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, there are other ways you can do your business with us. You can use self service or request someone to deal with us on your behalf. If you can’t access our forms, please contact us. We can help you access, complete and submit them.
Page last updated: 10 July 2020
This information was printed 3 August 2020 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.