Brown and National Disability Insurance Agency

This matter concerned an appeal by the Applicant, a 52-year-old man who developed Guillain Barre Syndrome, against a decision by the National Disability Insurance Agency (NDIA) to reduce his funding for support worker assistance and transport. The Applicant sought to maintain the level of support worker hours previously provided, while the NDIA argued for a reduced amount based on reassessment. The Administrative Appeals Tribunal (AAT) was required to determine whether transport funding and the level of support worker hours proposed by the NDIA were reasonable and necessary supports under the National Disability Insurance Scheme (NDIS) Act 2013.

The Tribunal considered the Applicant's goals and aspirations, which included maintaining independence and engaging in work and community activities. It examined various assessments and reports regarding the Applicant's functional capacity and support needs, noting that while some functional improvements had occurred, his overall support needs remained high. The Tribunal also considered the availability and effectiveness of onsite on-call (OOS) supports within the Applicant's Specialist Disability Accommodation (SDA) and the potential for duplication with other supports. Furthermore, the Tribunal assessed whether the requested supports were appropriate for NDIS funding, represented value for money, and took into account informal supports and other systems of service delivery.

In its reasoning, the Tribunal emphasised the NDIA's duty to assist the Tribunal in reaching the correct or preferable decision, noting that both parties could have provided more comprehensive information. The Tribunal found that transport funding was not a reasonable and necessary support, concluding that it duplicated the benefits of vehicle modifications already provided and that work-related travel should be a business expense. However, the Tribunal determined that while the NDIA's proposed 13 hours of support worker assistance per day, combined with OOS, offered some support, it did not fully meet the Applicant's goals for flexibility and spontaneous participation in social and economic activities. The Tribunal found that an additional two hours of 1:1 support worker assistance per week would be sufficient to address these unmet needs.

Consequently, the Tribunal varied the NDIA's decision by ordering the inclusion of an additional two hours per week of 1:1 support worker assistance in the Applicant's plan. The Tribunal affirmed the NDIA's decision to refuse transport funding. The reassessment date for the Applicant's plan was set for 12 months from the date of the decision, with all other supports to be funded on a pro-rata basis until that date.