Grac and National Disability Insurance Agency (NDIS) - [2025] ARTA 2054

Grac and National Disability Insurance Agency (NDIS) [2025] ARTA 2054 (3 October 2025)
Applicant/s:  Jerry Grac
Respondent:  National Disability Insurance Agency
Tribunal Number:                2023/8443
Tribunal:Senior Member S Webb
Place:Canberra
Date:3 October 2025

Decision:The Tribunal sets aside the decision under review and in substitution decides Mr Grac satisfies the ‘access criteria’ for the purposes of s 20(1)(a) of the National Disability Insurance Scheme Act 2013.

Statement made on 03 October 2025 at 2:52pm
Catchwords
NATIONAL DISABILITY INSURANCE SCHEME – application for access – access criteria – disability requirements – disability and psychosocial disability attributable to impairments – nature of impairments – no known remedial treatment – impairment likely permanent – meaning of ‘substantially reduced functional capacity’ – functional capacity substantially reduced in communication, social interaction, learning and self-management – capacity for social and economic participation affected – likely to require support under NDIS for life – decision set aside and substituted
Legislation
National Disability Insurance Scheme Act 2013, ss 3, 4, 9, 10, 17A, 20, 21, 24, 25, 29, 34
National Disability Insurance Scheme (Becoming a Participant) Rules 2016
Cases
DQKZ and National Disability Insurance Agency [2024] AATA 2276
Foster and National Disability Insurance Agency [2025] ARTA 718
HPSC and National Disability Insurance Agency [2021] AATA 727
JLZT and National Disability Insurance Agency [2022] AATA 541
Madelaine and National Disability Insurance Agency [2020] AATA 4025
Mulligan v National Disability Insurance Agency [2015] FCA 544
National Disability Insurance Agency v Davis [2022] FCA 1002
National Disability Insurance Agency v Foster [2023] FCAFC 11
National Disability Insurance Agency v Jones [2025] FCA 877
Palmanova Pty Ltd v Commonwealth of Australia [2025] HCA 35
Sutherland and National Disability Insurance Agency [2024] AATA 411
Secondary Materials
World Health Organisation International Classification of Functioning Disability and Health (2011), Geneva
Applying to the NDIS’ operational guidelines (Access Guidelines)
Statement of Reasons

Jerry Grac made a request to become a participant in the National Disability Insurance Scheme (NDIS). A delegate of the CEO of the National Disability Insurance Agency (NDIA) decided to refuse the request. This decision was confirmed on internal review. Mr Grac applied for review of this decision by the Administrative Appeals Tribunal (AAT).
The application was lodged under the Administrative Appeals Tribunal Act 1975 (AAT Act). The AAT Act was repealed and the Administrative Review Tribunal Act 2024 (ART Act) came into effect on 14 October 2024, establishing the Administrative Review Tribunal (Tribunal). Under the transitional provisions set out in Schedule 16 to the Administrative Review Tribunal (Consequential and Transitional Provisions No.1) Act 2024, the Tribunal has jurisdiction and power to conduct this review.
Mr Grac’s access request is to be decided under the National Disability Insurance Scheme Act 2013 (NDIS Act). In the course of the Tribunal proceedings, the ‘access criteria’ in Part 1, Chapter 3 of the NDIS Act were amended by the National Disability Insurance Scheme (Getting the NDIS Back on…

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 Grac and National Disability Insurance Agency (NDIS)

Details

AGLC: Grac and National Disability Insurance Agency (NDIS) [2025] ARTA 2054
Case: [2025] ARTA 2054
Decision Date: 3 October 2025

CaseChat Overview and Summary

The matter before the Administrative Appeals Tribunal involved Mr Grac and the National Disability Insurance Agency (NDIS). The dispute centred on Mr Grac's eligibility for support under the National Disability Insurance Scheme. Mr Grac sought access to the NDIS, arguing that he met the access criteria based on his disability and psychosocial impairments. The NDIS had previously denied his application, prompting Mr Grac to appeal the decision.

The primary legal issues before the Tribunal were whether Mr Grac's impairments met the disability requirements under section 24 of the NDIS Act, specifically whether his functional capacity was substantially reduced in key areas such as communication, social interaction, learning, and self-management, and whether he was likely to require support for life. The Tribunal also had to interpret the meaning of 'substantially reduced functional capacity' and determine if Mr Grac's condition met the threshold for lifelong support under the NDIS.

The Tribunal found that Mr Grac's impairments, which included no known remedial treatment and were likely to be permanent, substantially reduced his functional capacity in communication, social interaction, learning, and self-management. These impairments also affected his capacity for social and economic participation, leading the Tribunal to conclude that Mr Grac would likely require support under the NDIS for his lifetime. The Tribunal set aside the original decision of the NDIS and substituted its own decision, finding that Mr Grac satisfied the access criteria under the NDIS Act. Consequently, the Tribunal determined that Mr Grac met the disability requirements of the Act, making it unnecessary to consider the alternative early intervention requirements.

The final orders of the Tribunal were that the decision of the NDIS to deny Mr Grac's application for support was set aside and replaced with a decision that Mr Grac met the access criteria under the NDIS Act. The Tribunal directed the NDIS to provide Mr Grac with appropriate support, reflecting its finding that his lifelong needs were aligned with the scheme's provisions.

Orders

Orders of the court

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Background

Background to the litigation

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Evidence

Evidence Before The Court

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Decision

Reasons for decision

For the purposes of s 24(1)(e) of the NDIS Act, I am satisfied Mr Grac is likely to require support under the NDIS for his lifetime.Conclusion Mr Grac meets the ‘disability requirements’ in s 24 of the NDIS Act. It is not necessary to proceed further to determine if he also meets the alternative ‘early intervention requirements’ in s 25.From this it follows, the decision under review must be set aside and in substitution the Tribunal decides Mr Grac satisfies the ‘access criteria’ for the purposes of s 20(1)(a) of the NDIS Act.

Ratio Decidendi

Legal Principle Established

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