CPPM and National Disability Insurance Agency

This matter concerned an application by CPPM for review of a decision by the National Disability Insurance Agency (NDIA) to refuse access to the National Disability Insurance Scheme (NDIS). The NDIA had affirmed its original decision, concluding that CPPM did not meet the access criteria under section 21 of the *National Disability Insurance Scheme Act 2013* (Cth). The Administrative Appeals Tribunal (AAT) was required to determine whether CPPM met either the disability requirements under section 24 or the early intervention requirements under section 25 of the Act.

The legal issues before the AAT were whether CPPM's impairments were permanent or likely to be permanent, whether these impairments resulted in a substantially reduced functional capacity in any of the six prescribed activities, and whether any recommended supports were more appropriately funded through other general systems of service delivery. Specifically, the AAT had to consider the reviewer's findings that while CPPM's chronic pain from spinal stenosis was likely permanent, his bilateral shoulder condition was not sufficiently evidenced as permanent. The reviewer also found that CPPM's physical impairments did not lead to a substantially reduced functional capacity, as he did not typically require the support of another person, assistive technology, disability equipment, or home modifications to complete the prescribed activities. Furthermore, the AAT had to assess whether the longstanding nature of CPPM's impairments meant that providing support would not constitute early intervention, or if the evidence indicated that early intervention supports were likely to benefit CPPM in achieving the prescribed outcomes.

The AAT considered the evidence presented, including medical reports and testimony from CPPM. The reviewer had been satisfied that CPPM's spinal stenosis and associated chronic pain were permanent impairments, but had not been satisfied regarding the permanence of his bilateral shoulder condition due to a lack of detailed specialist information. The reviewer also concluded that CPPM did not demonstrate a substantially reduced functional capacity in the prescribed activities, as the evidence did not show a consistent need for significant support or specific equipment. Regarding early intervention, the reviewer determined that the chronic nature of CPPM's condition meant that current support would not be considered "early intervention" and that the evidence did not demonstrate likely benefit from such supports. The AAT ultimately affirmed the decision under review, finding that CPPM had not met the access criteria under section 21 of the NDIS Act.