Allen and National Disability Insurance Agency

This matter concerned an application by Ms Allen for review of a decision by the National Disability Insurance Agency (NDIA) to refuse her access to the National Disability Insurance Scheme (NDIS). Ms Allen suffers from Hypermobile Ehlers-Danlos Syndrome (HEDS), and the dispute centred on whether her condition met the eligibility requirements for the NDIS, specifically the disability requirements under section 24 and the early intervention requirements under section 25 of the *National Disability Insurance Scheme Act 2013* (Cth). The Administrative Appeals Tribunal (AAT) was tasked with determining these issues.

The Tribunal was required to consider two primary legal questions. Firstly, whether Ms Allen satisfied the disability requirements as set out in section 24 of the Act, which necessitates meeting all five specified criteria, including having a permanent impairment that affects her capacity for social and economic participation. Secondly, the Tribunal had to determine if Ms Allen met the early intervention requirements under section 25 of the Act, which relates to the provision of time-limited, goal-oriented services and therapies where the predominant purpose is treatment directly related to a person's health status.

In its reasoning, the Tribunal applied the principles established in previous cases, such as *YPRM and National Disability Insurance Agency*, which distinguish between services provided by the health system for chronic health conditions and supports provided by the NDIS for disabilities. The Tribunal found that while Ms Allen's HEDS was a permanent impairment affecting her capacity for social and economic participation, she did not meet the criteria under section 24(1)(c) of the Act, which requires a substantially reduced functional capacity in specific activities like communication, social interaction, learning, mobility, self-care, or self-management. Furthermore, the Tribunal concluded that the early intervention support Ms Allen required, as evidenced by reports from allied health professionals recommending strategies for managing her condition and improving physical function, was predominantly related to the management of her health status. Therefore, such support was considered to fall outside the scope of the NDIS and should be provided by the health system.

Consequently, the Tribunal found that Ms Allen did not fulfil the early intervention requirements under section 25 of the NDIS Act. The reviewable decision of the NDIA to affirm Ms Allen's ineligibility for the NDIS was therefore affirmed.