GFWJ and National Disability Insurance Agency

This matter concerned a review by the Administrative Appeals Tribunal of a decision made by the National Disability Insurance Agency (NDIA) regarding a Statement of Participant Supports for the Applicant, a child diagnosed with Autism Spectrum Disorder, Attention Deficit Hyperactive Disorder, and a Chromosomal Deletion. The Applicant's representative sought review of the NDIA's decision, arguing that the provided funding did not adequately account for the needs of a non-verbal child, specifically disregarding recommendations from the Applicant's speech therapist and providing insufficient funding for essential therapies.

The Tribunal was required to determine whether the additional support requested by the Applicant was reasonable and necessary pursuant to sub-section 34(1) of the National Disability Insurance Scheme Act 2013 (Cth). This involved assessing the adequacy of the NDIA's approved participant plan, which included funding for assistive technology and allied health professionals, against the Applicant's stated goals and developmental needs.

The Tribunal affirmed the NDIA's decision. While acknowledging the Applicant's significant diagnoses and the stated desire for increased speech therapy and occupational therapy, the Tribunal found that the existing plan, which had been revised following a remittal from the Tribunal, provided substantial funding for core supports and capacity building. The plan outlined specific goals related to speech and language development, social skills, motor skills, cognitive development, and emotional regulation, and the Tribunal was satisfied that the allocated funding was sufficient to address these objectives within the framework of reasonable and necessary supports.