, the proportion of denied claims soared above 80%.
The 13 percentage point increase in denied claims for cancer patients was the highest of any condition, along with “visceral disorders”, which refers to pain in organs of the chest, belly, or pelvis, and “inherited disorders”, which refers to genetic conditions. Cancer claims make up about 3% of the approximately 100,000 applications each year.
People with acquired brain impairment, chronic pain, infectious diseases, skin disorder and burns saw an 11 percentage point increase in rejected claims.
The report did not analyse separate eligibility changes introduced by the Gillard government, including new “impairment tables”, which experts say made it much harder for applicants to get the pension.
The Gillard and Abbott-era reforms aimed to reduce spending on the disability support pension, but in doing so have led to a record number of people who are sick or have disabilities on the jobseeker payment.
The new report comes with renewed focus on the payment, amid an ongoing Senate inquiry.
The disability discrimination commissioner, Ben Gauntlett, told the inquiry on Monday the eligibility criteria and application process were “onerous” and the government should consider whether they were “fit for purpose”.
Last week, the social services minister, Anne Ruston, was forced to defend the system after Guardian Australia reported the story of 29-year-old brain cancer patient George Upjohn, who is struggling to make ends meet on the much lower jobseeker payment.
Campaigners say cancer patients generally struggle to get on to the payment until their condition is terminal and that changes are needed to rules that require a condition to be “fully diagnosed, treated and stabilised”.
Former hospital worker Julie Stephen, 56, was rejected for the disability support pension while battling breast cancer last year.
After doctors found a lump in her breast, Stephen underwent chemotherapy, including a four-week course of the so-called “red devil”, a lumpectomy and radiation.
She finished radiation in April and was cleared of breast cancer in June, though she said she still had not recovered from “what they call that chemo brain”.
Stephen said she was fortunate her time on jobseeker payment coincided with a massive boost to the dole through the coronavirus supplement, which was withdrawn in March.
She called for more support, saying people with cancer need to focus on their recovery.
“The system needs a backup to help cancer patients that does not require them to jump through hoops to be considered.”
The HOI report found that people were now mostly like to have their claim fail because their condition was not “fully diagnosed, treated and stabilised”, with this making up 53% of all denied applications.
Previously people had been more likely to be rejected because their condition did not garner 20 points on the impairment tables, meaning it was not considered severe enough.
The report found the Abbott government’s changes were “appropriate relating to the policy intent, and effective in improving the integrity” of the disability support pension and were “cost-effective”, but noted they also “increased the time of decision making”.
A person could have been expected to wait 54 days on average in 2014, a figure that rose to 84 days by 2019.
For some conditions the average wait was even longer, with cancer patients waiting an average of 96 days by 2019, people with chronic pain waiting 109 days, and people with intellectual disabilities waiting 113 days.
The report made a number of minor recommendations, including the introduction of a new reporting template for a person’s treating doctor to submit as part of their application.
Economic Justice Australia was among the groups that welcomed that recommendation on Monday.
Ruston has insisted that the system is working, but Labor’s social services spokeswoman, Linda Burney, said the 2015 changes were “problematic”, particularly “forcing people to be assessed by doctors who don’t know them, instead of their own treating doctor who knows them best”.
A department of social services spokesperson said the 2015 changes were “aimed at improving the integrity of the assessment process in applying the existing eligibility criteria”.
“The evaluation found that the changes were appropriate and effective,” the spokesperson said.
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