BBMC and National Disability Insurance Agency

The Administrative Appeals Tribunal reviewed a decision of the National Disability Insurance Agency (NDIA) concerning the applicant's eligibility for early intervention support under the National Disability Insurance Scheme (NDIS). The applicant sought access to ongoing psychological therapy sessions, which the NDIA had declined.

The Tribunal was required to determine whether the applicant satisfied the early intervention requirements as set out in section 25 of the National Disability Insurance Scheme Act 2013 (Cth). Specifically, the Tribunal had to consider whether the applicant had an impairment likely to be permanent, whether the provision of supports would reduce future needs or alleviate the impact of the impairment, and crucially, whether the requested early intervention support was most appropriately funded or provided through the NDIS rather than other general systems, such as the health system.

The Tribunal considered extensive medical evidence from a clinical psychologist and a consultant psychiatrist, which confirmed the applicant's long-term mental health impairment, including major depressive disorder and panic disorder with agoraphobia. While the Tribunal was satisfied that the applicant met the criteria under sections 25(1) and 25(2) of the Act, finding that her impairments were likely permanent and that supports could mitigate their impact, it found she did not meet the requirements of section 25(3). The Tribunal applied the NDIS Operational Guideline 7.6 and 7.7, which state that the NDIS is responsible for non-clinical supports focused on functional ability, but not for clinical supports related to mental health. Given the nature of ongoing psychotherapy, the Tribunal concluded that such support was more appropriately funded through the general health system.

Consequently, the Tribunal affirmed the NDIA's internal review decision.