Darlow and National Disability Insurance Agency

This matter concerned an application by Mr Darlow for review of a decision by the National Disability Insurance Agency (NDIA) regarding his NDIS plan. The dispute centred on whether certain requested supports, including additional support worker assistance, a mini-CPAP machine, and a more expensive ergonomic desk and chair, constituted "reasonable and necessary supports" under the National Disability Insurance Scheme Act 2013 (Cth). The Administrative Appeals Tribunal (AAT) was required to determine the appropriateness and level of funding for these supports.

The Tribunal was tasked with assessing whether the requested supports would assist Mr Darlow to pursue his stated goals and aspirations, facilitate his social and economic participation, and represent "value for money". Specifically, the Tribunal considered the evidence regarding Mr Darlow's physical and psychological impairments, his independent living arrangements, and the extent to which the proposed supports would enhance his independence and ability to engage in community and economic activities. Credibility issues and the differing opinions of expert assessors were also relevant to the Tribunal's determination.

In its reasoning, the Tribunal applied the criteria for "reasonable and necessary supports" under section 34(1) of the NDIS Act. It found that support worker assistance, the mini-CPAP machine repayments, and an ergonomic desk and chair would assist Mr Darlow in pursuing his goals and participating in social and economic activities. However, the Tribunal was not satisfied that the more expensive ergonomic desk and chair requested by Mr Darlow met the "value for money" criterion, granting a lesser amount for this item. The Tribunal also determined a specific level of support worker assistance that it considered appropriate.

Consequently, the Tribunal set aside the NDIA's decision and remitted the matter for reconsideration. The NDIA was directed to approve a new NDIS plan for Mr Darlow that included funding for the mini-CPAP machine repayments, a specified level of support worker assistance, and a pro-rata replication of existing supports, excluding those already expended or replaced by the new provisions.