DGJJ and National Disability Insurance Agency

This matter concerned an application by the Applicant, DGJJ, challenging a decision by the National Disability Insurance Agency (NDIA) regarding funding for personal care and community access supports. The Applicant sought funding for full-time care, arguing that the NDIA's proposed funding did not adequately meet her needs. The Administrative Appeals Tribunal (AAT) was tasked with determining whether the requested full-time care constituted reasonable and necessary supports under the National Disability Insurance Scheme (NDIS) and whether care during hospitalisation was appropriately funded by the NDIA.

The Tribunal considered the principle that the NDIS is not intended to replace family support, acknowledging that parents typically provide substantial care for their children. However, it also recognised that the Applicant's care needs were significantly greater than those of other children her age, requiring full-time personal care. A key challenge for the Tribunal was the unreliability of the Applicant's mother's evidence, which was central to the case. The Tribunal found inconsistencies between the mother's assertions and contemporaneous records regarding the number of carers required for transport and the applicant's fluctuating health.

Ultimately, the Tribunal set aside the NDIA's previous decision and substituted its own. It determined that it was reasonable and necessary to provide funding for up to eight hours of active overnight assistance every night and up to ten hours of active daytime assistance every day for personal care and community access. This funding was to be provided seven days a week, with the exception of periods when funding was already provided by the NSW health system.