Claim for Disability Support Pension for a Terminal Illness form (SA494)
Use this form to claim Disability Support Pension for a terminal illness where your life expectancy is less than 2 years. You must be 16 to Age Pension age at the time of claiming.
Download and complete the Claim for Disability Support Pension for a Terminal Illness form.
You must provide current medical evidence with your claim. The medical evidence must show your diagnosis and prognosis. If you don’t have current medical evidence your treating health professional can complete the Verification of Terminal Illness section of the claim form.
Don’t use this form if your medical condition is not terminal. Instead read about claiming Disability Support Pension.
You may need to complete and submit the Income and Assets form with your claim.
This PDF is fillable. You can fill it out on your device, or print it and complete it by hand.
If you have a disability or impairment and use assistive technology, you may not be able to access our forms. If you can’t, please use self service, request someone to deal with us on your behalf, or contact us. We can help you access, complete and submit them.
Page last updated: 8 December 2020
This information was printed 19 January 2021 from https://www.servicesaustralia.gov.au/individuals/forms/sa494. It may not include all of the relevant information on this topic. Please consider any relevant site notices at https://www.servicesaustralia.gov.au/individuals/site-notices when using this material.