Request for Early Release of Superannuation report from Dr Jason Wong & Dr Aaron Lim

First Name *

Last Name *

Date of Birth *

Email Address *

Microsoft Word - Request for Early Release of Superannuation report from Dr Jason Wong.docx

The ATO will approve Early Release of Superannuation (ERS) funds on compassionate grounds for medical treatment for conditions related to you or your dependant, where the condition is life-threatening and the condition is not readily available through the public health system.

The definition of “life-threatening” is that the patient will either die within 12 months or suffer an irreversible degeneration of a condition that, if left untreated, would result in premature death. There must be a clear and direct link between the current state of the illness and the threat to the patient’s life.

Obesity on its own, is not life-threatening by ATO definition. However, where a patient has “morbid obesity” with BMI over 35 and poorly controlled obesity-related comorbidities such as high blood pressure, diabetes, obstructive sleep apnoea to name a few, or their BMI is over 40 with or without weight-related comorbidities, it is clear that within 12 months there will be deterioration in multiple areas of the patient’s health that will eventually result in premature death, although not necessarily within 12 months. Dr Wong/ Dr Lim will determine whether you will be eligible for him to support an application.

It is advised that you read the ATO website information below to be fully informed on the process, requirements and tax implications when applying for Early Release of Super:

https://www.ato.gov.au/Individuals/Super/In-detail/Withdrawing-and-using-your-super/Early-access-on-compassionate-grounds/

or

https://www.ato.gov.au/misc/downloads/pdf/qc60034.pdf

You can apply online through the ATO website using this link, once you have deemed eligibility and obtained a report supporting your application from your GP and Dr Wong/ Dr Lim . Alternatively, you can use a third party to assist you applying for ERS. If you are struggling to complete the application on your own, we strongly recommend using Supercare to complete the process for you.

When you have read through the information on the link above and have decided that you wish to proceed with accessing your superannuation to fund surgery, please sign the document in the space below and submit the form.

Please select the funding method that applies to you *

I have private health insurance and I wish to use Early Release of Super to cover out-of-pocket expenses.I am uninsured and wish to use Early Release of Super to cover all fees for surgery and treatment.I am uninsured and wish to use Early Release of Super to cover part of the fees for surgery and treatment (please state further details below)I wish to use Early Release of Super to cover my Allurion Balloon

If you have Private Health Insurance - What is your hospital excess payable? *

Comments

Who will apply for Early Release of Superannuation?

I will do the application to the ATO myself (online is recommended)I plan to use a third-party, such as MySuperCare to do the application for me - additional fees apply using this method

I would like to apply to the ATO to access my superannuation early to fund bariatric surgery/ Allurion Balloon and declare the following: *

I understand that Dr Wong/ Dr Lim will consider whether to support my application based on ATO guidelines, and his support does not mean that the ATO will accept the application.I have read all the relevant information available through the ATO including tax implications and the future effects on my superannuation balance.I understand that the funds withdrawn must be used to fund the intended bariatric surgery, and should I choose not proceed with surgery I will be required to return the money to my super fund. Failure to do so can be deemed as fraud.I would like Dr Wong/Dr Lim to prepare a medical report to the ATO for me to submit with my application.

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