DSP Support Letter

Disability Support Pension (DSP) – GP Support Letter Template Patient Details: - Name: John Smith - Date of Birth: 12/03/1978 - Address: 123 Main Street, Anytown - Centrelink Reference Number (CRN): 123456789 Treating Professional Details: - Name: Dr. Jane Doe - Qualification(s): MBBS, FRACGP - Provider Number: 1234567A - Practice Address: The Medical Clinic, 456 Oak Avenue, Anytown - Contact Number: 03 9876 5432 - Email: jane.doe@medicalclinic.com.au - Duration of Treatment: 5 years Medical Conditions: - Primary medical condition(s): Major Depressive Disorder, diagnosed 01/01/2018 by Dr. Smith (Psychiatrist). - Secondary medical condition(s): Chronic back pain, diagnosed 01/06/2015. Treatment History: - Treatment approaches trialled: Multiple courses of antidepressants (Sertraline, Citalopram), psychotherapy, and regular physiotherapy for back pain. - Treatment outcomes and adequacy: Partial response to antidepressants, with ongoing symptoms of low mood, fatigue, and anhedonia. Physiotherapy has provided some relief for back pain, but it remains a chronic issue. - Reason further treatment unlikely to help: Despite optimal treatment, the patient's symptoms have not significantly improved, and further interventions are unlikely to yield substantial functional gains. Functional Impact: Patient experiences significant limitations in their ability to work due to persistent low mood, fatigue, and chronic pain. These symptoms impact their concentration, energy levels, and ability to interact socially, making it difficult to maintain employment. - Mobility: No significant mobility difficulties. - Communication: No significant communication difficulties. - Social Interaction: Avoids social situations due to low mood and anxiety. - Learning & Cognition: Difficulty concentrating and remembering information. - Self-care: No significant self-care difficulties. - Domestic Tasks: Requires assistance with some household chores. - Financial & Administrative: Requires assistance managing bills. Capacity for Work: Based on my clinical assessment, it is my professional opinion that the patient’s condition results in a severe functional impairment, and they are unable to work or engage in education/training now or in the foreseeable future. Prognosis: Despite ongoing treatment, the patient’s condition has remained stable, and no improvement in functional capacity is expected within the next two years. Therefore, I certify that their condition is fully diagnosed, treated and stabilised. Declaration: I, Dr. Jane Doe, confirm that the information in this letter is accurate to the best of my knowledge and based on my clinical assessment. Please contact me if further information is required. Signature: Date: 01/11/2024