KDYG and National Disability Insurance Agency

This matter concerned an application by KDYG (the Applicant) for review of a decision by the National Disability Insurance Agency (NDIA) regarding her eligibility for the National Disability Insurance Scheme (NDIS). The central dispute revolved around whether the Applicant met the requirements for access to the Scheme, specifically concerning the permanence of her impairments and whether these impairments resulted in a substantially reduced functional capacity to undertake learning, self-care, and self-management.

The Tribunal was required to determine two primary legal issues. Firstly, whether the Applicant's impairments were permanent, a prerequisite for NDIS access. Secondly, the Tribunal had to assess whether these permanent impairments led to a substantially reduced functional capacity in specific areas, namely learning, self-care, and self-management, as defined by the NDIS legislation and associated rules.

In its reasoning, the Tribunal considered the Applicant's medical history and treatment, noting her subjective experience of "good and bad days" and her belief that further mental health support was necessary. The Tribunal applied the principles from *Mulligan v National Disability Insurance Agency* [2015] FCA 544, which interpreted section 24(1)(c) of the NDIS Act and Rule 5.8 of the Participant Rules. Rule 5.8 outlines the circumstances under which a person is deemed to have a substantially reduced functional capacity. The Applicant's legal representative relied on Rule 5.8(b), which requires an assessment of the outcome or effect of an impairment on specific activities. The Tribunal also considered the definition of "usual" in the context of functional capacity, referencing dictionary definitions and the Applicant's long-standing struggle with her impairments since approximately 1995. Evidence indicated that the Applicant's partner now oversees almost every aspect of her life, suggesting a significant and ongoing need for support in self-care and self-management, consistent with the NDIS operational guidelines.

Consequently, the Tribunal set aside the NDIA's reviewable decision and substituted its own decision, finding that the Applicant meets the disability requirements of the Act, specifically section 24.