Kirgiz and National Disability Insurance Agency

The matter before the Tribunal concerned an application for review of a decision made by the National Disability Insurance Agency (NDIA) to refuse access to the National Disability Insurance Scheme (NDIS). The applicant had sought access to the NDIS, providing medical information detailing coronary artery disease, a heart transplant, congestive heart failure, lumbar disc hernia, and chronic neck pain, which collectively impacted her mobility, social interaction, and self-care. The NDIA had initially determined that the applicant did not meet the access requirements, specifically citing that her impairments were not permanent or likely to be permanent, and that she did not demonstrate a substantially reduced functional capacity.

The legal issues before the Tribunal were whether the applicant's impairments were permanent or likely to be permanent, and whether these impairments resulted in a substantially reduced functional capacity, as required by section 24(1)(b) of the National Disability Insurance Scheme Act 2013 (Cth). The Tribunal was also required to consider whether the applicant met the overall access criteria under section 21 of the Act, which includes the disability requirements.

The Tribunal's reasoning focused on the nature and impact of the applicant's conditions. It was noted that the applicant had undergone a heart transplant in 2014 and continued to require ongoing treatment and rehabilitation to maintain her health. Furthermore, her lumbar disc hernia caused constant pain and limited her mobility, requiring assistance with daily tasks. The Tribunal considered the medical evidence, including the applicant's own account of her limitations and the professional reports, to assess the permanency of her impairments and their effect on her functional capacity. The Tribunal concluded that the applicant's conditions were indeed permanent and resulted in a substantially reduced functional capacity, thereby meeting the disability requirements for NDIS access.

Consequently, the Tribunal set aside the NDIA's decision of 28 July 2020. In substitution, the Tribunal decided that the applicant met the access criteria under section 21(1)(a), (b), and (c)(i) of the National Disability Insurance Scheme Act 2013.