LJJY and National Disability Insurance Agency

This matter concerned an application by LJJY (the Applicant) for funding for after-school care under the National Disability Insurance Scheme (NDIS). The Applicant, diagnosed with Autism, had a Level 3 severity requiring substantial support. The National Disability Insurance Agency (the Agency) had previously decided not to include the requested after-school support in the Applicant's NDIS plan, a decision that was affirmed on internal review. The Applicant sought review of this decision.

The court was required to determine whether the requested after-school support constituted "reasonable and necessary supports" under section 34 of the National Disability Insurance Scheme Act 2013 (Cth). Specifically, the court had to consider whether the support would assist the Applicant to pursue his stated goals and aspirations, facilitate his social and economic participation, represent value for money, and be effective and beneficial having regard to current good practice.

The court found that while the Applicant's parents had goals for him to develop improved cognitive skills, language use, fine motor and self-care skills, and to learn to interact with others and stay safe in the community, there was insufficient evidence to satisfy the requirements of section 34(1)(c) and (d). The court noted a lack of expert evidence regarding current good practice and the likely benefit of the proposed support. Consequently, the court could not be satisfied that the requested support was reasonable and necessary.

The decision of the Agency, which affirmed the refusal to provide in-home care assistance for the Applicant, was therefore affirmed.