Gianakis and National Disability Insurance Agency (NDIS) - [2025] ARTA 515

Gianakis and National Disability Insurance Agency (NDIS) [2025] ARTA 515 (27 April 2025)

Decision and Reasons for Decision

Applicant/s: Ageliki Gianakis

Respondent: National Disability Insurance Agency

Tribunal Number: 2023/6804

Tribunal: General Member L Proske

Place: Adelaide

Date: 27 April 2025

Decision:The Tribunal sets aside the decision under review and remits the matter for reconsideration in accordance with the order that:

1. The statement of participant supports specifies the reasonable and necessary supports include:

a)120 hours of physiotherapy

b)Capital Supports Home Modification funding in the amount of $200,480.00 consisting of:

External access point $30,000.00

Ensuite $65,000.00

Floor levelling $40,000.00

3 door widenings $40,000.00

(external access point, bedroom, ensuite)

Site toilet (3 months) $ 4,000.00

Project management fees 12 per cent $21,480.00

2. The physiotherapy support listed at paragraph (1)(a) replaces Ms Gianakis’ existing funding for physiotherapy and Therapy Assistant Level 2.

3. All other supports in Ms Gianakis’ existing statement of participant supports, excepting any one-off assistive technology supports already used, are to be replicated pro-rate from the date the supports listed at paragraph (1) are included in Ms Gianakis’ statement of participant supports.

4. The management of funding for reasonable and necessary supports is to remain the same as the management of funding for those supports as specified in Ms Gianakis’ existing statement of participant supports.

5. The date the Respondent must reassess Ms Gianakis’ plan is to be 12 months after the date on which the supports in paragraph (1) are included in Ms Gianakis’ statement of participant supports.

Statement made on 27 April 2025 at 1:14pm

Catchwords
NATIONAL DISABLITY INSURANCE SCHEME – reasonable and necessary supports – physiotherapy – complex home modifications – value for money – effective and beneficial – decision set aside and remitted for reconsideration
Legislation
Administrative Appeals Tribunal Act 1975 National Disability Insurance Scheme Act 2013
National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No. 1) Act 2024
Administrative Review Tribunal Act 2024
Administrative Review Tribunal (Consequential and Transitional Provisions No.1) Act 2024 National Disability Insurance Scheme (Supports for Participants) Rules 2013
National Disability Insurance Scheme (Getting the NDIS Back on Track No. 1) (NDIS Supports) Transitional Rules 2024

Cases
Drake and Minister for Immigration and Ethnic Affairs (1979) 46 FLR 409
Beezley v Repatriation Commission [2015] FCAFC 165 McGarrigle v National Disability Insurance Agency [2017] FCA 308 National Disability Insurance Agency v WRMF [2020] FCAFC 79
Public Trustee of South Australia (as litigation representative for Isherwood) v National Disability Insurance Agency (No 2) [2023] FCA 852
Secondary Materials

NDIS Guideline – Reasonable and Necessary Supports

NDIS Guideline – Home Modifications

Statement of Reasons

INTRODUCTION

The Applicant (Ms Gianakis) is 57 years old.1 She became a participant of the National Disability Insurance Scheme (NDIS) on 14 July 2020 based on impairments arising from Multiple Sclerosis (MS).2

1 Ms Gianakis’ Statement of Facts, Issues and Contentions (Ms Gianakis’ SFIC), [1].
2 Respondent’s Statement of Facts, Issues and Contentions (Respondent’s SFIC), [1].

Grounds of appeal

[14] The appellant contends that the primary judge erred in finding that the respondent had discharged the onus of establishing the matters required under the relevant provision.

[15] It was submitted that his Honour failed to give adequate weight to the evidence of the second witness, and that the findings of fact were not reasonably open on the material before the Court.

[16] The respondent, for its part, submits that no error is disclosed, and that the conclusions reached were well within the range of outcomes available to the primary judge.

Consideration

[17] It is convenient to deal first with the question of construction, as the resolution of that issue informs the remaining grounds advanced by the appellant.

[18] For the reasons that follow, we are of the view that the appeal should be allowed in part and the matter remitted for further determination.

Continue reading Gianakis and National Disability Insurance Agency (NDIS)

Details

AGLC: Gianakis and National Disability Insurance Agency (NDIS) [2025] ARTA 515
Case: [2025] ARTA 515
Decision Date: 27 April 2025

CaseChat Overview and Summary

The dispute between Gianakis and the National Disability Insurance Agency (NDIS) was heard by the Administrative Appeals Tribunal. The issue at hand was whether the NDIS had adequately considered the reasonableness and necessity of certain supports requested by Gianakis, including physiotherapy services and complex home modifications. The applicant argued that these supports were essential for his well-being and had been overlooked in the NDIS's assessment. The NDIS defended its decision, stating that the provided supports were sufficient and that the requested items did not meet the criteria for reasonable and necessary supports under the scheme.

The Tribunal was tasked with determining whether the NDIS had correctly applied the relevant legislative and policy framework when assessing the applicant's request for additional supports. Specifically, the court had to consider whether the NDIS had appropriately evaluated the necessity and reasonableness of the requested physiotherapy and home modifications, and if the decision-making process had been fair and in accordance with the applicable guidelines. The Tribunal also examined whether the NDIS had given appropriate weight to the value for money, effectiveness, and overall benefit to the applicant when making its determination.

In its decision, the Tribunal found that the NDIS had not adequately considered the evidence and arguments presented by Gianakis regarding the necessity and reasonableness of the requested supports. The Tribunal determined that the NDIS's decision was flawed due to an insufficient assessment of the benefits and value for money associated with the requested physiotherapy and home modifications. Consequently, the Tribunal set aside the NDIS's decision and remitted the matter back for reconsideration, ensuring that the NDIS would properly evaluate the applicant's needs and the appropriateness of the requested supports under the scheme.

The Tribunal did not make any final orders in this case, as it was required to remit the matter back to the NDIS for reconsideration in light of the findings. The NDIS is now obligated to reassess Gianakis's request for physiotherapy and complex home modifications, taking into account the Tribunal's guidance and ensuring a fair and thorough evaluation of the reasonableness and necessity of the requested supports.

Orders