FBJV and National Disability Insurance Agency

This matter concerned an application by FBJV to become a participant in the National Disability Insurance Scheme (NDIS). The dispute arose because the National Disability Insurance Agency (NDIA) had decided that FBJV did not meet the access criteria under sections 24 and 25 of the *National Disability Insurance Scheme Act 2013* (Cth). The Administrative Appeals Tribunal was required to review this decision.

The Tribunal was tasked with determining whether FBJV's impairments, primarily chronic pain secondary to endometriosis, resulted in a "substantially reduced functional capacity" to undertake any one or more of the specified activities listed in the NDIS Act. Additionally, the Tribunal had to consider whether FBJV met the early intervention requirements for access to the scheme.

In reaching its decision, the Tribunal considered various forms of evidence, including lay evidence from FBJV detailing her daily experience of pain and its impact on her ability to work and care for her children, as well as medical reports from a surgeon, a gynaecologist, and a general practitioner. The Tribunal noted that while FBJV experienced significant pain and functional limitations, it found that these did not meet the threshold for a "substantially reduced functional capacity" as defined by the NDIS Act. The Tribunal also considered the NDIA's Operational Guideline, which provides guidance on access criteria. Ultimately, the Tribunal concluded that FBJV did not meet the disability requirements under section 24 or the early intervention requirements under section 25 of the NDIS Act.

Consequently, the Tribunal affirmed the NDIA's decision that FBJV did not meet the access criteria under section 21 of the NDIS Act to become a participant in the scheme.